The Therapeutic Effect of Targeted Intrinsic Foot Muscles Exercises in Plantar Fasciitis
Overview
- Phase
- Not Applicable
- Intervention
- Not specified
- Conditions
- Plantar Fasciitis, Chronic
- Sponsor
- Chinese University of Hong Kong
- Enrollment
- 64
- Locations
- 1
- Primary Endpoint
- cross sectional area (CSA) of Abductor Hallucis (AbH), Flexor hallucis brevis (FHB), Flexor digitorum brevis (FDB), quadratus plantae (QP)
- Last Updated
- 3 years ago
Overview
Brief Summary
A reduction of intrinsic foot muscle sizes has been identified in patients with chronic plantar fasciitis. Weaker intrinsic foot muscles has been suggested to decrease the medial longitudinal arch height and subsequently increase extra tensile stress in the plantar fascia, resulting in the chronicity of the condition. Therefore, it is speculated that atrophic intrinsic foot muscles may be a significant risk factor of developing chronic plantar fasciitis. The purpose of this study is to investigate the effect of an 8-week targeted intrinsic foot muscles exercise regimen on the intrinsic foot muscle size, symptomatic relief, and foot function improvement in long-distance runners with chronic plantar fasciitis.
Detailed Description
Distance runners are defined as running with more than 20km per week for more than 2 years. All recruited participants have \> 1 year of plantar fasciitis. The diagnosis were made based on clinical symptoms and the thickness of plantar fasciitis \> 4.0mm at the medial tubercle of heel by ultrasound imaging. Arm 1: The purpose of this arm of the study is to determine if a 8-week targeted foot muscle exercise regimen, instructed with real-time ultrasound, affect the intrinsic foot muscle size, symptomatic relief, and foot function improvement of distance runners with plantar fasciitis. 32 participants will be recruited in this arm. Arm 2: This group will not engage in any training, but will serve as a comparator for the intervention arm.
Investigators
Lau On Yue
Principal Investigator
Chinese University of Hong Kong
Eligibility Criteria
Inclusion Criteria
- •A weekly mileage of at least 20km
- •Have running experience of at least 2 years prior to the experiment
- •if they reported tenderness on palpation of the medial calcaneal tuberosity and exhibited one of the following complaints:
- •Plantar heel pain \> 1 year
- •Pain on visual analog scale of equal to or greater than 4 out of 10
- •pain on the first step in the morning or after prolonged sitting,
- •pain on prolonged standing and/or walking
- •pain when running
Exclusion Criteria
- •Contraindications to MRI scans
- •had undergone surgery to the plantar fascia or
- •local steroid injection within the last 3 months or
- •Any of the following conditions:
- •systemic arthritis,
- •neurologic conditions
- •any coexisting painful musculoskeletal condition of the lower limb.
Outcomes
Primary Outcomes
cross sectional area (CSA) of Abductor Hallucis (AbH), Flexor hallucis brevis (FHB), Flexor digitorum brevis (FDB), quadratus plantae (QP)
Time Frame: week 12
ultrasound measurement
muscle thickness (MT) of Abductor Hallucis (AbH), Flexor hallucis brevis (FHB), Flexor digitorum brevis (FDB), quadratus plantae (QP)
Time Frame: week 12
ultrasound measurement
Visual Analog Scale (VAS) pain at first steps in the morning
Time Frame: week 12
measuring 100 mm in length marked from 0 (absence of pain) to 100 mm (worst imaginable pain)
Navicular Drop test
Time Frame: week 12
Supinated foot (\<5mm); Neutral foot (5-9mm); pronated foot (\>9mm)
Visual Analog Scale (VAS) worst pain of the day
Time Frame: 12
measuring 100 mm in length marked from 0 (absence of pain) to 100 mm (worst imaginable pain)
Foot and Ankle Ability Measure (FAAM)
Time Frame: week 12
Higher scores represent higher levels of function, with 100% representing no dysfunction.
Foot posture index
Time Frame: week 12
Pronated postures are given a positive value, the higher the value the more pronated. Supinated features are given a negative value, the more negative the value the more supinated. For a neutral foot the final score should lie somewhere around zero
Secondary Outcomes
- Postural control(week 12)