Pain, Plantar Fasciitis, Chronic
Conditions
Keywords
Strengthening, training, intrinsic foot muscle
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.
Interventions
OTHERtargeted intrinsic foot muscle exercises
4 targeted intrinsic foot muscle exercises
Sponsors
Chinese University of Hong Kong
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
DOUBLE (Subject, Outcomes Assessor)
Masking description
Team members collecting outcomes data will not know participant allocation
Intervention model description
Randomized controlled trial with one intervention arm and one control arm
Eligibility
Sex/Gender
ALL
Age
18 Years to 60 Years
Healthy volunteers
Yes
Inclusion criteria
1. A weekly mileage of at least 20km 2. Have running experience of at least 2 years prior to the experiment 3. 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
1. Contraindications to MRI scans 2. had undergone surgery to the plantar fascia or 3. local steroid injection within the last 3 months or 4. Any of the following conditions: * systemic arthritis, * neurologic conditions * any coexisting painful musculoskeletal condition of the lower limb.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Navicular Drop test | baseline | Supinated foot (\<5mm); Neutral foot (5-9mm); pronated foot (\>9mm) |
| muscle thickness (MT) of Abductor Hallucis (AbH), Flexor hallucis brevis (FHB), Flexor digitorum brevis (FDB), quadratus plantae (QP) | baseline | ultrasound measurement |
| cross sectional area (CSA) of Abductor Hallucis (AbH), Flexor hallucis brevis (FHB), Flexor digitorum brevis (FDB), quadratus plantae (QP) | Baseline | ultrasound measurement |
| Visual Analog Scale (VAS) pain at first steps in the morning | baseline | measuring 100 mm in length marked from 0 (absence of pain) to 100 mm (worst imaginable pain) |
| Visual Analog Scale (VAS) worst pain of the day | baseline | measuring 100 mm in length marked from 0 (absence of pain) to 100 mm (worst imaginable pain) |
| Foot and Ankle Ability Measure (FAAM) | baseline | Higher scores represent higher levels of function, with 100% representing no dysfunction. |
| Foot posture index | baseline | 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
| Measure | Time frame | Description |
|---|---|---|
| Postural control | baseline | three 10-seconds eyes opened trials and three 10-seconds eyes closed trials with single-leg stance |
Countries
Hong Kong
Contacts
Primary ContactOn Yue LAU, PhD candidate
Outcome results
None listed