Plantar Fascitis, Plantar Fasciitis, Chronic, Heel Pain Syndrome
Conditions
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
Interventions
OTHERstretching exercises
stretching exercises of the plantar fascia, gastrocnemius and soleus
DEVICEultrasound
therapeutic ultrasound upon the most painful point on the medial calcaneal tubercle. The parameters involved a pulsed mode (duty cycle 50%) using an intensity of 1.5 W/cm2 and a 1 MHz of frequency for 5 minutes
OTHERrigid tape
low-dye tapping will be done to provide mechanical correction to plantar fascia and medial longitudinal arch
OTHERmobilization
mobilization techniques for the talocrural joint in weight bearing and non-bearing positions and subtalar joint
OTHERmyofascial release
deep tissue release of the plantar fascia and flexor hallucis longus in a stretched position of the plantar fascia
strengthening exercise of the plantar intrinsic muscles using short foot exercise and strengthening of the Achilles tendon and windlass mechanism using unilateral heel raise exercises
Sponsors
Horus University
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
SINGLE (Subject)
Masking description
double blinded randomized controlled trial (participants blinded to the intervention and statistician blinded to group assignment)
Eligibility
Sex/Gender
ALL
Age
40 Years to 60 Years
Healthy volunteers
No
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
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| 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
| Measure | Time frame | Description |
|---|---|---|
| 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. |
| 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 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 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 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. |
Countries
Egypt
Outcome results
None listed