Clinical trial NCT05462002: Intrinsic Foot Muscle Morphology and Function in Runners With and Without Plantar Fasciitis
Official title: Intrinsic Foot Muscle Morphology and Function in Runners With and Without Plantar Fasciitis
Study type: OBSERVATIONAL
Overall status: UNKNOWN
Conditions: Plantar Fascitis
Keywords: intrinsic foot muscle, plantar fasciitis, runners, balance, postural control
Lead sponsor: Chinese University of Hong Kong
Sponsor class: OTHER
First posted: 2022-07-18
Enrollment: 64
Sex: ALL
Minimum age (years): 18
Maximum age (years): 60
Standard ages: ADULT
Observational model: CASE_CONTROL
Time perspective: CROSS_SECTIONAL
Sampling method: PROBABILITY_SAMPLE
Study population: distance runners who run more than 20km per week for at least 2 years.

Brief summary: Plantar fasciitis is one of the most common musculoskeletal conditions in distance runners. 44% of patients still had the symptoms after 15 years from the first onset. The chronicity of the condition may lead to significant limitations on daily activities and even cessation of running. In the concept of foot core system, the intrinsic foot muscles work together with plantar fascia to stabilize the foot arches and provide dynamic support to the foot during functional activities. Given that the intrinsic foot muscles also play an important role as a direct sensors of foot deformation, postural control may be compromised during pathological state. Therefore, this study aim to investigate the differences in the muscle thickness and cross-sectional area of intrinsic foot muscles and postural control in runners with and without plantar fasciitis. We hypothesized that runners with plantar fasciitis demonstrate small intrinsic foot muscles sizes and poor postural control when compared with the asymptomatic counterparts.

Detailed description: this is a case-control study, using ultrasound imaging (USG) to examine the differences in muscle thickness (MT) and cross-sectional area (CSA) of Abductor Hallucis (AbH), flexor hallucis brevis (FHB), flexor digitorum brevis (FDB), and quadratus plantae (QP), and postural control in runners with and without plantar fasciitis. All participants were recruited through recruitment flyers and word of mouth from local running community. The dependent variables included navicular height using navicular drop test, foot posture using the 6-item Foot Posture Index (FPI-6). The actual status of symptoms was evaluated by visual analog scale (VAS) pain at the first steps in the morning, VAS pain at worst of the day, the Foot Function Index Revised short form (FFI-R S), and the Foot and Ankle Ability Measure (FAAM).

The postural control was assessed by three 10-seconds eyes opened trials and three 10-seconds eyes closed trials single-leg stance recorded on an instrumented force platform . (AMTI. Watertown, MA) at 50 Hz. Center of pressure velocity (cm/s) was calculated for each condition using Balance Clinic software (AMTI. Watertown, MA). In addition, percent modulation was calculated using equation 1 to provide an estimate of a participant's reliance on visual information for the postural control of intrinsic foot muscles.

Equation 1 is as followed.

% modulation= (eyes open velocity-eyes closed velocity)/(eyes open velocity)

Larger negative values represent a greater impairment to postural control when vision is removed and suggest a greater reliance on visual information.

Eligibility criteria: Inclusion Criteria:

* distance runners who run more than 20km per week for at least 2 years. Runners who were between 18 and 60 years of age with symptoms of chronic plantar fasciitis: if they reported tenderness on palpation of the medial calcaneal tuberosity, thickness of plantar fascia \>4.0mm at insertion with USG, and exhibited one of the following complaints: 1. plantar heel pain \> 1 month; 2 pain on the first step in the morning or after prolonged sitting; 3. pain on prolonged standing; 4 pain when running.

Exclusion Criteria:

* Those who had undergone surgery to the plantar fascia, or had local injection within the last 3 months, or had any coexisting painful musculoskeletal condition of the lower limb, or any neurological or systematic disease were excluded

Primary outcomes:
measure: Muscle thickness (MT) of Abductor Hallucis (AbH), Flexor Hallucis Brevis (FHB), Flexor Digitorum Brevis (FDB), Quadratus Plantae (QP)
timeFrame: baseline
measure: Cross sectional area (CSA) of Abductor Hallucis (AbH), Flexor Hallucis Brevis (FHB), Flexor Digitorum Brevis (FDB), Quadratus Plantae (QP)
timeFrame: baseline
measure: postural control
timeFrame: baseline
measure: Visual Analog Scale (VAS) pain at first steps in the morning
timeFrame: baseline
measure: Visual Analog Scale (VAS) worst pain of the day
timeFrame: baseline
measure: Foot and Ankle Ability Measure (FAAM)
timeFrame: baseline
measure: Foot Function Index revised short form (FFI-RS)
timeFrame: baseline
Secondary outcomes:
measure: Foot posture index (FPI)
timeFrame: Baseline
measure: Navicular drop
timeFrame: Baseline
Other outcomes:
Locations:
city: Sha Tin
country: Hong Kong
facility: CUHK-ORT Sports Injury Research Laboratory
Study officials:
affiliation: Chinese University of Hong Kong
name: On Yue Lau, PhD candidate
role: PRINCIPAL_INVESTIGATOR
References: