The management of Calcaneal apophysitis

2017-01-09T03:29:30Z (GMT) by Alicia Marie James
Calcaneal apophysitis is a commonly occurring musculoskeletal condition that affects children between the ages of 8-14 years. It presents as pain at the posterior aspect of the calcaneus, often limiting the childs participation in sporting activities. Throughout the literature treatment modalities have addressed the perceived contributing factors. There is a limited amount of robust evidence regarding the contributing factors and the effectiveness of the available treatment modalities. This thesis aims to review the available evidence and provide evidence for interventions that address the pain and disability experienced by children presenting with calcaneal apophysitis.
       Research Aims:
       1. Identify the possible contributing factors to the pain experienced by chilldren presenting with calcaneal apopohysitis.
   2. Compare whether prefabricated orthoses are superior to heel raises for minimising the disability associated with calcaneal apophysitis
   3. Examine whether footwear (current footwear versus provision of new, athletic footwear) interacts with the comparison between the prefabricated orthoses and heel raise interventions.
   4. Compare child and parent perceptions of the impact of calcaneal apophysitis on the child’s quality of life.
   This thesis is presented as a series of manuscripts that have been published or submitted to peer reviewed journals for publication. Additional information has been provided in the form of introductory and supplementary chapters to allow for a cohesive explanation of the study.
       This thesis begins with an explanation of the condition calcaneal apophysitis it’s suspected aetiology, diagnosis and currently utilized treatment options. This chapter (1) also includes a systematic review that was published in the Journal of Foot and Ankle Research. Chapter 2 presents the protocol paper for the randomized effectiveness trial, it also includes the amendment to the initial protocol; an additional 6 months follow up period. Chapters 3 presents the associated or contributing factors in children that present with pain due to calcaneal apophysitis, the anthropometric data collected and analyzed were published in the Journal of Pediatrics. Chapter 4 presents the outcomes of the 12-month effectiveness trial, which was published in the British Journal of Sports Medicine. Chapter 5 presents the publication examining the quality of life impact of calcaneal apophysitis from both the child and parent’s perspective. The final chapter provides an overview of the thesis, summarizing and integrating the results of the study with previous literature and proposes a treatment philosophy for clinicians.