Cognitive Training for Pain , Balance and Foot Function in Plantar Fasciitis

Effect of Cognitive Training on Pain , Foot Function, and Balance in Patients With Planter Fasciitis : A Randomized Controlled Trial

This randomized controlled trial aims to compare the effects of cognitive training exercises versus stretching and strengthening exercises on pain, functional dilatability, and static balance. Participants will be assigned to two groups: a cognitive training group or a stretching and strengthening exercise group. The cognitive training group will perform exercises targeting cognitive and neuromuscular control plus stretching and strengthening exercise , while the control group will perform stretching and strengthing exercises only. Outcome measures will include pain intensity, foot functional disability , and static balance. The results of this study will provide evidence regarding the effectiveness of cognitive training with stretching and strengthing exercises compared to stretching and strengthIng only exercises in improving musculoskeletal function and balance.

and impaired balance. It is characterized by degeneration of the plantar fascia due to repetitive stress, leading to pain, especially during weight-bearing activities. In addition to local tissue pathology, alterations in neuromuscular control and sensorimotor function may contribute to persistent symptoms and functional limitations.

Recent approaches in rehabilitation have highlighted the role of cognitive training in enhancing motor control, attention, and sensorimotor integration. Cognitive training, particularly when combined with movement tasks (dual-task training), may improve postural control and functional performance by optimizing central nervous system processing. However, there is limited evidence regarding its effectiveness in patients with plantar fasciitis.

This randomized controlled trial aims to investigate the effect of cognitive training on pain intensity, functional disability, and static balance in individuals with plantar fasciitis. Participants will be randomly assigned into two groups. The experimental group will receive a cognitive training program incorporating attention-demanding and dual-task exercises integrated with functional movements plus stretching and strengthing exercises . The control group will perform a conventional stretching and strengthing exercise program targeting the plantar fascia and related lower limb musculature.

Outcome measures will include pain intensity, functional disability, and static balance. Assessments will be conducted at baseline and after completion of the intervention period.

The results of this study are expected to provide evidence on the effectiveness of cognitive training as a rehabilitation approach for improving pain, functional outcomes, and balance in patients with plantar fasciitis.

Inclusion Criteria:

• Adults aged 18 to 60 years. Clinically diagnosed with plantar fasciitis by a physician or physiotherapist. Experiencing heel pain for at least 4 weeks. Ability to stand and perform basic functional and balance tests. Willingness to participate and provide informed consent. Not currently receiving other structured physical therapy or cognitive training programs during the study period.

Exclusion Criteria:

• History of lower limb surgery or fractures affecting the foot or ankle. Presence of neurological disorders affecting balance or motor control (e.g., stroke, Parkinson's disease).

Systemic inflammatory or rheumatologic conditions (e.g., rheumatoid arthritis). Severe musculoskeletal deformities of the lower limb or foot. Recent corticosteroid injection in the heel region within the last 3 months. Current participation in other structured rehabilitation or exercise programs. Pregnancy (if applicable due to balance and biomechanical changes). Inability to understand or follow instructions related to the intervention.