The Acute Effect of Isotonic Versus Isometric Exercise Versus Walking on Pain in Individuals With Plantar Fasciopathy

NCT03264729 | Completed

• 1 other identifier: N-20170021
• Study Type: interventional
• Target: 20
• Locations: 1 country
• Sites: 1

Brief Summary

This study investigates the acute effect of isotonic versus isometric exercise versus walking on pain in individuals with plantar heel pain and an ultrasound-diagnosed plantar fasciopathy. The hypothesis is that isometric exercise will induce greater participant rated pain relief than isotonic exercise and walking during aggravating activity.

Conditions

Plantar Fasciopathy

Keywords

plantar heel pain

Outcome Measures

Primary Outcomes (1)

• Change in pain

  This is measured during an aggravating task on a 100 mm VAS, where 0 mm is no pain and 100 mm is worst pain imaginable and is also referred to as exercise-induced hypoalgesia (EIH)

  Immediately before and after each exercise/walking

Secondary Outcomes (3)

• Change in pressure pain threshold

  Immediately before and after each exercise/walking

• Change in thickness of the plantar fascia

  Immediately before and after each exercise/walking

• Pain

  During each exercise/walking

Study Arms (3)

Isometric exercise

EXPERIMENTAL

Other: Isometric exercise

Isotonic exercise

ACTIVE COMPARATOR

Other: Isotonic exercise

Walking

ACTIVE COMPARATOR

Other: Walking

Interventions

Isometric exercise OTHER

The isometric exercise is performed standing with the forefoot on a step. The participant is instructed to stand still with the ankle joint in neutral and hold this position. Supporting oneself for balance by placing the hands on a wall or a rail is allowed. The participant performs 5 sets of 45-second isometric holds. The load used is the heaviest possible load that the participant is able to withstand for 1 minute. As with the isotonic exercise, if the participant's body weight is inadequate the participant is fitted with a backpack with books and/or weights.

Isometric exercise

Isotonic exercise OTHER

The isotonic exercise is performed standing with the forefoot on a step. The toes are maximally dorsi-flexed by placing a towel underneath them. The participant is instructed to perform a heel-raise to a maximal plantar flexion in the ankle joint, and afterwards to lower the heel to maximal dorsi flexion. Supporting oneself for balance by placing the hands on a wall or a rail is allowed. The participant performs 4 sets of 8 repetitions with a load of 8RM. The contraction time is 3s concentric, 2s isometric and 3s eccentric and will be guided by a metronome. If the participant's body weight is inadequate to reach sufficient loading during the exercises the participant is fitted with a backpack with books and/or weights.

Isotonic exercise

Walking OTHER

The walking will be performed barefoot and the participant will be instructed in walking at a pace similar to the pace they would use when walking around in their home. The duration of the walking session will be four minutes to match the duration during the exercises.

Walking

Eligibility Criteria

• Age: 18 Years+
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• History of inferior heel pain for at least three months before enrolment
• Pain on palpation of the medial calcaneal tubercle or the proximal plantar fascia
• Thickness of the plantar fascia of 4.0 mm or greater
• Pain during at least one of three pain aggravating activities (static stance, half squat and heel raise)
• Mean heel pain of ≥ 20 mm on a 100 mm VAS \[0mm = no pain, 100mm = worst pain imaginable\] during the past week

You may not qualify if:

• Below 18 years of age
• History of inflammatory systemic diseases
• Pain or stiffness in the 1st metatarsophalangeal joint to an extent where the exercises cannot be performed
• Prior heel surgery
• Pregnancy
• Pain medication
• Corticosteroid injection for plantar fasciopathy within the past six months

Sponsors & Collaborators

• Aalborg University: lead

Study Sites (1)

Research Unit for General Practice

Aalborg East, 9220, Denmark

Location

Related Publications (1)

• Riel H, Vicenzino B, Jensen MB, Olesen JL, Holden S, Rathleff MS. The effect of isometric exercise on pain in individuals with plantar fasciopathy: A randomized crossover trial. Scand J Med Sci Sports. 2018 Dec;28(12):2643-2650. doi: 10.1111/sms.13296. Epub 2018 Oct 1.

  PMID: 30203866 DERIVED

MeSH Terms

Interventions

Exercise; Walking

Intervention Hierarchy (Ancestors)

Motor Activity; Movement; Musculoskeletal Physiological Phenomena; Musculoskeletal and Neural Physiological Phenomena; Locomotion

Study Officials

• Henrik Riel, M.Sc.

  Research Unit for General Practice in Aalborg, Department of Clinical Medicine, Aalborg University

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: SINGLE
• Who Masked: PARTICIPANT
• Purpose: TREATMENT
• Intervention Model: CROSSOVER
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: PhD Student

Study Record Dates

• First Submitted: August 15, 2017
• First Posted: August 29, 2017
• Study Start: August 24, 2017
• Primary Completion: October 3, 2017
• Study Completion: October 3, 2017
• Last Updated: October 5, 2017

Record last verified: 2017-10

Locations

DK (1)