Physiotherapy Protocols in Treating Plantar Fasciitis
Condition: Plantar Fascitis
MeSH terms: Fasciitis; Fasciitis, Plantar
Study type: Interventional

Summary: 
      This study aimed to investigate the efficacy of different physical therapy protocols in the
      treatment of chronic plantar fasciitis patients. Patients in this study were randomly
      assigned into 3 groups. Group A received ultrasound therapy protocol, group B received radial
      shock wave therapy protocol and group C received a combination of both ultrasound therapy and
      radial shock wave therapy protocol. All patients were also received a traditional physical
      therapy program. Foot function was evaluated by foot function index and ankle dorsiflexion
      range of motion was measured by Baseline® bubble inclinometer at the baseline and 4 weeks
      after treatment
    

Detailed description: 
      Sixty nine patients having unilateral chronic plantar fasciitis will be recruited for the
      study from Al-Qurayyat General Hospital, in Al-Jouf Region, Saudi Arabia. The inclusion
      criteria were as follows: patients suffered planter fasciitis of more than 3 months, maximum
      tenderness near the medial calcaneal insertion and pain was greater than 4 on visual analogue
      scale during taking the first steps in the morning. Patients were excluded if they had
      previous ankle or foot surgery or pathology, or if they had a previous history of shock wave
      therapy or topical corticosteroid injections to the ankle or foot, circulatory disturbances
      in the lower extremities, neuropathic or radicular pain in the lower limbs. Participants with
      systemic diseases that cause foot discomfort, such as ankylosing spondylitis, psoriatic
      arthritis, rheumatoid arthritis, and gout, as well as those with type I or type II diabetes
      and pregnancy, were also excluded from the study.

      The patients were randomly assigned into 3 equal groups (n = 23). Group A received ultrasound
      therapy protocol using Enraf Nonius Sonoplus 490, Netherlands. Group B received radial shock
      wave therapy protocol using Swiss DolorClast® Master, Electro Medical Systems, SA, Nyon,
      Switzerland. Group C received a combination of both ultrasound therapy and radial shock wave
      therapy protocol. All patients also received a traditional physical therapy program (3
      sessions per week, for 4 weeks) consisting of Calf muscles stretching and plantar fascia
      stretching. Foot function and Ankle dorsiflexion range of motion were evaluated at the
      baseline and 4 weeks after treatment.
    

Intervention name(s): Group A; Group B; Group C
Intervention type(s): Procedure; Procedure; Procedure
Intervention description(s): Patients received ultrasound therapy protocol with the following parameters (1 MHz frequency, intensity of 1.5 W/cm2 and use of continuous mode of ultrasound for 5 minutes), in addition to a conventional physiotherapy program consisting of calf muscles stretching, plantar fascia stretch, strengthening exercises and manual massage for 3 sessions per week, for 4 weeks; Patients received radial shock wave therapy protocol with the following parameters (1) the energy level was 0.12 mJ/mm2 equivalent to 2.5 bar intensity, (2) the number of shoots was 2000, (3) the frequency was 8 Hz, in addition to the same conventional physiotherapy program given for group A; Patients received both ultrasound and radial shock wave therapy, in addition to the same conventional physiotherapy program given for group A
Other intervention name(s): Ultrasound therapy protocol; Radial shock wave therapy protocol; Combined therapy protocol
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Single (Outcomes Assessor)
Primary purpose: Treatment
Keywords: plantar fasciitis; foot function index; ultrasound; radial shock wave