Active Release Technique vs. Dynamic Soft Tissue Mobilization for Plantar Pain
Comparison of Active Release Technique Versus Dynamic Soft Tissue Mobilization on Pain, Range of Motion, Functional Outcomes and Disability in Subjects With Plantar
Plantar fasciitis is one of the most common causes of heel pain encountered in musculoskeletal and orthopedic physiotherapy practice. It is characterized by degenerative changes at the origin of the plantar fascia on the medial calcaneal tubercle, leading to pain, stiffness, and functional limitations during weight-bearing activities. Patients typically report sharp heel pain that is most severe during the first steps in the morning or after prolonged rest, which significantly affects gait and daily functional activities.Current evidence suggests that plantar fasciitis is not purely an inflammatory condition but rather a degenerative fasciopathy resulting from repetitive microtrauma, abnormal foot biomechanics, prolonged standing, obesity, and tightness of the gastrosoleus complex. These mechanical stressors lead to microtears, collagen degeneration, and thickening of the plantar fascia, ultimately resulting in chronic pain and disability.Objective of this study is to compare the effectiveness of Active Release Technique and Dynamic Soft Tissue Mobilization on pain, function, and disability in patients with plantar fasciitis. All the subjects who will eligible for the criteria will randomly allocated in to Group A(ART) and Group B(DSTM).Taping will be our baseline treatment.. This study will be a randomized controlled trial conducted at Pro Care Physiotherapy Clinic, Ittefaq Hospital, and Iffat Anwar Medical Complex over a period of four months. A total of 62 participants will be recruited using probability convenient sampling and randomly allocated into two groups. Group A will receive Active Release Technique along with baseline taping, while Group B will receive Dynamic Soft Tissue Mobilization along with baseline taping. Both groups will receive three sessions per week for four weeks.Outcome measures will include the Numerical Pain Rating Scale (NPRS) and Foot Function Index (FFI) to assess pain and functional disability. Assessments will be taken at baseline, 2nd week, and 4th week. Data will be analyzed using SPSS version 24, and both intra-group and inter-group comparisons will be performed using appropriate statistical tests.
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Study Type
Study Type
Enrollment (Actual)
Enrollment
Phase
Phase
- Not Applicable
Contacts and Locations
Study Locations
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Punjab Province
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Lahore, Punjab Province, Pakistan, 54000
- University of Management & Technology
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-
Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria:
Age 25 to 60 years. Presence of unilateral plantar fasciitis. Participants with positive Windlass test. Symptoms more than 6 weeks of duration diagnosed by orthopaedician. Reported pain with the first step out of the bed in the morning or with the first step after prolonged immobilization and presence of heel pain with prolonged standing on the medial calcaneal tubercle plantar aponeurosis confirmed by palpation. both male and female will be included. Pain intensity of ≥3 on the Visual Analog Scale (VAS) or Numeric Pain Rating Scale (NPRS).
Participants willing to provide informed consent and comply with the treatment protocol.
Exclusion Criteria:
Reported previous history of cancer, peripheral vascular diseases, lower extremity fractures Had a trauma or history of surgery to the foot or ankle. Diabetic neuropathy. People who have undergone steroid therapy, platelet rich plasma therapy in the past 3 months.
Severe foot deformities (e.g., severe pes planus or pes cavus) requiring specialized management.
Open wounds, skin infections, or allergies preventing the application of taping.
Presence of inflammatory or systemic diseases such as Rheumatoid Arthritis, Ankylosing Spondylitis, or Gout.
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: Single
Number of Arms
Arms and Interventions
Participant Group / ArmParticipant Group / Arm |
Intervention / TreatmentIntervention / Treatment |
|---|---|
|
Experimental: Active Release Technique (ART)
The patient will sit in a long-sitting position while the therapist assesses muscle and fascial tightness using their hands. The therapist applies specific pressure along the affected tissue from origin to insertion while the muscle is shortened. The patient is then instructed to lengthen the muscle by dorsiflexing the foot. Each session lasts approximately 10 minutes, three times a week for four weeks, along with baseline taping. |
The patient will sit in a long-sitting position while the therapist assesses muscle and fascial tightness using their hands. The therapist applies specific pressure along the affected tissue from origin to insertion while the muscle is shortened. The patient is then instructed to lengthen the muscle by dorsiflexing the foot. Each session lasts approximately 10 minutes, three times a week for four weeks, along with baseline taping. |
|
Active Comparator: Dynamic Soft Tissue Mobilization
The therapist will perform 10 minutes of deep, forceful soft tissue mobilization on tight and painful areas of the posterior calf muscles, applying pressure across the muscle fibers medially and laterally. The patient will also perform a passive straight leg raise combined with ankle dorsiflexion using a long belt to improve neural mobility. |
The therapist will perform 10 minutes of deep, forceful soft tissue mobilization on tight and painful areas of the posterior calf muscles, applying pressure across the muscle fibers medially and laterally. The patient will also perform a passive straight leg raise combined with ankle dorsiflexion using a long belt to improve neural mobility. |
What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Pain by Numerical Rating Scale (NPRS)
Time Frame: At baseline and after 6 weeks
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Numeric Rating Scale (NPRS) is most frequently used instruments to measure pain. The 11-point numeric with 0 representing No pain, 1- 3 representing Mild Pain (nagging, annoying, interfering little with ADLs), 4-6 representing Moderate Pains (interferes significantly with ADLs), 7-10 representing Sever Pain (disabling, unable to perform ADLs). |
At baseline and after 6 weeks
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Disability by Foot Function Index (FFI)
Time Frame: At baseline and after 6 weeks
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The Foot Function Index (FFI) is a widely used patient-reported outcome measure developed to assess the impact of foot pathology on pain, disability, and activity limitation.The questionnaire consists of 23 items divided into three subscales: Pain (9 items), Disability (9 items), and Activity Limitation (5 items). The questions assess foot pain severity and the extent to which foot problems affect daily functional activities such as walking, standing, climbing stairs, and participation in routine activities. |
At baseline and after 6 weeks
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Joint Range of Motion by Goniometer
Time Frame: At baseline and after 6 weeks
|
The patient's knee will be flexed to 30°, with the ankle in the anatomical position. The goniometer axis will be placed near the lateral ankle, with the stationary arm aligned along the fibula and the movable arm along the fifth metatarsal. The examiner will measure both passive and active ankle dorsiflexion using a goniometer. The normal range of ankle dorsiflexion is approximately 15°-20°. |
At baseline and after 6 weeks
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Collaborators and Investigators
Sponsor
Sponsor
Publications and helpful links
Study record dates
Study Major Dates
Study Start (Actual)
Study Start
Primary Completion (Estimated)
Primary Completion
Study Completion (Estimated)
Study Completion
Study Registration Dates
First Submitted
First Submitted
First Submitted That Met QC Criteria
First Submitted That Met QC Criteria
First Posted (Actual)
First Posted
Study Record Updates
Last Update Posted (Actual)
Last Update Posted
Last Update Submitted That Met QC Criteria
Last Update Submitted That Met QC Criteria
Last Verified
Last Verified
More Information
Terms related to this study
Keywords
Other Study ID Numbers
Other Study ID Numbers
- RE-207-2026
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
IPD Plan Description
The results data collected , de-identified individual participant data will be shared.
IPD Sharing Time Frame
6 months after the publication of the manuscript.
IPD Sharing Access Criteria
The data can be requested from the corresponding author.
IPD Sharing Supporting Information Type
- STUDY_PROTOCOL
- SAP
- ICF
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
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