Effect of Selected Rehabilitation Program in Patients With Plantar Fasciitis

Not Applicable

Recruiting

• Conditions: Plantar Fascitis; Plantar Fasciitis, Chronic; Heel Pain Syndrome
• Interventions: Other: stretching exercises; Other: rigid tape; Device: ultrasound; Other: mobilization; Other: strengthening exercise; Other: myofascial release

• Registration Number: NCT06456944
• Lead Sponsor: Horus University

Brief Summary

This study will be done to investigate the effect of the selected rehabilitation program for PF on plantar fascia thickness, clinical outcomes such as pain, foot function, dorsiflexion ROM and pressure pain threshold and alignment such as rearfoot eversion angle and foot posture index in patients with PF.

Detailed Description

Plantar fasciitis (PF), which constitutes approximately 15% of all foot disorders, is the most prevalent cause of heel pain. It is a long-term degenerative process that is impacted by subtalar pronation and pes planus. One million US patients saw primary care physicians with PF between 1995 and 2000. There is not enough data to determine the best physical therapy management techniques for individuals with heel pain, despite the existence of multiple successful treatment approaches. this study investigated at how a mechanically based rehabilitation program affected patients with PF in terms of foot alignment, plantar fascia thickness, pain, pressure pain threshold, ROM and foot function. The approach included strengthening the plantar intrinsic muscles of the foot, plantar fascia specific stretching and Achilles tendon stretching, and passively correcting the pathomechanics of the foot by low dye tapping and high load resistance exercise for Achilles tendon and windlass mechanism

Study Timeline

• Study First Submitted: 2024-06-08
• Study First Submitted QC: 2024-06-08
• Study First Posted: 2024-06-13
• Study Start: 2024-06-15
• Status Verified: 2025-02
• Last Update Submitted: 2025-02-04
• Last Update Posted: 2025-02-06
• Primary Completion: 2025-03-15
• Study Completion: 2025-04-15

Recruitment & Eligibility

• Status: RECRUITING
• Sex: All
• Target Recruitment: 48

Inclusion Criteria

• Plantar medial heel pain: most noticeable with initial steps after a period of inactivity, but also worse following prolonged weight-bearing
• Pain with palpation of the proximal insertion of the plantar fascia
• Positive windlass test
• flat foot posture utilizing the foot posture index
• age range from 40 to 60 years

Exclusion Criteria

• tarsal tunnel syndrome
• atrophy of the fat pad.
• diabetic patients or patients with rheumatoid arthritis
• corticosteroid injection over the last sex months

Study & Design

• Study Type: INTERVENTIONAL
• Study Design: PARALLEL

Arm && Interventions

Group	Intervention	Description
selected rehabilitation program	rigid tape	involves 24 patients and will be given the selected rehabilitation program involving (self-stretching exercise, mobilization of the ankle and subtalar, rigid tape and unilateral heel raising exercise 3 times per week for 8 weeks.
selected rehabilitation program	stretching exercises	involves 24 patients and will be given the selected rehabilitation program involving (self-stretching exercise, mobilization of the ankle and subtalar, rigid tape and unilateral heel raising exercise 3 times per week for 8 weeks.
selected rehabilitation program	strengthening exercise	involves 24 patients and will be given the selected rehabilitation program involving (self-stretching exercise, mobilization of the ankle and subtalar, rigid tape and unilateral heel raising exercise 3 times per week for 8 weeks.
traditional program	stretching exercises	involves 24 patients and will be given the traditional program involving (self-stretching exercise, mobilization of the ankle and subtalar, plantar fascial release and ultrasonic therapy 3 times per week for 8 weeks.
selected rehabilitation program	mobilization	involves 24 patients and will be given the selected rehabilitation program involving (self-stretching exercise, mobilization of the ankle and subtalar, rigid tape and unilateral heel raising exercise 3 times per week for 8 weeks.
traditional program	mobilization	involves 24 patients and will be given the traditional program involving (self-stretching exercise, mobilization of the ankle and subtalar, plantar fascial release and ultrasonic therapy 3 times per week for 8 weeks.
traditional program	ultrasound	involves 24 patients and will be given the traditional program involving (self-stretching exercise, mobilization of the ankle and subtalar, plantar fascial release and ultrasonic therapy 3 times per week for 8 weeks.
traditional program	myofascial release	involves 24 patients and will be given the traditional program involving (self-stretching exercise, mobilization of the ankle and subtalar, plantar fascial release and ultrasonic therapy 3 times per week for 8 weeks.

Primary Outcome Measures

Name	Time	Method
Assessing the change in pain intensity	At baseline and following 8 weeks	VAS is typically composed of a 100 mm horizontal line attached to two opposed labels, the left end marked "no pain" and the right end marked "worst possible pain. Patients were marked a score on the scale by a vertical line that exactly refer to their pain

Secondary Outcome Measures

Name	Time	Method
Assessing the change in range of motion	At baseline and following 8 weeks	The bubble inclinometer is used to measure the angle of the tibia relative to the floor during active ankle dorsiflexion, while the patient lunges forward with their heel on the ground and knee in line with the second toe.
Assessing the change in rear foot angle	At baseline and following 8 weeks	using kinovea motion analysis software, the rearfoot (calcaneus) angle is measured as the angle between the bisection of the lower one-third of the leg and the bisection of the calcaneus. The MLA is classified as: normal arch 2-8°, low arch ≥ 8.1° and high arch ≤ 1.9.
Assessing the change in pressure pain threshold	At baseline and following 8 weeks	the pressure algometer is utilized to measure the pressure pain threshold (PPT), The patient lay supine, in a relaxed position, with his feet hanging over the edge of the bed with no pressure on the heel. PPT is measured by laying the patient supine with feet hanging over the bed, without pressure on the heel. PPT is determined by applying pressure to the skin until the patient experiences pain.
Assessing the change in plantar fascia thickness	At baseline and following 8 weeks	using the ultrasound, participants were positioned in a prone position with relaxed arms and legs, and measurements were taken with the ankle joint in neutral or slightly dorsi-flexion. Electro-conductive gel was applied to the US transducer and plantar surface of foot before imaging. The transducer was placed longitudinally on the calcaneus surface to obtain a clear image of the plantar fascia.
Assessing the change in foot posture	At baseline and following 8 weeks	using the foot posture index. It is a clinical measure of foot posture, either supinated or pronated, using 6 items for assessment of foot and scoring of each item from -2 to +2
Assessing the change in foot function	At baseline and following 8 weeks	The Arabic version of the foot function index (FFI) is a widely used self-reporting measure used to assess the impact of foot pathology on pain, disability, and activity limitation. It is a reliable and sensitive outcome measure for patients with foot and ankle disorders. The FFI's subscale scores range from 0% to 100%, with higher scores indicating lower function and a poorer quality of life.

Trial Locations

Locations (2)

Outpatient clinic, Faculty of Physical Therapy, Horus University, Egypt; 🇪🇬 Damietta, Egypt

out-patient clinic, Faculty of Physical Therapy, Horus university; 🇪🇬 Damietta, Egypt