Outcomes of the Proprioception and Strengthening Exercise Program in Chronic Plantar Fasciitis

NCT07754214 | Recruiting

• 1 other identifier: 05-2026/01
• Study Type: interventional
• Target: 105
• Locations: 1 country
• Sites: 1

Brief Summary

Plantar fasciitis is a common cause of heel pain, and although stretching exercises are a standard first-line treatment, current evidence on adding proprioception or knee-strengthening exercises remains limited. This study investigates whether adding knee strengthening or proprioception exercises to a standard stretching program improves pain, function, and disability in patients with chronic plantar fasciitis, and whether these interventions produce measurable changes in the biomechanical and kinesiological properties of the foot, ankle, and knee.

Conditions

Plantar Fasciitis, Chronic

Keywords

plantar fasciitis; strengthening; stretching; proprioception; chronic plantar fasciitis

Outcome Measures

Primary Outcomes (4)

• Pain Intensity (First-Step Morning, Evening, and Overall Daily Pain)

  Pain intensity during the first steps in the morning, before going to bed, and overall daily pain will be assessed using the Visual Analog Scale (VAS). The scale consists of a 10-cm horizontal line ranging from 0 (no pain) to 10 (worst imaginable pain), on which participants mark the point corresponding to their perceived pain level.

  Baseline (Week 0), post-intervention (Week 6), and follow-up (Week 12).

• Pressure Pain Threshold (PPT)

  PPT will be assessed using a Baseline® 12-1442 dolorimeter (22-lb sensitivity range; Fabrication Enterprises Inc., USA) to evaluate deep-tissue mechanical sensitivity. With the participant positioned prone and the feet hanging off the table, gradually increasing pressure will be applied to the midpoint of the plantar fascia insertion at the calcaneus. The pressure at which the participant first perceives pain will be recorded. Three measurements will be taken at 30-second intervals, and the mean value will be used for analysis.

  Baseline (Week 0), post-intervention (Week 6), and follow-up (Week 12).

• Foot Function and Health Status (Revised Foot Function Index, FFI-R)

  The FFI-R is a self-reported, multidimensional questionnaire comprising 68 items across four subscales: pain and stiffness, social and emotional consequences, dysfunction, and activity limitation. Each item is scored from 1 to 4, with higher scores indicating poorer foot health and greater functional limitation.

  Baseline (Week 0), post-intervention (Week 6), and follow-up (Week 12).

• Foot and Ankle Function (Foot and Ankle Outcome Score, FAOS)

  The FAOS is a 42-item self-reported questionnaire assessing five subscales: pain, other symptoms, activities of daily living, sports and recreation, and foot-and-ankle-related quality of life. Each item is scored from 0 to 4.

  Baseline (Week 0), post-intervention (Week 6), and follow-up (Week 12).

Secondary Outcomes (8)

• Myofascial Tissue Biomechanical Properties

  Baseline (Week 0), post-intervention (Week 6), and follow-up (Week 12).

• Plantar Fascia Ultrasonographic Parameters

  Baseline (Week 0), post-intervention (Week 6), and follow-up (Week 12).

• Ankle Dorsiflexion Range of Motion (ROM)

  Baseline (Week 0), post-intervention (Week 6), and follow-up (Week 12).

• First Metatarsophalangeal (MTP) Joint Range of Motion

  Baseline (Week 0), post-intervention (Week 6), and follow-up (Week 12).

• Joint Position Sense (JPS) (Ankle-Knee and Hip)

  Baseline (Week 0), post-intervention (Week 6), and follow-up (Week 12).

Study Arms (3)

Stretching Only

ACTIVE COMPARATOR

This group will perform plantar fascia-gastrocnemius-soleus stretching exercises alone (twice daily, 7 days per week, for 6 weeks).

Other: Stretching

Stretching and Proprioception

EXPERIMENTAL

In addition to the standard stretching program, this group will receive supervised proprioception exercises three times per week for 6 weeks.

Other: Proprioception and Stretching Exercises

Stretching and Knee Strengthening

EXPERIMENTAL

In addition to the standard stretching program, this group will receive supervised knee strengthening exercises three times per week for 6 weeks.

Other: Knee Strengthening and Stretching Exercises

Interventions

Stretching OTHER

Participants will perform standardized plantar fascia and gastrocnemius-soleus stretching exercises. The protocol consists of stretching twice daily, 7 days per week, for 6 weeks.

Stretching Only

Proprioception and Stretching Exercises OTHER

In addition to the standard stretching protocol, participants in this group will perform a supervised, 6-week progressive proprioception exercise program administered by a physiotherapist three times per week. Exercises will be performed under both eyes-open and eyes-closed conditions on progressively less stable surfaces with task difficulty advanced on a weekly basis.

Stretching and Proprioception

Knee Strengthening and Stretching Exercises OTHER

In addition to the standard stretching protocol, participants in this group will perform a supervised, 6-week progressive knee-strengthening program administered by a physiotherapist three times per week.

Stretching and Knee Strengthening

Eligibility Criteria

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

You may qualify if:

• Age between 18 and 65 years.
• Formal diagnosis of plantar fasciitis, characterized by sharp pain during the first steps in the morning, pain that increases with prolonged activity, localized tenderness on palpation of the medial calcaneal tubercle or proximal fascia, and a positive Windlass test.
• Symptom duration of at least 3 months.
• Heel pain intensity score of Visual Analog Scale (VAS) \> 3.
• Voluntary agreement to participate, evidenced by signing the written informed consent form.

You may not qualify if:

• History of acute lower-extremity trauma.
• History of prior foot or ankle surgery.
• Corticosteroid injection to the affected heel within the preceding 6 months.
• Presence of systemic inflammatory or rheumatologic disease.
• Uncontrolled systemic disease (e.g., uncontrolled hypertension, uncontrolled diabetes mellitus).
• Current or past history of malignancy.
• Current pregnancy.
• Body mass index (BMI) ≥ 30 kg/m².
• Any musculoskeletal, neuromuscular, ocular, or vestibular disorder that could impair balance or limit the ability to stand unsupported.
• Neurocognitive or psychiatric conditions precluding adherence to the exercise protocols or outcome assessments.

Sponsors & Collaborators

• Karamanoğlu Mehmetbey University: lead

Study Sites (1)

Karaman Training and Research Hospital

Karaman, 70100, Turkey (Türkiye)

RECRUITING

MeSH Terms

Conditions

Fasciitis, Plantar

Interventions

Proprioception

Condition Hierarchy (Ancestors)

Fasciitis; Musculoskeletal Diseases; Foot Diseases

Intervention Hierarchy (Ancestors)

Vestibulocochlear Physiological Phenomena; Physiological Phenomena; Sensation; Nervous System Physiological Phenomena; Musculoskeletal and Neural Physiological Phenomena

Study Officials

• Aynur Basaran, MD, Prof.

  Karamanoğlu Mehmetbey University

  PRINCIPAL INVESTIGATOR

Central Study Contacts

Sule Kosar, MD

CONTACT

+90 506 145 9656; sulekosar@kmu.edu.tr

Aynur Basaran, Prof. MD

CONTACT

+90 537 562 06 66; aynurbasaran@gmail.com

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: PRINCIPAL INVESTIGATOR
• PI Title: MD

Study Record Dates

• First Submitted: August 4, 2026
• First Posted: August 10, 2026
• Study Start: August 1, 2026
• Primary Completion (Estimated): December 31, 2026
• Study Completion (Estimated): December 31, 2026
• Last Updated: August 10, 2026

Record last verified: 2026-08

Locations

TU (1)