Effects Of Navicular Mobilization In Patients With Planter Fasciitis

The significance of studying the effects of navicular mobilization in patients suffering from plantar fasciitis lies in its potential to provide valuable insights into non-invasive treatment approaches for a common and debilitating foot condition such as flat foot. Understanding how this therapy impacts navicular height, pain and disability of the foot can lead to improved clinical outcomes and a better understanding of the biomechanical factors contributing to plantar fasciitis. Ultimately, this research may help refine treatment strategies and enhance the quality of life for individuals suffering from this condition

Study Overview

• Status: Completed
• Conditions: Plantar Fascitis
• Intervention / Treatment: Other: navicular mobilization along conventional therapy.; Other: conventional therapy

Detailed Description

The foot is a complex structure comprising numerous bones, muscles, and ligaments that work together to provide support and facilitate movement. It is supported by three arches: the medial longitudinal arch, the lateral longitudinal arch, and the transverse arch. The medial longitudinal arch plays a crucial role in absorbing weight, but issues like ligament laxity and muscle weakness can cause it to shorten, leading to conditions like plantar fasciitis. Plantar fasciitis, a common overuse injury, occurs when the plantar fascia, a fibrous tissue that supports the arch of the foot, becomes inflamed due to repetitive strain, especially during activities that increase its stretch, such as barefoot walking or stair climbing. People with flat feet are more susceptible to plantar fasciitis due to the overstretching of the plantar fascia caused by the lack of arch support.

Navicular drop, a measure of the navicular bone height, also plays a significant role in foot biomechanics and the development of plantar fasciitis. High navicular height leads to increased foot pronation and tension on the plantar fascia, while low navicular height causes overpronation and arch collapse, both of which can result in inflammation of the plantar fascia. Physiotherapists use techniques like navicular mobilization to address issues related to the navicular bone and improve blood circulation, healing, and pain relief in cases of plantar fasciitis. By understanding the biomechanics of the foot and employing targeted interventions, healthcare professionals can help manage and prevent conditions like plantar fasciitis, allowing individuals to maintain optimal foot health and functionality.

• Study Type: Interventional
• Enrollment (Actual): 32
• Phase: Not Applicable

Contacts and Locations

Study Locations

• Pakistan
  • Punjab
    • Faisalābad, Punjab, Pakistan
      • DHQ Hospital

Participation Criteria

Eligibility Criteria

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

Description

Inclusion Criteria:

• Plantar fasciitis with flat foot.
• Positive Flat foot cases diagnosed with foot print measurement.
• Unilateral or bilateral involvement with chronic plantar fasciitis
• Diagnosed case of plantar fasciitis will be taken with navicular drop.
• Navicular Drop (ND) of > 10mm

Exclusion Criteria:

• Patients with Peripheral vascular diseases.
• Patients with History of fractures in the lower limb
• Patients with Skin infections and wounds on the foot
• Patients with any neurological deficit involving foot.
• Patients with a history of foot or ankle surgery.

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Treatment
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: None (Open Label)

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: navicular mobilization along with conventional therapy.; In the prone position, when the foot is stabilized by a towel underneath, navicular mobilization is administered. The therapist's fixing hand wraps the calcaneus, grasps the talus bone, and fixes it. By placing the thumb on the plantar surface of the foot and pushing with the thumb of the other hand in a dorsal direction, navicular mobilization is provided. This dorsal glide will be given with 2 sets of 5 minutes. Each session will be of 30 minutes.	Other: navicular mobilization along conventional therapy.; In the prone position, when the foot is stabilized by a towel underneath, navicular mobilization is administered. The therapist's fixing hand wraps the calcaneus, grasps the talus bone, and fixes it. By placing the thumb on the plantar surface of the foot and pushing with the thumb of the other hand in a dorsal direction, navicular mobilization is provided. This dorsal glide will be given with 2 sets of 5 minutes. Each session will be of 30 minutes.
Other: conventional therapy; ultrasound therapy at 1.5 w/cm2 for 7 minutes in continuous mode at a 3MHz frequency. Stretching targets the medial arch and surrounding muscles like calf and tibialis posterior with exercises such as arch lift, heel raise, towel pickup, and toe lift. Additionally, strengthening exercises for intrinsic foot muscles like standing toe curls and towel toe curls are included. Ice pack application for 10 minutes follows	Other: conventional therapy; ultrasound therapy at 1.5 w/cm2 for 7 minutes in continuous mode at a 3MHz frequency. Stretching targets the medial arch and surrounding muscles like calf and tibialis posterior with exercises such as arch lift, heel raise, towel pickup, and toe lift. Additionally, strengthening exercises for intrinsic foot muscles like standing toe curls and towel toe curls are included. Ice pack application for 10 minutes follows

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Numeric Pain Rating Scale	The Numerical Pain Rating Scale (NPRS) is a subjective measure in which individuals rate their pain on an eleven-point numerical scale. The scale is composed of 0 (no pain at all) to 10 (worst imaginable pain). According to researches NPRS shows excellent reliability (0.97 and 0.99, respectively) for the measurement of musculoskeletal pain	four weeks
(Foot Function Index)	Foot function index is a questionnaire used to assess pathological impact on foot with respect to disability, limitations of activity and pain. It consists of 23 questions which are sub divided into three sub scales. These three sub scales are pain, activity limitation and disability.(19) It's scoring is done by adding these scales which range is from 0 to 100. Minimum score is 0 and maximum is 100. Where 0 shows no pain and 100 shows worst pain.	four weeks
Navicular drop test	Navicular drop test is used to measure static foot assessment in Sagittal plane of navicular tuberosity in neutral state. The tuberosity of the navicular bone is measured in neutral position, relaxed and stance position. Supinated foot showed less than 5mm, neutral foot shows range from 6 to 8mm or 5 to 9mm and pronated foot shows reading from greater than 10 to 15 or greater than 9mm.	four weeks
Foot print analysis	In this technique, participants created footprints on paper while standing, submerged clean feet a normal foot, while SPI > 1.15 denotes a flat foot. (22) The correlation test and intraclass correlation coefficient showed that I was a valid and reliable in diagnosing flatfoot (0.427, 0.446).	four weeks

Collaborators and Investigators

• Sponsor: Riphah International University
• Investigators: Principal Investigator: Maria khalid, MSOMPT, Riphah International University

Study record dates

Study Major Dates

• Study Start (Actual): April 2, 2024
• Primary Completion (Actual): June 10, 2024
• Study Completion (Actual): July 1, 2024

Study Registration Dates

• First Submitted: April 18, 2024
• First Submitted That Met QC Criteria: April 18, 2024
• First Posted (Actual): April 22, 2024

Study Record Updates

• Last Update Posted (Actual): July 23, 2024
• Last Update Submitted That Met QC Criteria: July 22, 2024
• Last Verified: July 1, 2024

More Information

Terms related to this study

• Keywords: Flat Foot; Planter Fasciitis; Foot Navicular bone; Mobilization,
• Additional Relevant MeSH Terms: Foot Diseases; Musculoskeletal Diseases; Fasciitis; Fasciitis, Plantar
• Other Study ID Numbers: REC 01801 Kainat Fatima

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO

Drug and device information, study documents

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