Effects Of Ankle Mobility Exercises And Heel Drop Training In Planter Fasciitis

NCT06142123 | Unknown DMC

• 1 other identifier: REC/RCR&AHS/23/0433
• Study Type: interventional
• Target: 26
• Locations: 1 country
• Sites: 1

Brief Summary

Planter fasciitis is a common cause of heel pain in adults. Planter fasciitis is frequently seen among athletes playing various sports. However, it is more prevalent in professional runner. The Biomechanical stresses including the increase in the intensity, frequency or the time frame of weight bearing activities that subject athlete's feet to continuous impact loads, surfaces with inadequate cushioning or improper shoe replacement are some of extrinsic risk factors associated with planter fasciitis.3-D ankle mobility exercises are improvised for treatment of plantar fasciitis, these comprise D2 diagonal PNF leg patterns, comprising of flexion-abduction-internal rotation and extension-adduction-external rotation. Heel drop exercise training is another useful intervention used for treating PF; the protocol consists transferring their body weight onto the forefoot of their dominant legs while slightly flexing their ankles. To get back to baseline, the non-dominant leg is given more weight, and the dominant leg's knee was remained fully extended to maintain higher gastrocnemius activation. A Randomized clinical trial will be conducted at Pakistan Sports Board and Boston Physiotherapy Clinic Lahore through consecutive sampling technique on patients which will be allocated through opaque sealed enveloped into Group A and Group B. Group A will be treated with 3-D ankle mobility exercises and Group B will be treated with eccentric heel drop training. Outcome measures tools will be conducted through NPRS, Foot and Ankle Ability Measure (FAAM) and The VISA-A questionnaire: An index of the severity of Achilles tendinopathy after four weeks. Data will be analyzed using SPSS software version 25. After assessing normality of data by Shapiro-wilk test, it will be decided either parametric or non-parametric test will be used within a group or between two groups.

Conditions

Planter Fasciitis; Eccentric Heel Drop Training; 3-D Ankle Mobility

Keywords

Eccentric heel drop training, 3-D ankle mobility

Outcome Measures

Primary Outcomes (2)

• Foot and Ankle Ability Measure (FAAM)

  The Foot and Ankle Ability Measures Scale is a collection of self-administered questionnaire comprising 29 questions that is split down into two subscales: activities of daily living (21 questions) and sports population (8 questions)(15). With an ICC value of 0.89 for Activities of Daily Living (ADL) and 0.87 for the Sports subscale, it has a significant level of reliability

  pre and 4 weeks post interventional

• Numeric Pain Rating Scale

  Patient level of pain will be assessed using this scale. This scale ranges from 0 to 10. 0 indicates "no pain" and 10 indicates "worst pain"

  pre and 4 weeks post interventional

Secondary Outcomes (1)

• The VISA-A questionnaire: An index of the severity of Achilles tendinopathy: The VISA-A questionnaire: An index of the severity of Achilles tendinopathy

  pre and 4 weeks post interventional

Study Arms (2)

Group A

EXPERIMENTAL

Group A will be treated with 3-D Ankle Mobility Exercises with combined isotonic (agonist) technique at ankle joint. Two diagonal (D2) Flexion-Extension patterns from the PNF leg patterns will be used. Both the techniques will be first performed in prone lying against the resistance of the therapist and then in crook lying. The patients will receive Intervention consisting 14 sets (7 sets for each 3-D extension-flexion \[1 set (1 min) = exercise 30sec + rest 30 sec\]) performed for 15 minutes thrice per week for four weeks

Other: 3-D Ankle Mobility Exercises(A)

Group B

EXPERIMENTAL

Group B will be treated with Eccentric Heel Drop Training and Conventional physiotherapy treatment All patients will be treated once daily with 10 sets of 15 repetitions with a frequency of 2sec per repetitions and an interval of 30 sec between each set of Eccentric Heel drop training, 4 days a week for four weeks

Other: Eccentric Heel Drop Training(B)

Interventions

3-D Ankle Mobility Exercises(A) OTHER

The techniques will be first performed in prone lying against the resistance of the therapist and then in crook lying. 1. The participant will perform the D2 extension pattern (Planter-flexion-supination inversion-toe flexion) using the CI technique in the prone position according to the resistance of therapist. 2. The participant will perform the D2 flexion pattern (Dorsi-flexion-pronation eversion-toe extension) using CI technique in the prone position according to the resistance of therapist. 3. The participant will perform the D2 extension pattern (Planter-flexion-supination inversion-toe flexion) using the CI technique in the crook-lying position according to the resistance of therapist. 4. The participant will perform the D2 flexion pattern (Dorsi-flexion-pronation eversion-toe extension) using CI technique in the crook-lying position according to the resistance of therapist.

Group A

Eccentric Heel Drop Training(B) OTHER

: Group B will be treated with Eccentric Heel Drop Training. It will comprise of following exercises (14). 1. Eccentric loading exercises of calf muscles. 2. Conventional physiotherapy treatment including Ultrasound Plantar fascia stretching Calf muscle stretching Intrinsic muscles strengthening

Group B

Eligibility Criteria

• Age: 18 Years - 35 Years
• Gender Eligibility Details: Female athletes
• Healthy Volunteers: Yes
• Age Groups: Adult (18-64)

You may qualify if:

• Clinical diagnosis based on the clinical presentation Pain on palpation along the proximal plantar fascia with or without radiographic evidence of a plantar calcaneal bone spur Pain reporting of minimum of 2 on NPRS Athletes with 18 years to 35 years of age Chronic plantar fasciitis of more than 3 months. Female athletes playing more than 2 years in sports including runners, Soccer players, cricket players, cyclist, body builders.

You may not qualify if:

• Chronic pain syndrome or other foot pains Peripheral vascular disease that results in rest pain or intermittent claudication or venous stasis ulceration Calcaneal stress fracture or show evidence of a foreign body or tumor of the affected heel as viewed radio graphically Pregnant females Previously suffered a rupture or surgery of the plantar fascia within the 5 years preceding participation in the investigation Existing or prior osteomyelitis of the involved calcaneus

Sponsors & Collaborators

• Riphah International University: lead

Study Sites (1)

Boston Physiotherapy Clinic

Lahore, Punjab Province, Pakistan

RECRUITING

Related Publications (5)

• Trojian T, Tucker AK. Plantar Fasciitis. Am Fam Physician. 2019 Jun 15;99(12):744-750.

  PMID: 31194492 BACKGROUND

• Petraglia F, Ramazzina I, Costantino C. Plantar fasciitis in athletes: diagnostic and treatment strategies. A systematic review. Muscles Ligaments Tendons J. 2017 May 10;7(1):107-118. doi: 10.11138/mltj/2017.7.1.107. eCollection 2017 Jan-Mar.

  PMID: 28717618 BACKGROUND

• Alonso-Fernandez D, Taboada-Iglesias Y, Garcia-Remeseiro T, Gutierrez-Sanchez A. Effects of the Functional Heel Drop Exercise on the Muscle Architecture of the Gastrocnemius. J Sport Rehabil. 2020 Nov 1;29(8):1053-1059. doi: 10.1123/jsr.2019-0150. Epub 2019 Dec 6.

  PMID: 31810057 BACKGROUND

• Konrad A, Gad M, Tilp M. Effect of PNF stretching training on the properties of human muscle and tendon structures. Scand J Med Sci Sports. 2015 Jun;25(3):346-55. doi: 10.1111/sms.12228. Epub 2014 Apr 10.

  PMID: 24716522 BACKGROUND

• Johannsen F, Olesen JL, Ohlenschlager TF, Lundgaard-Nielsen M, Cullum CK, Jakobsen AS, Rathleff MS, Magnusson PS, Kjaer M. Effect of Ultrasonography-Guided Corticosteroid Injection vs Placebo Added to Exercise Therapy for Achilles Tendinopathy: A Randomized Clinical Trial. JAMA Netw Open. 2022 Jul 1;5(7):e2219661. doi: 10.1001/jamanetworkopen.2022.19661.

  PMID: 35816306 BACKGROUND

Study Officials

• Muniba Afzal

  Riphah International University

  PRINCIPAL INVESTIGATOR

Central Study Contacts

Malia Younas

CONTACT

+92 325 8292286; Maliayounas62@gmail.com

Amna shahid

CONTACT

+92 334 4512823; amna.shahid@riphah.edu.pk

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: SINGLE
• Who Masked: OUTCOMES ASSESSOR
• Purpose: TREATMENT
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: SPONSOR

Study Record Dates

• First Submitted: November 15, 2023
• First Posted: November 21, 2023
• Study Start: September 1, 2023
• Primary Completion: December 20, 2023
• Study Completion: January 5, 2024
• Last Updated: November 21, 2023

Record last verified: 2023-11

Data Sharing

• IPD Sharing: Will not share

Locations

PA (1)