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This study aims to compare the effects of foot core strengthening and sensorimotor re-training, each combined with routine physical therapy, on pain, functional ability, and plantar pressure in patients with Plantar Fasciitis.
Participants will be divided into two groups: one receiving foot core strengthening with routine physical therapy and the other receiving sensorimotor re-training with routine physical therapy. The study will evaluate which intervention is more effective in reducing pain, improving function, and normalizing plantar pressure distribution.
Plantar Fasciitis is a common musculoskeletal disorder characterized by heel pain, reduced functional capacity, and altered plantar pressure distribution. It is often associated with overuse, poor biomechanics, and weakness of intrinsic foot muscles.
Routine physical therapy management includes stretching exercises ( plantar fascia and calf stretching), strengthening, manual therapy, and physical modalities. However, recent rehabilitation approaches emphasize the importance of intrinsic muscle strengthening and sensorimotor control.
This study is designed to compare two active rehabilitation approaches combined with routine physical therapy:
Group A: Foot Core Strengthening + Routine Physical Therapy
Participants in this group will receive:
Intrinsic foot muscle strengthening exercises ( short foot exercise, toe curls) Routine physical therapy (stretching, manual therapy, modalities) This approach aims to improve medial longitudinal arch support, enhance foot stability, and reduce mechanical stress on the plantar fascia.
Group B: Sensorimotor Re-training + Routine Physical Therapy
Participants in this group will receive:
Sensorimotor and proprioceptive training ( balance exercises, unstable surface training) Routine physical therapy (stretching, manual therapy, modalities) This approach focuses on improving neuromuscular control, proprioception, and dynamic stability of the foot and ankle.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Group A: Foot Core Strengthening with Routine Physical Therapy | Experimental | Participants in this group will receive foot core strengthening exercises targeting intrinsic foot muscles along with routine physical therapy including stretching, manual therapy, and physical modalities for management of Plantar Fasciitis. |
|
| Group B: Sensorimotor Re-training with Routine Physical Therapy | Experimental | Participants in this group will receive sensorimotor and proprioceptive training along with routine physical therapy including stretching, manual therapy, and physical modalities for management of Plantar Fasciitis. |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Foot Core Strengthening with Routine Physical Therapy | Other | Participants will receive a structured foot core strengthening program targeting intrinsic foot muscles, including exercises such as short foot exercise, toe curls, toe spreading, and marble pickup. These exercises aim to improve medial longitudinal arch stability and reduce stress on the plantar fascia. In addition, routine physical therapy will be provided, including plantar fascia stretching, gastrocnemius-soleus stretching, manual therapy techniques, and appropriate physical modalities. Sessions will be conducted 3-5 times per week for a duration of 4-8 weeks, along with a prescribed home exercise program. |
| Measure | Description | Time Frame |
|---|---|---|
| Pain Intensity | Pain intensity will be assessed using the Visual Analog Scale (VAS), where participants rate their heel pain during first steps in the morning and during activity. It is a reliable tool to measure pain severity in patients with Plantar Fasciitis. | Baseline and at the end of 4-8 weeks of intervention |
| Measure | Description | Time Frame |
|---|---|---|
| Plantar Pressure Distribution | Plantar pressure will be measured using a pressure analysis system to evaluate changes in load distribution across different regions of the foot during standing and walking. | Baseline and at the end of 4-8 weeks of intervention |
| Foot Function |
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Inclusion Criteria:
Age 35-60 Years Sharp and worsen pain with the first few steps out of bed in morning. Clinical diagnosis of plantar fasciitis of at least three months duration -
Exclusion Criteria:
History of ankle and foot surgery Diagnosis for Peripheral neuropathy, Tarsal tunnel syndrome Corticosteroid injection into heel within the last three months. Diagnosed neurological and rheumatological disease calcaneal fractures Pregnant Women-
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| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Muqaddas Muqadds | Contact | +92 306 5821079 | mmuqadas614@gmail.com | |
| Nabeela Dawood | Contact | +92 331 5337445 | nabeela.dawood@ubas.edu.pk |
| Name | Affiliation | Role |
|---|---|---|
| Nabeela Dawood | Lahore University of Biological and Applied Sciences | Study Chair |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Lahore University of Biological and Applied Sciences | Lahore | Punjab Province | Pakistan |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 33530860 | Background | Hamstra-Wright KL, Huxel Bliven KC, Bay RC, Aydemir B. Risk Factors for Plantar Fasciitis in Physically Active Individuals: A Systematic Review and Meta-analysis. Sports Health. 2021 May-Jun;13(3):296-303. doi: 10.1177/1941738120970976. Epub 2021 Feb 3. | |
| 26654252 | Background | Kamonseki DH, Goncalves GA, Yi LC, Junior IL. Effect of stretching with and without muscle strengthening exercises for the foot and hip in patients with plantar fasciitis: A randomized controlled single-blind clinical trial. Man Ther. 2016 Jun;23:76-82. doi: 10.1016/j.math.2015.10.006. Epub 2015 Oct 30. |
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This is an open-label study in which no masking is applied. Both participants and care providers are aware of the assigned interventions, including foot core strengthening with routine physical therapy and sensorimotor re-training with routine physical therapy. Outcome assessments will be conducted using standardized tools; however, no blinding of assessors is implemented.
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| Sensorimotor Re-training with Routine Physical Therapy | Other | Participants will receive a structured sensorimotor re-training program focusing on proprioception, balance, and neuromuscular control. Exercises will include single-leg stance, balance training on stable and unstable surfaces, wobble board exercises, and gait training. Routine physical therapy will also be provided, including plantar fascia stretching, gastrocnemius-soleus stretching, manual therapy techniques, and appropriate physical modalities. Sessions will be conducted 3-5 times per week for a duration of 4-8 weeks, along with a prescribed home exercise program. |
|
Functional ability will be evaluated using the Foot Function Index (FFI), which assesses pain, disability, and activity limitation related to foot conditions. |
| Baseline and at the end of 4-8 weeks of intervention |
| 30252428 | Background | Scherger JE. Consider Muscle Strengthening for Plantar Fasciitis. Am Fam Physician. 2018 Oct 1;98(7):407. No abstract available. |
| 23798950 | Background | Tahririan MA, Motififard M, Tahmasebi MN, Siavashi B. Plantar fasciitis. J Res Med Sci. 2012 Aug;17(8):799-804. |
| ID | Term |
|---|---|
| D036981 | Fasciitis, Plantar |
| ID | Term |
|---|---|
| D005208 | Fasciitis |
| D009140 | Musculoskeletal Diseases |
| D005534 | Foot Diseases |
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