None listed
Conditions
Brief summary
Eighty participants with plantar fasciitis due to calcaneal spur will be selected from the outpatient clinic of the faculty of physical therapy, Cairo University. Participants then will undergo a physical examination and data collection by a blinded therapist to the treatment allocation and application and with more than 9 years of experience. A Plain X-ray will be performed to confirm the presence of calcaneal spur. Additionally, Windlass test will be used to determine plantar fascia abnormalities in weight bearing and non-weight bearing positions. Outcome measure will be collected prior to the first treatment session as a baseline measure and at the end of the 3-week intervention period as a post-intervention measure, and it will include pain assessed by a Visual analogue scale and Foot Functional Index. After the physical examination and data collection, participants will then be randomly assigned into 4 groups. Group A: 20 patients will receive Extracorporeal Shock Wave Therapy (ESWT) and low level laser therapy (LLLT) with stretching exercise and ice massage twice a week for 3 weeks. Group B: 20 patients will receive ESWT with stretching exercise and ice massage twice a week for 3 weeks. Group C: 20 patients will receive LLLT with stretching exercise and ice massage twice a week for 3 weeks. Group D: 20 patients in Control group will receive stretching exercise and ice massage twice a week for 3 weeks. Treatment application: Four blinded physical therapists with experience ranging from 3-5 years will deliver each treatment in each group. They will be blinded to other treatment groups, to the recruitment of subjects and as well as the physical examination. To monitor adherence to treatment sessions, each physical therapist will register attendance of sessions in a note book.
Interventions
After the physical examination and data collection, participants will then be randomly assigned into 4 groups.
Group A: 20 patient will receive Extracorporeal Shock Wave Therapy (ESWT) and low level laser therapy (LLLT) with stretching exercise and ice massage twice a week for 3 weeks.
Group B: 20 patient will receive ESWT with stretching exercise and ice massage twice a week for 3 weeks.
Group C: 20 patient will receive LLLTwith stretching exercise and ice massage twice a week for 3 weeks.
Gro
After the physical examination and data collection, participants will then be randomly assigned into 4 groups. Group A: 20 patient will receive Extracorporeal Shock Wave Therapy (ESWT) and low level laser therapy (LLLT) with stretching exercise and ice massage twice a week for 3 weeks. Group B: 20 patient will receive ESWT with stretching exercise and ice massage twice a week for 3 weeks. Group C: 20 patient will receive LLLTwith stretching exercise and ice massage twice a week for 3 weeks. Group D: 20 patient in Control group will receive stretching exercise and ice massage twice a week for 3 weeks. Treatment application: Four blinded physical therapists with experience ranging from 3-5 years will deliver each treatment in each group. They will be blinded to other treatment groups, to the recruitment of subjects and as well as the physical examination. To monitor adherence to treatment sessions, each physical therapist will register attendance of sessions in a note book. 1- Extracorporeal Shock Wave Therapy (ESWT) application: Intellect RPW chattanoga (model 2074 - 230 V- , 50Hz Mexico) shockwave device will be used. Device specification includes a compressed air output of 1.4- 5 bar, power increment settings at 2 bar, pulse frequency 0.5-35 Hz and Pulse Width of Approx. 6 - 12 ms with a single or continuous mode. Patient will lie in the supine position; barefooted, the area treated will be marked. Ultra Sound gel will be then applied on the region that will receive the shock wave twice a week for 3 weeks. Dosage will be 3x3000 shock waves/session of high energy 0.2 mJ/mm2, 8hz and 2 bars for 15-20 minutes 2- LLLT will be administered with a gallium–arsenide (GaAs) laser with an infrared wavelength of 904 nm (Irradia medical laser, M/D Laser Professional, Stockholm, Sweden) with three infrared diodes. With the patient in a supine position and barefooted, laser emitting a divergent 635-nm (red) laser light generating a 17-mW output will be applied twice a week for 3 weeks. Exposure time during the LLLT will be 10 minutes across the dorsal foot, the myofascial junction of the heel, and the plantar aspect of the heel, simultaneously. 3- Stretching for plantar fascia: with the patient sitting, he will cross the affected leg over the other leg. then the therapist will hold the affected foot and pull the toes back towards shin. This creates tension/stretch in the arch of the foot/plantar fascia. Therapist will then check for the appropriate stretch position by gently rubbing the thumb over the arch of the affected foot. The plantar fascia should feel firm, like a guitar string. the stretch will be then held for a count of 20, and repeated 3-5 repetitions. 4- Ice Massage: using an ice cone, with the patient in seated position,he will cross the affected leg over the other leg the ice will be massaged around the whole plantar fascia in vertical, longitudinal and circular strokes for 10-15 minutes
Sponsors
School of Physical Therapy, Cairo University
Study design
Allocation
Randomised controlled trial
Intervention model
Factorial
Primary purpose
Treatment
Masking
Blinded (masking used) (Caregiver, Investigator, Outcomes Assessor)
Eligibility
Sex/Gender
All
Age
40 Years to 60 Years
Healthy volunteers
No
Inclusion criteria
1-Age ranged from 40-60 years old of both genders (Krukowska et al; 2016). 2-Participants suffering from pain for at least 3 months with no prior physical therapy for at least 3 months prior to the study and an unsuccessful treatment using non-steroidal anti-inflammatory drugs (NSAID) 3-Particiapents whom have plantar fasciitis due to calcaneal spur that is confirmed with a plain X-ray. 4- A positive windlass test
Exclusion criteria
1- Muscloskeletal injuries at foot, ankle, knee or spine. 2- Diabetic foot 3- Pregnant female 4- Individuals whom receive local corticosteroid injection in the last two months. 5- Individuals that undergone physical therapy prior to the study in the past 3 months.
Outcome results
None listed