Effects of morphological and mechanical properties of plantar fascia and heel pad on balance performance in asymptomatic females

Abstract

IntroductionPersonal differences in morphological and mechanical properties of plantar fascia and heel fat pad may be an important parameter regarding an individual’s balance performance. The purpose of this study was to investigate the effect of thickness and stiffness of heel fat pad and plantar fascia on balance performance in asymptomatic sedentary females. Materials and methodsThis study was carried out on 37 asymptomatic sedentary females between the ages of 19 and 35 years. Balance assessments during single-leg standing were carried out using Biodex Balance Systems (Biodex Medical Systems, Shirley, NY, USA). In this study, the individuals’ balance performance was assessed using the center of balance (COB) parameters, which were the standard deviation of the COB amplitude in the anterior–posterior (AP_SD) and medial–lateral (ML_SD) directions. Stiffness and thickness measurements of heel fat pad and plantar fascia were performed using an ACUSON S3000 Ultrasound System and a 9L4 probe (4–9MHz) (Siemens Medical Solution, Mountain View, CA, USA). ResultsAP_SD during single-leg standing tests had a moderate correlation with heel pad thickness (r=0.46, p=0.004) and heel pad stiffness (r=0.41, p=0.011), and a fair correlation with plantar fascia thickness (r=0.34, p=0.038) and plantar fascia stiffness (r=0.38, p=0.021). ML_SD during single-leg standing tests had a moderate correlation with heel pad thickness (r=0.41, p=0.013) and heel pad stiffness (r=0.53, p=0.001), and a fair correlation with plantar fascia thickness (r=0.40, p=0.015). ConclusionIt was found that higher plantar fascia and heel fat pad stiffness and thickness are related to higher postural sway in anterior–posterior and medial–lateral directions based on the single-leg balance tests. These results suggest that the morphological and mechanical properties of plantar fascia and heel fat pad play an important role in balance performance.