Effects of Deep Transverse Friction Massage and Instrument Assisted Soft Tissue Mobilization in Plantar Fasciitis.

Comparative Effects of Deep Transverse Friction Massage and Instrument Assisted Soft Tissue Mobilization Techniques on Pain Intensity, Disability and Functional Capacity in Plantar Fasciitis.

The objective of study is to compare the pain intensity, disability and functional capacity by Deep Transverse Friction Massage and Instrument Assisted Soft Tissue Mobilization Techniques in patients with plantar fasciitis.

Study Overview

• Status: Recruiting
• Conditions: Plantar Fascitis
• Intervention / Treatment: Other: DEEP TRANSVERSE FRICTION MASSAGE; Other: INSTRUMENT ASSISTED SOFT TISSUE MOBILIZATION TECHNIQUES

Detailed Description

This randomized clinical trial will be conducted at Ghurki Trust and Teaching Hospital and Jinnah Hospital, Lahore. The study will target pregnant females aged 18 to 40 years who are clinically diagnosed with plantar fasciitis using the Windlass test. Exclusion criteria include a history of ankle or foot fracture or surgery within the past six months, as well as any neurological deficits. A total of 52 participants will be recruited using the non-probability convenience sampling technique and randomly assigned into two equal groups. Participants in both groups will receive the same baseline treatment. Group A will receive Deep Transverse Friction Massage (DTFM), while Group B will receive Instrument Assisted Soft Tissue Mobilization Techniques (IASTMT). The study aims to compare the effectiveness of these two manual therapy techniques on pain intensity, disability, and functional capacity. The Numeric Pain Rating Scale (NPRS) will be used to assess pain levels. Disability will be evaluated using the Foot Function Index (FFI), and the 6-Minute Walk Test (6MWT) will be employed to measure functional capacity. Data collected from participants will be entered and statistically analyzed using SPSS version 21 to determine the comparative effectiveness of the two treatment approaches in managing plantar fasciitis during pregnancy.

• Study Type: Interventional
• Enrollment (Estimated): 52
• Phase: Not Applicable

Contacts and Locations

• Study Contact: Name: imran amjad; Phone Number: 03324390125; Email: imran.amjad@riphah.edu.pk

Study Locations

• Pakistan
  • Punjab Province
    • Lahore, Punjab Province, Pakistan, 6400
      • Recruiting
      • Riphah medical center
      • Contact: sobia ghafoor, MSPT-OM; Phone Number: 03214979172; Email: Sobia.physio@gmail.com
      • Principal Investigator: Barera Fatima, MSPT(WH)

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Adult
• Accepts Healthy Volunteers: Yes

Description

Inclusion Criteria:

• Pregnant females Second trimester 12th to 34th week
• Multiparous
• Plantar fasciitis diagnoses with Windlass test
• NPRS pain level 3 to 7

Exclusion Criteria:

• History of ankle and foot fractures

• Surgery in previous 6 months

  • Neurologic deficit High risk pregnancy
• Previous manual therapy interventions for the foot region
• Those who previously received systemic or local steroid injection within 3 months or locally injected with any other material
• Dermatological disease i.e; injury, trauma, foot ulcer over the foot

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: DEEP TRANSVERSE FRICTION MASSAGE; Deep friction massage (DFM), also known as cross friction massage, is a specific connective tissue massage	Other: DEEP TRANSVERSE FRICTION MASSAGE; 12 sessions total (approx.1 and half month) and 2 sessions per week with mild to moderate manual pressure. 15 - 20 min per session will be given to patient for 6 weeks
Experimental: INSTRUMENT ASSISTED SOFT TISSUE MOBILIZATION TECHNIQUES; ASTM techniques involve the use of specialized instruments to manipulate soft tissue structures. These instruments are designed to provide an efficient detection of soft tissue dysfunction and accurate application of force during treatment.	Other: INSTRUMENT ASSISTED SOFT TISSUE MOBILIZATION TECHNIQUES; • 12 sessions total, (approximately 1 and half month) and 2 sessions per week. Low to moderate pressure with tool will applied for 15 - 20 min per session for 6 weeks

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Numeric Pain Rating Scale (NPRS)	The Numeric Pain Rating Scale (NPRS) was employed to evaluate pain intensity for all participants in both groups prior to and following the 8-week intervention program. This is 11-point (0-10) self-reporting tool is presented as a 10-cm horizontal line where 0 indicates no pain, 1-3 signifies mild pain, 4-6 represents moderate pain, and 7-10 denotes severe pain. The maximum value corresponds to the worst pain, while the minimum value indicates the absence of pain.	6th week
Foot Function Index (FFI)	A Foot Function Index (FFI) was developed to measure the impact of foot pathology on function in terms of pain, disability and activity restriction. The FFI is a self-administered index consisting of 23 items divided into 3 sub-scales. Both total and sub-scale scores are produced.	6th week
6 min walk test (6MWT)	used to determine functional ability. The individual walked swiftly for six minutes along a 100-foot hallway, recording the distance travelled in total. If a person with plantar fasciitis has pain or discomfort in the foot during the test, it can suggest the presence of the condition. During the 6-minute walk test, look for indicators of plantar fasciitis as follows.	6th week

Collaborators and Investigators

• Sponsor: Riphah International University
• Investigators: Principal Investigator: sobia ghafoor, MSPT-OM, Riphah International University

Publications and helpful links

General Publications

• Sahr ME, Grünebaum A, Positano RC, Nwawka OK, Chervenak FA, Positano RG. Common foot and ankle disorders in pregnancy: the role of diagnostic ultrasound. Journal of perinatal medicine. 2024;52(7):674-87
• Foraldy J, Jehosua S, Momole A, Tumewah R, Runtuwene T, Wariki WMV. Plantar Fascia Thickness Difference Between Pregnant and Nulliparous in Indonesia. Journal of Medical Ultrasound. 2024;32(4):323-8.
• Khairy E, Esmail A, Amin FS, Qudahh MA, Zahran MR. Integrated Neuromuscular Inhibition Technique versus Instrument Assisted Soft Tissue Mobilization in Patients with Chronic Plantar Fasciitis. Egyptian Journal of Hospital Medicine. 2024;96(1):2570-7.
• Pisirici P, Cil ET, Coskunsu DK, Saylı U, Subasi F. Extracorporeal shockwave therapy versus graston instrument-assisted soft-tissue mobilization in chronic plantar heel pain: a randomized controlled trial. Journal of the American Podiatric Medical Association. 2022;112(6).
• Gala M, Kulkarni P, Kumar A. Comparison of immediate effect of plantar fascia release by roller massager and transverse friction massage on hamstring flexibility in desk job workers. Int J Physiother Res. 2021;9:3954-9.

Study record dates

Study Major Dates

• Study Start (Actual): October 1, 2025
• Primary Completion (Estimated): June 1, 2026
• Study Completion (Estimated): July 1, 2026

Study Registration Dates

• First Submitted: May 4, 2026
• First Submitted That Met QC Criteria: May 4, 2026
• First Posted (Actual): May 8, 2026

Study Record Updates

• Last Update Posted (Actual): May 8, 2026
• Last Update Submitted That Met QC Criteria: May 4, 2026
• Last Verified: May 1, 2026

More Information

Terms related to this study

• Keywords: friction; massage; Plantar Fascitis; Pain Measurement
• Other Study ID Numbers: REC/RCR & AHS/25/0501

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