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Randomized Controlled Trial
. 2024 Sep;27(3):487-500.
doi: 10.1007/s40477-023-00833-0. Epub 2023 Nov 2.

Sonographic and clinical effects of manual physical therapy for plantar fasciitis: randomized prospective controlled trial

Abdul Sattar Arif Khammas  1   2 , Rozi Mahmud  3 , Hasyma Abu Hassan  3 , Idris Ibrahim  3 , Safwan Saeed Mohammed  4
Affiliations
Randomized Controlled Trial

Sonographic and clinical effects of manual physical therapy for plantar fasciitis: randomized prospective controlled trial

Abdul Sattar Arif Khammas et al. J Ultrasound. 2024 Sep.

Abstract

Objective: This study aimed to evaluate the efficacy of manual physiotherapy on clinical outcomes, morphology of plantar fascia (PF), thicknesses of calcaneal fat pad (CFP) and Kager's fat pad (KFP) with ultrasound imaging in plantar fasciitis (PFS) patients. Also, to evaluate the PF thickness, pain and foot functional outcomes among PFS phases.

Methods: A randomized controlled trial was conducted on 122 subjects divided into three groups: group A (40 patients with PFS) underwent manual physiotherapy, group B (42 patients with PFS) without any intervention and group C (40 healthy subjects) were matched by age, gender and BMI with each patient in group A and B. The following outcomes were evaluated at baseline and one-month of follow-ups: morphology of PF and thicknesses of CFP and KFP, pain, foot functional limitation.

Results: PF thickness was significantly thickened in group A and B compared to group C (P < 0.001). A significant decrease in incidence of PF echogenicity and CFP thickness were found in group A and B compared to group C. Moreover, significant improvement was observed in PF thickness (P < 0.001), PF echogenicity (P < 0.001) and CFP thickness (P = 0.002) in group A at one-month after the treatment. Furthermore, pain intensity and foot functional limitation was significantly improved within group A after receiving the treatment. Significant improvement was noted in PF thickness, pain intensity and foot functional limitation among patients with acute phase.

Conclusion: The manual physiotherapy is effective in treatment of PF thickening, hypoechogenicity, pain intensity and activity limitations, particularly in patients associated with acute PFS.

Keywords: Manual physiotherapy; Plantar fasciitis; Ultrasound.

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Conflict of interest statement

The authors have no relevant financial or non-financial interests to disclose.

Figures

Fig. 1
Fig. 1
Ultrasound imaging for PF at calcaneal insertion, showing normal (a), acute PFS (b), subacute PFS (c) and chronic PFS (d). PF plantar fascia, PFS plantar fasciitis, C calcaneus
Fig. 2
Fig. 2
Flow chart of the study
Fig. 3
Fig. 3
Ultrasound imaging for PF in patients with PFS. PF was measured before treatment (a) and 1-month after the treatment (b) at calcaneal insertion (1), 2 cm distal to the calcaneal insertion (2) and 4 cm distal to the insertion (3). PF plantar fascia, PFS plantar fasciitis, C Calcaneus
Fig. 4
Fig. 4
Ultrasound imaging for CFP in patients with PFS before treatment (a) and 1-month after the treatment (b). PFS plantar fasciitis, CFP calcaneal fat pad, C calcaneus
Fig. 5
Fig. 5
Ultrasound imaging for KFP in patients with PFS before treatment (a) and 1-month after the treatment (b). PFS plantar fasciitis, KFP calcaneal fat pad, AT achilles tendon
See this image and copyright information in PMC

References

    1. Landorf B, Menz B (2008) Plantar heel pain and fasciitis. BMJ Clin Evid. 2008:1589–1602 - PMC - PubMed
    1. Cole BJ, Schumacher HR (2005) Injectable corticosteroids in modern practice. J Am Acad Orthop Surg 13:37–46 10.5435/00124635-200501000-00006 - DOI - PubMed
    1. Crawford F, Thomson CE (2003) Interventions for treating plantar heel pain. Cochrane Database Syst Rev, p. 1–20 - PubMed
    1. Kamonseki DH, Gonçalves GA, Liu CY, Júnior IL (2016) 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 23:76–82 10.1016/j.math.2015.10.006 - DOI - PubMed
    1. Nahin RL (2018) Prevalence and pharmaceutical treatment of plantar fasciitis in United States adults. J Pain 19:885–896 10.1016/j.jpain.2018.03.003 - DOI - PMC - PubMed

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