Cognitive Training for Pain , Balance and Foot Function in Plantar Fasciitis (COG-PLANT)

Effect of Cognitive Training on Pain , Foot Function, and Balance in Patients With Planter Fasciitis : A Randomized Controlled Trial

This randomized controlled trial aims to compare the effects of cognitive training exercises versus stretching and strengthening exercises on pain, functional dilatability, and static balance. Participants will be assigned to two groups: a cognitive training group or a stretching and strengthening exercise group. The cognitive training group will perform exercises targeting cognitive and neuromuscular control plus stretching and strengthening exercise , while the control group will perform stretching and strengthing exercises only. Outcome measures will include pain intensity, foot functional disability , and static balance. The results of this study will provide evidence regarding the effectiveness of cognitive training with stretching and strengthing exercises compared to stretching and strengthIng only exercises in improving musculoskeletal function and balance.

Study Overview

• Status: Recruiting
• Conditions: Planter Fasciitis
• Intervention / Treatment: Behavioral: cognitive training; Behavioral: stretching and strengthing exercises

Detailed Description

and impaired balance. It is characterized by degeneration of the plantar fascia due to repetitive stress, leading to pain, especially during weight-bearing activities. In addition to local tissue pathology, alterations in neuromuscular control and sensorimotor function may contribute to persistent symptoms and functional limitations.

Recent approaches in rehabilitation have highlighted the role of cognitive training in enhancing motor control, attention, and sensorimotor integration. Cognitive training, particularly when combined with movement tasks (dual-task training), may improve postural control and functional performance by optimizing central nervous system processing. However, there is limited evidence regarding its effectiveness in patients with plantar fasciitis.

This randomized controlled trial aims to investigate the effect of cognitive training on pain intensity, functional disability, and static balance in individuals with plantar fasciitis. Participants will be randomly assigned into two groups. The experimental group will receive a cognitive training program incorporating attention-demanding and dual-task exercises integrated with functional movements plus stretching and strengthing exercises . The control group will perform a conventional stretching and strengthing exercise program targeting the plantar fascia and related lower limb musculature.

Outcome measures will include pain intensity, functional disability, and static balance. Assessments will be conducted at baseline and after completion of the intervention period.

The results of this study are expected to provide evidence on the effectiveness of cognitive training as a rehabilitation approach for improving pain, functional outcomes, and balance in patients with plantar fasciitis.

• Study Type: Interventional
• Enrollment (Estimated): 80
• Phase: Not Applicable

Contacts and Locations

• Study Contact: Name: Sahar M Abdelmutilibe, PHD; Phone Number: N/P 0021027620061; Email: sahar.mowad@pt.bsu.edu.eg

Study Locations

• Egypt
  • Cairo, Egypt
    • Recruiting
    • Outpatient clinics of the Faculty of Physical Therapy, Beni Suef University
    • Contact: Sahar M Abdelmutilibe, PHD; Phone Number: N/P 0021027620061; Email: sahar.mowad@pt.bsu.edu.eg
    • Contact: sahar m abdelmutilibe, PHD; Phone Number: N/P 0021110374341; Email: saharmowad04@gmail.com

Participation Criteria

Eligibility Criteria

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

Description

Inclusion Criteria:

• Adults aged 18 to 60 years. Clinically diagnosed with plantar fasciitis by a physician or physiotherapist. Experiencing heel pain for at least 4 weeks. Ability to stand and perform basic functional and balance tests. Willingness to participate and provide informed consent. Not currently receiving other structured physical therapy or cognitive training programs during the study period.

Exclusion Criteria:

• History of lower limb surgery or fractures affecting the foot or ankle. Presence of neurological disorders affecting balance or motor control (e.g., stroke, Parkinson's disease).

Systemic inflammatory or rheumatologic conditions (e.g., rheumatoid arthritis). Severe musculoskeletal deformities of the lower limb or foot. Recent corticosteroid injection in the heel region within the last 3 months. Current participation in other structured rehabilitation or exercise programs. Pregnancy (if applicable due to balance and biomechanical changes). Inability to understand or follow instructions related to the intervention.

Study Plan

How is the study designed?

Design Details

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

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: Cognitive Training Group; Participants in this group will receive a structured cognitive training program integrated with functional movement tasks. The training will focus on improving attention, motor control, and sensorimotor integration through dual-task and task-oriented exercises designed to enhance postural control and functional stability. Sessions will be conducted over the intervention period with progressive difficulty based on participant performance.	Behavioral: cognitive training; Participants will receive a structured cognitive training program incorporating dual-task and task-oriented exercises. The intervention focuses on enhancing attention, motor planning, and sensorimotor integration during functional activities. Exercises are progressively advanced based on participant performance to improve postural control and functional stability.; Behavioral: stretching and strengthing exercises; Participants will perform a standardized stretching and strengthing program targeting the plantar fascia and associated lower limb muscles. The intervention consists of static stretching exercises aimed at improving tissue flexibility, reducing muscle tightness, and supporting pain reduction. Exercises will be performed in a controlled and consistent manner throughout the study period.
Experimental: stretching and strengthing exercises; Participants in this group will receive a conventional stretching and strengthing exercise program targeting the plantar fascia and related lower limb muscles. The exercises will focus on improving flexibility and reducing tissue tightness. Stretching will be performed in a standardized manner over the intervention period.	Behavioral: stretching and strengthing exercises; Participants will perform a standardized stretching and strengthing program targeting the plantar fascia and associated lower limb muscles. The intervention consists of static stretching exercises aimed at improving tissue flexibility, reducing muscle tightness, and supporting pain reduction. Exercises will be performed in a controlled and consistent manner throughout the study period.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Pain by VAS	Pain intensity will be assessed using the Visual Analogue Scale (VAS), a 10 cm scale ranging from 0 (no pain) to 10 (worst imaginable pain). Participants will be asked to rate their current level of heel pain.	at baseline and post treatment (4 weeks)
functional disability	Functional disability will be assessed using the Foot Function Index (FFI), which evaluates pain, disability, and activity limitation in individuals with foot disorders. Higher scores indicate greater disability.	at baseline and post treatment (4 weeks)
static balance	Static balance will be assessed using a standardized balance test (e.g., single-leg stance test). Participants will be evaluated based on their ability to maintain a stable posture for a specified duration under controlled conditions.	at baseline and post treatment ( 4 weeks)

Collaborators and Investigators

• Sponsor: Beni-Suef University
• Investigators: Principal Investigator: Sahar M Abdelmutilibe, PHD, Faculty of Physical Therapy, Beni Suef University, Cairo, Egypt

Study record dates

Study Major Dates

• Study Start (Actual): February 3, 2026
• Primary Completion (Estimated): May 4, 2026
• Study Completion (Estimated): May 25, 2026

Study Registration Dates

• First Submitted: April 30, 2026
• First Submitted That Met QC Criteria: April 30, 2026
• First Posted (Actual): May 6, 2026

Study Record Updates

• Last Update Posted (Actual): May 6, 2026
• Last Update Submitted That Met QC Criteria: April 30, 2026
• Last Verified: April 1, 2026

More Information

Terms related to this study

• Keywords: cognitive training; stretching exercises; Plantar Fasciitis; Heel Pain; strengthIng exercises
• Additional Relevant MeSH Terms: Musculoskeletal Diseases; Foot Diseases; Fasciitis; Fasciitis, Plantar; Therapeutics; Patient Care; Health Services; Health Care Facilities Workforce and Services; Rehabilitation; Aftercare; Continuity of Patient Care; Neurological Rehabilitation; Cognitive Training
• Other Study ID Numbers: FPTBSURE/0112/15426 (Registry Identifier: faculty of physical therapy , Beni- Suef University)

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO
• IPD Plan Description: Individual participant data will not be shared due to privacy and confidentiality considerations. Data may be available upon reasonable request from the principal investigator and in accordance with institutional regulations.

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No
• product manufactured in and exported from the U.S.: No