SLR - April 2010 - Susan King
Reference:
Scher, D.L., Belmont Jr., P.J., Bear, R., Mountcastle, S.B., Orr, J.D., and Owens, B.D. (2009). The incidence of plantar fasciitis in the United States Military. The Journal of Bone and Joint Surgery (American), 91, 2867-2872.
Scientific Literature Reviews
Reviewed by: Susan King, DPM
Residency Program: Botsford Hospital, Farmington Hills, Michigan
Podiatric Relevance:
This study provides insight on the incidence of plantar fasciitis in the population of the United States Military in order to identify high-risk groups within general physically active populations so that preventative measures can be implemented.
Methods:
This study utilizes the Defense Medical Epidemiology Database to gather demographic information on patients seeking military medical treatment worldwide. The authors used the database to determine the total number of patients with plantar fasciitis in the ambulatory system from 1998-2006. The patients were then categorized by sex, race, rank, military service, and age. The incidence rate is reported as per 1000 person-years. Rate ratios were calculated using Poisson regression.
Results:
There was a total of 127,057 patients with plantar fasciitis which is 12,116,044 person-years. The overall incidence of plantar fasciitis in the poplulation of the United States military was determined to be 10.5 per 100 person-years. It was 18.0 for women and 9.2 for men. The rate ratio was significantly increased for women in all age categories. The incidence rate was 9.7 for whites, 13.1 for blacks, and 10.7 for others. Blacks were found to have a significantly increased incidence ratio. The incidence ratio was 10.8 for the junior enlisted, 8.8 for the junior officers, 10.2 for the senior enlisted, and 12.9 for the senior officers. It was also determined that the incidence ratio for the junior enlisted compared to junior officers was significant in all age subcategories. The incidence rate was 14.8 for the Army, 7.8 for the Navy, 8.3 for the Air Force, and 8.8 for the Marines. It was discovered that older service members had a higher incidence rate for plantar fasciitis compared with younger service members. The forty and older age group had the highest incidence rate, which was 16.6.
Conclusions:
The study determined an overall incidence rate in a specific population. Currently there are no studies that have determined incidence rates in the overall populations. This study also compares the incidence rates between age, gender, race, rank, and service group. The study is limited by the fact that there were multiple physicians that evaluated the patients and therefore decreased the accuracy. It also does not account for the patients that have symptoms and do not seek treatment. The study does provide the ability to identify high-risk groups within the generally physically active population in order to implement preventative measures.