Effects Of Muscle Energy Versus Counter Strain Technique on Pain, Function and Satisfaction Level in Planter Fasciitis

Study Overview
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Brief Summary
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Previous studies has discussed the effects of muscle energy technique and counterstrain technique in upper trapezius and low back pain but no comparative study is found on planter fasciitis patients. In this study we are going to compare the effects of muscle energy technique and counterstrain technique with routine physical therapy in relation with pain, functional status and satisfaction level in planter fasciitis patients

Detailed Description
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Heel pain is one of the most prevalent musculoskeletal diseases of the lower limb, affecting both physically active and sedentary people. Amongst the possible causes, planter fasciitis is one of the most common cause of heel pain. Planter fasciitis is a degenerative syndrome resulting from the repeated injury at its origin on the calcaneus. Its most common symptom is discomfort in the plantar area of the foot and, more specifically, in the inferior part of the heel. It is frequently more intense while taking your first steps in the morning or after a period of physical inactivity, and it worsens with prolonged standing or weight-lifting activities. It is not frequently linked to nocturnal discomfort or paresthesia. Different physiotherapy treatment conventions help in pain relieving for example, rest, taping, stretching, orthosis-night brace, Silicon heel cups and myofascial release. This study will compare the effects of Muscle Energy Technique versus Counterstrain Technique in patients with plantar Fasciitis.

Official Title
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Comparative Effects Of Muscle Energy Technique And Counter Strain Technique On Pain, Functional Status And Satisfaction Level In Planter Fasciitis Patients

Conditions
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Plantar Fasciitis

Intervention / Treatment
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* Other: Muscle Energy Technique
* Other: Counterstrain Technique


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Age 20 to 68 years. Both male and female. Patients are clinical diagnosed by the orthopedic surgeon. Patients present with pain that persist for more than 4 weeks in heel and planter surface of foot. Pain with the first steps after inactivity Exclusion Criteria: • Patients with history of ankle and foot fracture. Congenital or acquired deformity of ankle and foot. Patients with arthritis. Pervious history of surgery for planter fasciitis. Patients use an assistive device for walking. Patients use corticosteroid injection in heel.

Ages Eligible for Study
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Minimum Age: 20 Years
Maximum Age: 68 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Allocation: Randomized
Intervention Model: Parallel Assignment
Interventional Model Description: Group A: Muscle energy technique along with routine physical therapy, Group B: Counterstrain technique along with routine physical therapy
Masking: Double


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Group A<br>This group will receive muscle energy technique along with routine physical therapy. This protocol will be given for 3 alternative days for 2 weeks . Each session will be of 50 mins. Data will be collected at baseline , at 1st week and at 2nd week. | Other: Muscle Energy Technique<br>* For Gastrocnemius muscle, subject will be in supine position keeping knee fully extended and therapist on affected side in walking position. The subject's ankle joint will be dorsiflexed until a resistance feel and will ask to hold this position and exert 20% of force towards plantar flexion for a period of 5 to 7 seconds. Resistance will be released and relaxation of 5 seconds will be given during which the ankle will was passively dorsiflexed to a new barrier. 5 repetitions will be given.<br>|
| Active Comparator: Group B<br>This group will receive counterstrain technique along with routine physical therapy. This protocol will be given for 3 alternative days for 2 weeks . Each session will be of 50 mins. Data will be collected at baseline , at 1st week and at 2nd week. | Other: Counterstrain Technique<br>* Therapist places thumb on tender point at plantar fascia insertion while patient in supine position with ipsilateral knee flexed. Plantar flex the toes and ankle while monitoring sore site with thumb, curling around tender point until monitoring thumb feels symptomatic relief. Supination/pronation of foot will be added if necessary. The position of ease will be maintained for 90 secs until tissues beneath monitoring thumb softens. Tender spot is re-evaluated once the foot is returned to neutral without moving the thumb. It will be repeated 3 times for 30 secs resting interval in-between<br>* Other names: Spontaneous Release by Positioning;|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Pain Intensity | Pain intensity will be measured by Visual Analogue Scale (VAS) | Change in pain intensity will be measured at baseline, at end of first week, at end of second week | 
| Function | Functional status will be measured by Foot and Ankle Ability Measure (FAAM) | Change in Functional Status will be measured at baseline, at end of first week, at end of second week | 
| Satisfaction Level | Satisfaction level will be measured by Short-Form Patient Satisfaction Questionnaire (PSQ-18) | Level of satisfaction will be observed at end of First Session, at end of first week, at end of second week | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Counterstrain, Function, METs, Pain, Plantar Fasciitis, Satisfaction