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The objective of study is to compare the pain intensity, disability and functional capacity by Deep Transverse Friction Massage and Instrument Assisted Soft Tissue Mobilization Techniques in patients with plantar fasciitis.
This randomized clinical trial will be conducted at Ghurki Trust and Teaching Hospital and Jinnah Hospital, Lahore. The study will target pregnant females aged 18 to 40 years who are clinically diagnosed with plantar fasciitis using the Windlass test. Exclusion criteria include a history of ankle or foot fracture or surgery within the past six months, as well as any neurological deficits. A total of 52 participants will be recruited using the non-probability convenience sampling technique and randomly assigned into two equal groups. Participants in both groups will receive the same baseline treatment. Group A will receive Deep Transverse Friction Massage (DTFM), while Group B will receive Instrument Assisted Soft Tissue Mobilization Techniques (IASTMT). The study aims to compare the effectiveness of these two manual therapy techniques on pain intensity, disability, and functional capacity. The Numeric Pain Rating Scale (NPRS) will be used to assess pain levels. Disability will be evaluated using the Foot Function Index (FFI), and the 6-Minute Walk Test (6MWT) will be employed to measure functional capacity. Data collected from participants will be entered and statistically analyzed using SPSS version 21 to determine the comparative effectiveness of the two treatment approaches in managing plantar fasciitis during pregnancy.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| DEEP TRANSVERSE FRICTION MASSAGE | Experimental | Deep friction massage (DFM), also known as cross friction massage, is a specific connective tissue massage |
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| INSTRUMENT ASSISTED SOFT TISSUE MOBILIZATION TECHNIQUES | Experimental | ASTM techniques involve the use of specialized instruments to manipulate soft tissue structures. These instruments are designed to provide an efficient detection of soft tissue dysfunction and accurate application of force during treatment. |
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| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| DEEP TRANSVERSE FRICTION MASSAGE | Other | 12 sessions total (approx.1 and half month) and 2 sessions per week with mild to moderate manual pressure. 15 - 20 min per session will be given to patient for 6 weeks |
| Measure | Description | Time Frame |
|---|---|---|
| Numeric Pain Rating Scale (NPRS) | The Numeric Pain Rating Scale (NPRS) was employed to evaluate pain intensity for all participants in both groups prior to and following the 8-week intervention program. This is 11-point (0-10) self-reporting tool is presented as a 10-cm horizontal line where 0 indicates no pain, 1-3 signifies mild pain, 4-6 represents moderate pain, and 7-10 denotes severe pain. The maximum value corresponds to the worst pain, while the minimum value indicates the absence of pain. | 6th week |
| Foot Function Index (FFI) | A Foot Function Index (FFI) was developed to measure the impact of foot pathology on function in terms of pain, disability and activity restriction. The FFI is a self-administered index consisting of 23 items divided into 3 sub-scales. Both total and sub-scale scores are produced. | 6th week |
| 6 min walk test (6MWT) | used to determine functional ability. The individual walked swiftly for six minutes along a 100-foot hallway, recording the distance travelled in total. If a person with plantar fasciitis has pain or discomfort in the foot during the test, it can suggest the presence of the condition. During the 6-minute walk test, look for indicators of plantar fasciitis as follows. | 6th week |
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Inclusion Criteria:
Exclusion Criteria:
History of ankle and foot fractures
Surgery in previous 6 months
Previous manual therapy interventions for the foot region
Those who previously received systemic or local steroid injection within 3 months or locally injected with any other material
Dermatological disease i.e; injury, trauma, foot ulcer over the foot
Plantar fasciitis during pregnancy
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| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| imran amjad | Contact | 03324390125 | imran.amjad@riphah.edu.pk |
| Name | Affiliation | Role |
|---|---|---|
| sobia ghafoor, MSPT-OM | Riphah International University | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Riphah medical center | Recruiting | Lahore | Punjab Province | 6400 | Pakistan |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 39213647 | Background | Sahr ME, Grunebaum A, Positano RC, Nwawka OK, Chervenak FA, Positano RG. Common foot and ankle disorders in pregnancy: the role of diagnostic ultrasound. J Perinat Med. 2024 Aug 27;52(7):674-687. doi: 10.1515/jpm-2024-0276. Print 2024 Sep 25. | |
| 39801557 | Background | Foraldy J, Jehosua S, Momole A, Tumewah R, Runtuwene T, Wariki WMV. Plantar Fascia Thickness Difference Between Pregnant and Nulliparous in Indonesia. J Med Ultrasound. 2024 Nov 30;32(4):323-328. doi: 10.4103/jmu.jmu_142_23. eCollection 2024 Oct-Dec. |
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| INSTRUMENT ASSISTED SOFT TISSUE MOBILIZATION TECHNIQUES | Other | • 12 sessions total, (approximately 1 and half month) and 2 sessions per week. Low to moderate pressure with tool will applied for 15 - 20 min per session for 6 weeks |
|
| Background | Khairy E, Esmail A, Amin FS, Qudahh MA, Zahran MR. Integrated Neuromuscular Inhibition Technique versus Instrument Assisted Soft Tissue Mobilization in Patients with Chronic Plantar Fasciitis. Egyptian Journal of Hospital Medicine. 2024;96(1):2570-7. |
| 36125974 | Background | Pisirici P, Cil ET, Coskunsu DK, Sayli U, Subasi F. Extracorporeal Shockwave Therapy Versus Graston Instrument-Assisted Soft-Tissue Mobilization in Chronic Plantar Heel Pain: A Randomized Controlled Trial. J Am Podiatr Med Assoc. 2022 Nov-Dec;112(6):21-036. doi: 10.7547/21-036. |
| Background | Gala M, Kulkarni P, Kumar A. Comparison of immediate effect of plantar fascia release by roller massager and transverse friction massage on hamstring flexibility in desk job workers. Int J Physiother Res. 2021;9:3954-9. |