Navicular Mobilization in Patients of Planter Fasciitis

April 15, 2026 updated by: University of Lahore

Navicular Mobilization With and Without Conventional Physical Therapy in Patients of Planter Fasciitis

The study will be randomised clinical trial. This study will be conducted at the University of Lahore Teaching Hospital, Lahore, Pakistan. A sample size of 48 will be randomly allocated into two experimental groups, (24 participants in each group), by using sealed envelope method. All the screened and willing participants were randomly allocated into two groups. Group A will be given navicular mobilization and group B will be given conventional therapy with navicular mobilization. Treatment will be given for 4 weeks 4 sessions/ week with total of 16 sessions. Assessment to be taken at baseline, 2nd week and 4th week. The participants randomly allocated in Group A will receive navicular mobilization. In navicular mobilization, Subject- prone lying, Therapist- standing on tested side. 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. Four sessions will be given per week for 4 weeks. The participants randomly allocated in Group B will receive conventional physical therapy with navicular mobilization. In navicular mobilization, Subject- prone lying, Therapist- standing on tested side. 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. In Conventional therapy, ultrasound with an output of 1.5 w/cm2 for 7 minutes using a continuous mode with a frequency of 3MHz, stretching of planter fascia, strengthening of medial arch and foot surround muscles such as calf and tibialis posterior will be done by doing exercises like arch lift, heel raise, towel pickup, toe lift, strengthening exercises for intrinsic foot muscles, standing toe curls, towel toe curls and Ice pack for 10 minutes .These exercises will be performed in a set of 3 with 12 repetitions in each set in one session. This treatment session will be of 30 minutes and will be give 4 session per week for 4 weeks.

Study Overview

Status

Active, not recruiting

Detailed Description

• Screening: Participants who meet the inclusion criteria will be recruited using a convenient sampling technique. This involves selecting participants who are readily available and willing to participate in the study.

• Allocation: Eligible participants will be screened and informed about the study including its purpose, procedures, potential risks and benefits. Informed consent will be obtained from each participant prior to their formal enrolment in the study.

• Randomization: Following the baseline assessment, the randomization was conducted using the Online Randomizer tool (https://www.randomizer.org/). By specifying the group numbers, participants per group, and the total participants, unique identification numbers were generated for each participant.

• Blindness: This study a single blinded, the patients were kept blinded about the study.

• Intervention Group A: The participants randomly allocated in Group A will receive navicular mobilization. In navicular mobilization, Subject- prone lying, Therapist- standing on tested side. 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. Four sessions will be given per week for 4 weeks.

Group B: The participants randomly allocated in Group B will receive conventional physical therapy with navicular mobilization. In navicular mobilization, Subject- prone lying, Therapist- standing on tested side. 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. In Conventional therapy, ultrasound with an output of 1.5 w/cm2 for 7 minutes using a continuous mode with a frequency of 3MHz, stretching of planter fascia, strengthening of medial arch and foot surround muscles such as calf and tibialis posterior will be done by doing exercises like arch lift, heel raise, towel pickup, toe lift, strengthening exercises for intrinsic foot muscles, standing toe curls, towel toe curls and Ice pack for 10 minutes .These exercises will be performed in a set of 3 with 12 repetitions in each set in one session. This treatment session will be of 30 minutes and will be give 4 session per week for 4 weeks.

Outcome Variables:

  1. Pain (Numeric Pain Rating Scale)
  2. Disability (Foot Function Index)
  3. Navicular height drop (Navicular drop test)

Study Type

Interventional

Enrollment (Estimated)

48

Phase

  • Not Applicable

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Locations

    • Punjab Province
      • Lahore, Punjab Province, Pakistan, 55150
        • University of Lahore Teaching Hospital

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

  • Adult

Accepts Healthy Volunteers

No

Description

Inclusion Criteria:

  • Participants between 18 to 32 years of age.
  • Plantar fasciitis with flat foot.
  • Positive Flat foot cases diagnosed with foot print measurement
  • Both males and females
  • 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

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

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

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
Experimental: Navicular Mobilization
In navicular mobilization, Subject- prone lying, Therapist- standing on tested side. 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.
In navicular mobilization, Subject- prone lying, Therapist- standing on tested side. 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.
In Conventional therapy, ultrasound with an output of 1.5 w/cm2 for 7 minutes using a continuous mode with a frequency of 3MHz, stretching of planter fascia, strengthening of medial arch and foot surround muscles such as calf and tibialis posterior will be done by doing exercises like arch lift, heel raise, towel pickup, toe lift, strengthening exercises for intrinsic foot muscles, standing toe curls, towel toe curls and Ice pack for 10 minutes .
Experimental: Conventional physical therapy + Navicular Mobilization
In Conventional therapy, ultrasound with an output of 1.5 w/cm2 for 7 minutes using a continuous mode with a frequency of 3MHz, stretching of planter fascia, strengthening of medial arch and foot surround muscles such as calf and tibialis posterior will be done by doing exercises like arch lift, heel raise, towel pickup, toe lift, strengthening exercises for intrinsic foot muscles, standing toe curls, towel toe curls and Ice pack for 10 minutes.In navicular mobilization, Subject- prone lying, Therapist- standing on tested side. 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.
In navicular mobilization, Subject- prone lying, Therapist- standing on tested side. 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.
In Conventional therapy, ultrasound with an output of 1.5 w/cm2 for 7 minutes using a continuous mode with a frequency of 3MHz, stretching of planter fascia, strengthening of medial arch and foot surround muscles such as calf and tibialis posterior will be done by doing exercises like arch lift, heel raise, towel pickup, toe lift, strengthening exercises for intrinsic foot muscles, standing toe curls, towel toe curls and Ice pack for 10 minutes .

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Foot Function Index
Time Frame: Baseline, 3rd week, 6th week
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. 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. During the initial administration of the questionnaire, Cronbach's alpha was determined to be = 0.78 for the FFI total score while the subscales ranged from 0.80 to 0.61
Baseline, 3rd week, 6th week
Numeric Pain Rating Scale
Time Frame: Baseline, 3rd week, 6th week
Numeric rating scales consist of a series of numbers rating pain intensity, typically from 0 to 10 or with 0 being "no pain" and 10 "the worst pain imaginable."
Baseline, 3rd week, 6th week
Navicular drop test
Time Frame: Baseline, 3rd week, 6th week
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. All testers' measurements of showed high levels of intra- and inter-rater reliability (ICC = 0.83 to 0.95) of navicular drop test.
Baseline, 3rd week, 6th week

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Investigators

  • Principal Investigator: Asim Arif, Phd scholar, University of Lahore

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Actual)

June 30, 2025

Primary Completion (Estimated)

April 15, 2026

Study Completion (Estimated)

April 15, 2026

Study Registration Dates

First Submitted

December 30, 2025

First Submitted That Met QC Criteria

April 15, 2026

First Posted (Actual)

April 22, 2026

Study Record Updates

Last Update Posted (Actual)

April 22, 2026

Last Update Submitted That Met QC Criteria

April 15, 2026

Last Verified

August 1, 2025

More Information

Terms related to this study

Other Study ID Numbers

  • UOL/IREB/25/09/0049

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

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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