Effect of Graston Technique on Planter Thickness in Patients With Planter Fasciitis (PF)

this study will be conducted to investigate the effect of Graston Technique on Planter Thickness in Patients With Planter Fasciitis

Study Overview

• Status: Not yet recruiting
• Conditions: Plantar Fascitis
• Intervention / Treatment: Other: Garston technique; Other: exercise program

Detailed Description

Plantar fasciitis (PF), generally a self-limiting condition, is identified as one of the most common causes of heel pain in adults. It affects both sedentary and athletic populations .

It may be considered that PF emerges due to excessive and prolonged standing or running, which causes an acute inflammation or micro-tears, and degenerative changes plantar fascia. The persistence of these risk factors inhibits the regular repair process thus collagen degeneration occurs, causing the structural changes of the plantar fascia. Numerous interventions have been described for treatment of PF, which include: Stretching calf or plantar region which is performed with the patient stands with staggered legs facing toward a wall, with both hands stretched out .The Graston technique can break up scar tissue and restore soft tissue. The Graston technique is a type of manual therapy in which patented stainless-steel instruments are used to restore soft tissue motion by breaking up scar tissue. fifty patients with planter fasciitis will be assigned randomly to two equal groups; first one will receive graston technique in addition to exercise program, the second one will receive exercise program only for six weeks

• Study Type: Interventional
• Enrollment (Estimated): 50
• Phase: Not Applicable

Contacts and Locations

• Study Contact: Name: mostafa elshenawy, master; Phone Number: 01124009013; Email: melshenawy584@gmail.com
• Study Contact Backup: Name: mohamed elgendy, professor; Phone Number: 01005747169; Email: prof.mgendy@hotmail.com

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Adult
• Accepts Healthy Volunteers: No

Description

Inclusion Criteria:

• patients that Clinically diagnosed cases of plantar fasciitis not less than 6 weeks.
• patients willing to precipitate in the study and take treatment for 6 successive weeks.
• Heel pain felt maximally over the plantar aspect of heel
• Pain in the heel on the first step in the morning
• No history of rest pain in the heel

Exclusion Criteria:

• Subjects with clinical disorders where therapeutic ultrasound is contraindicated such as infective conditions of foot, tumor, calcaneal fracture, metal implant around ankle.
• Subjects with a clinical disorder where myofascial release is contraindicated as dermatitis.
• Subjects with impaired circulation to lower extremities
• Subjects with referred pain due to sciatica and other neurological disorders.
• Arthritis
• Corticosteroids injection in heel preceding 3 months

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Treatment
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: Double

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: Garston technique; the patients will receive graston technique with exercise program three times aweek for six weeks	Other: Garston technique; the patients will receive instrumented assisted soft tissue mobilization using the Graston technique, which includes the application of a cream to the posterior calf and plantar foot from the knee to the toes to reduce friction on the skin. The Graston tools will be used to mobilize the tissues of the triceps surae and plantar foot bypassing the tools along the leg and foot; Other: exercise program; the patients will receive pedaling an exercise bicycle for 5 min with minimal resistance to warm the tissues, gastrocnemius stretches performed on a step for three repetitions held for 30 sec each , plantar fascia stretching performed in a seated position for three repetitions held for 30 sec each, and foot intrinsic muscular strengthening using a short foot exercise. Ice will be offered as needed for pain management after each session in addition to home program exercise
Active Comparator: exercise program; the patients will receive an exercise program three times a week for six weeks	Other: exercise program; the patients will receive pedaling an exercise bicycle for 5 min with minimal resistance to warm the tissues, gastrocnemius stretches performed on a step for three repetitions held for 30 sec each , plantar fascia stretching performed in a seated position for three repetitions held for 30 sec each, and foot intrinsic muscular strengthening using a short foot exercise. Ice will be offered as needed for pain management after each session in addition to home program exercise

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
plantar thickness	Ultrasonography will be used to measure planter thickness	up to six weeks

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
pain intensity	Visual Analogue Scale (VAS) will be used to assess pain intensity: The VAS is a 100-mm horizontal line that may be used to quantify symptoms in a continuous fashion. Patients will instructed to indicate the intensity of their pain by marking on a line anchored by "no pain" on the left and "worst imaginable pain" on the right .	up to six weeks
pain intensity at the first step	numerical pain rating scale (NPRS) will be used to measure pain intensity at the first step. NPRS is a 10cm horizontal line t. Patients will instructed to indicate the intensity of their pain by marking on a line anchored by "no pain" on the left and "worst imaginable pain" on the right side.	up to six weeks
functional levels of foot	The Foot and Ankle Ability Measure (FAAM) questionnaire will be used to assess foot function. The FAAM is a self-reported questionnaire that comprehensively assesses the physical function of those with musculoskeletal conditions of the leg, foot, and ankle. It has a 21-item subscale for measuring the function of the individual with his or her activities of daily living (ADLs) and a ten-item subscale for measuring function with sports. The ADL subscale will be used for this study. The instrument is scored on a Likert scale from 4 to 0, with 4 representing ''no difficulty'' as going up stairs and 0 representing ''unable to do.'' The answers are then converted to a scale from 0 to 100, with a higher score representing a higher functional level.	up to six weeks
pain pressure threshold	The pressure algometer device will be used to measure pain pressure threshold	up to six weeks

Collaborators and Investigators

• Sponsor: Cairo University

Study record dates

Study Major Dates

• Study Start (Estimated): February 10, 2024
• Primary Completion (Estimated): April 30, 2024
• Study Completion (Estimated): April 30, 2024

Study Registration Dates

• First Submitted: January 31, 2024
• First Submitted That Met QC Criteria: January 31, 2024
• First Posted (Actual): February 8, 2024

Study Record Updates

• Last Update Posted (Actual): February 8, 2024
• Last Update Submitted That Met QC Criteria: January 31, 2024
• Last Verified: January 1, 2024

More Information

Terms related to this study

• Keywords: graston technique; planter thickness; planter fasciitis
• Additional Relevant MeSH Terms: Foot Diseases; Musculoskeletal Diseases; Fasciitis; Fasciitis, Plantar
• Other Study ID Numbers: P.T.REC/012/002947

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No