Efficacy of Manual Therapy in Plantar Fasciitis
Condition: Plantar Fasciitis
MeSH terms: Fasciitis; Fasciitis, Plantar
Study type: Interventional

Summary: 
      Plantar fasciitis is characterized by localized pain at the insertion site of the plantar
      fascia on the calcaneus. The pain worsens in the morning with the first step of the foot,
      after resting or at the beginning of a workout, it can increase after intense activity and
      persist even when it stops. The first-line plantar fasciitis treatment is conservative.
      Although few studies have currently evaluated the effectiveness of physical therapy, it
      appears that the combination of several techniques is more effective than any technique used
      in isolation. The objective of this study is to know the results of two manual therapy
      treatments in terms of pain and functionality with a direct action on the plantar fascia.

      Patients diagnosed with plantar fasciitis will be recruited. They will be randomly assigned
      into two intervention groups: Group 1 will receive a direct treatment on the plantar fascia
      and posterior aspect of the leg to relax and elongate the tissues. It will consist of manual
      therapy of the foot and ankle, treatment of the trigger points of the soleus muscle and
      plantar square, and also massage, and passive stretching and group 2 will receive a placebo
      treatment with superficial massage. The intervention consists of a weekly session for 4
      weeks, evaluations will be carried out at the beginning of treatment, at the end of the
      treatment and a follow-up one month. The evaluations will consist of ankle goniometry, pain,
      lower limb functionality dynamic balance, function and daily activities and ankle ability
      scale and pain on pressure.
    

Detailed description: 
      Introduction Plantar fasciitis is characterized by localized pain at the insertion site of
      the plantar fascia on the calcaneus, which can radiate toward the medial edge of the foot.
      The pain worsens in the morning with the first step of the foot, after resting or at the
      beginning of a workout, it can increase after intense activity and persist even when it
      stops. These symptoms can lead to functional limitation and prolonged disability. It is one
      of the most common foot pathologies. The first-line plantar fasciitis treatment is
      conservative. Although few studies have currently evaluated the effectiveness of physical
      therapy, it appears that the combination of several techniques is more effective than any
      technique used in isolation.

      The objective of this study is to know the results of two manual therapy treatments in terms
      of pain and functionality with a direct action on the plantar fascia.

      Material and methods

      Patients diagnosed with plantar fasciitis will be recruited. Patients will sign an
      explanatory informed consent for the project before starting it. All patients are volunteers.
      They will be randomly assigned into two intervention groups:

        -  Group 1 will receive a direct treatment on the plantar fascia and posterior aspect of
           the leg to relax and elongate the tissues. It will consist of manual therapy of the foot
           and ankle, treatment of the trigger points of the soleus muscle and plantar square, and
           also massage, and passive stretching.

        -  Group 2 will receive a placebo treatment with superficial massage. The intervention
           consists of a weekly session for 4 weeks, evaluations will be carried out at the
           beginning of treatment, at the end of the treatment and a follow-up one month.

      The evaluations will consist of ankle goniometry, pain measurement using the visual analog
      scale (VAS), pain and lower limb functionality with the validated Foot Function Index (FFI)
      scale, dynamic balance using the Star Excursion Balance Test, evaluation of the function and
      daily activities with the Foot and ankle ability measure (FAAM) scale and pain on pressure
      using an algometer.
    

Intervention name(s): Manual Therapy; Placebo massage
Intervention type(s): Other; Other
Intervention description(s): Mobilization, massage and stretching; Kneading and rubbing without intention to treat
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Double (Participant, Investigator)
Primary purpose: Treatment
Keywords: pain; function; treatment