The Ranjeet-Kunal Index for Scoring Plantar fasciitis (RKISP) is a proposed system to score or grade the symptoms of plantar fasciitis or plantar heel pain to quantify the symptoms and potentially use as a prognostic indicator.
It was proposed by Ranjeet Choudhary and Kishor Kunal from the Department of Orthopaedics in the All India Institute Of Medical Sciences in Raipur, India in a publication in the journal, Revista Brasileira de Ortopedia (Sao Paulo) in 2021. The authors named the index after themselves.
They proposed variables in the index based on VAS, BMI, and the cushioning of shoes. It is unclear from the paper and methodology as to how they arrived at those and eliminated others, but they claim it was based on a literature review and the correlation of risk factors to the VAS in their study.
Reference:
Ranjeet Choudhary, Kishor Kunal; Modifiable Risk Factors of Plantar Fasciitis in Non-Athletic Patients and Proposal of a New Objective Assessment System – RKISP; Rev Bras Ortop (Sao Paulo) 2021 Jun;56(3):368-371. doi: 10.1055/s-0040-1716762. (link)
Calculating the Ranjeet-Kunal Index:
The authors used the WHO grading of BMI for the Indian population with a BMI >24.99 defined as obesity I and >29.99 as obesity II. The Index scores 1 point for obesity I and 2 points for obesity II.
They considered a VAS of <4.5 as being unremarkable pain so that is not included in the index (or given a score of 0). A VAS of >4.5 is given a score of 1. Severe pain, with VAS >7.5 is assigned 2 points in the scoring for the index.
An “ill-cushioned” shoe is scored 1.
No definition or criteria for an “ill-cushioned” shoe was given in the paper.
The total of the three variables is the RKISP score and has a potential maximum score of 5 (BMI>29.99; VAS>7.5; ill-cushioned footwear = 1).
Use of the Ranjeet-Kunal Index;
The authors claim without any data or a prospective study that:
Prognosis of conservative management is inversely proportional to index. This can be understood in a way that a higher index is prone to have more conservative ways of management that can be used. For example, a patient that presents with an index of 2 with a VAS of 9/10 but wears a well-cushioned shoe and has a BMI < 24.99 will have a worse prognosis than a patient with an index of 4 wearing worn out shoes and classified with obesity II with a VAS of 5 with conservative management.
Commentary:
- Better clarity is needed on how the variables in the index were determined. Studies that do this are usually from a larger dataset and are determined by something like a regression analysis or other modeling.
- Nothing at this stage is known on the sensitivity, specificity, reliability and repeatability of the index.
- A prospective study is needed to determine the prognostic value of the index.
- The authors named the index after themselves which is against what could be considered best practice in the naming of “diseases” and the preferred discontinuation of eponyms in medicine.
Related Pages:
Barrett Staging and Grading of Plantar Fasciitis
BMI and Plantar Fasciitis
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