Effects of age and leg length upon central loop of the Gastrocnemius-soleus H-reflex latency

BACKGROUND: central loop of the gastrocnemius-soleus H-reflex latency (T(c)) that looks promising in the diagnosis of S1 radiculopathy; has been investigated in a few studies and only two of them have focused on the constitutional factors affecting it. Although leg length has been shown to contribute to the T(c), the role of age is controversial. More confusing, none of the previously performed studies have used strict criteria to rule out subclinical neuropathy, so the results could be misleading. This study has been performed to determine the influence of leg length and age on T(c )among a carefully selected group of healthy volunteers. METHODS: after screening forty six volunteers by taking history, physical examination and a brief electrophysiologic study; forty of them were selected to enroll into the study. T(c )was obtained in all the study subjects and leg length and age were recorded for correlational analyses. RESULTS: this group was consisted of 26 males (65%) and 14 females (35%) with the age range of 19–65 years (Mean ± SD: 37 ± 10.7) and leg length range of 29.5–43 centimeters (36.4 ± 3.4). Mean ± SD for T(c )was 6.78 ± 0.3. We found a significant correlation between T(c )and leg length (p value= 0.003, r = 0.49 and confidence interval 95% = 0.59–0.88), no significant correlation was found between age and T(c )(p value= 0.48, r = 0.11), also we obtained the regression equation as: T(c )= 0.04L + 5.28 CONCLUSIONS: in contrast to leg length, age was not correlated with T(c). Future studies are required to delineate other contributing factors to T(c)

The real risks of steroid injection for plantar fasciitis, with a review of conservative therapies

This article presents a review of conservative therapies for plantar fasciitis pain reduction with a discussion of steroid therapy risks. The therapies reviewed include orthoses, stretching, extracorporeal shockwave, BTX-A, and corticosteroid injection/iontophoresis. These modes were included based on the availability of double blinded randomized controlled trials. We noted the following findings. Orthoses, regardless of type, can improve pain levels. Plantar stretching shows limited short-term benefit (1 month), but can reflect significant long-term improvement (10 months). Extracorporeal shockwave therapy shows equivocal benefit with some studies showing significant improvement and others showing none. Although BTX-A injections were the least studied, significant pain improvement was demonstrated in the short and long term. Steroid injection/iontophoresis showed significant improvement in the short term (1 month). Steroid therapy, when coupled with plantar stretching, can provide efficacious pain relief; however, steroid injections should be combined with ultrasound monitoring to reduce complications