Abstract
Objective
To evaluate the efficacy of botulinum toxin A (BTX-A) for the treatment of plantar
fasciitis through a meta-analysis of randomized controlled trials (RCTs) focusing
on pain and functional outcomes since current literature has supported a potential
benefit of BTX-A.
Data Sources
The MEDLINE, EMBASE, Web of Science, and Scopus databases were searched until December
2020 for RCTs reporting the effects of BTX-A injections on plantar fasciitis. The
complementary literature search included Cochrane Central Register of Controlled Trials,
Clinicaltrials.gov, and greylit.org.
Study Selection
Only RCTs assessing the effect of BTX-A injections on pain, functional improvement,
or plantar fascia thickness in patients with plantar fasciitis were included. Multiple
researchers carried out the screening process of the 413 records.
Data extraction
Data were extracted independently and in duplicate using a standardized data extraction
format. Information was contrasted by a third observer.
Data Synthesis
BTX-A injections resulted in significant pain relief (mean difference, −2.07 [95%
CI, −3.21 to −0.93]; P=.0004; I2=97%) and functional improvement (standardized mean difference, 1.15 [95% CI, 0.39-1.91];
P=.003; I2=87%). A subanalysis indicated that pain relief was sustained at 12 months while functional
improvement remained significant after 0-6 months. The results were not affected by
a single study after sensitivity analysis. The site of injection and the use or not
of ultrasound-guided injections may account for potential sources of interstudy heterogeneity.
Conclusions
This meta-analysis suggests both a statistically significant and a clinically meaningful
improvement on plantar fasciitis symptoms after BTX-A treatment.
Keywords
List of abbreviations:
BTX-A (botulinum toxin A), FHSQ (Foot Health Status Questionnaire), MD (mean difference), MCID (minimal clinically important difference), RCT (randomized controlled trial), VAS (visual analog scale)To read this article in full you will need to make a payment
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Article info
Publication history
Published online: October 21, 2021
Accepted:
October 1,
2021
Received in revised form:
September 24,
2021
Received:
April 14,
2021
Footnotes
Disclosures: none
Identification
Copyright
© 2021 The American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.
