Relationship Between Central Sensitization and Clinical Features in Plantar Fasciitis
2026年6月5日 更新者：Feyza Nur Yucel、Sultan Abdulhamid Han Training and Research Hospital, Istanbul, Turkey
IInvestigation of the Relationship Between Central Sensitization and Clinical, Functional, and Ultrasonographic Parameters In Plantar Fasciitis
Plantar fasciitis is a common cause of heel pain and is traditionally considered a mechanical musculoskeletal disorder.
Recent evidence suggests that central sensitization may also contribute to pain in individuals with plantar fasciitis.
This study aims to investigate the relationships between neurophysiological variables (pressure pain threshold, central sensitization, and pain intensity), psychological factors (pain catastrophizing, kinesiophobia, anxiety, and depression), ultrasonographic findings (plantar fascia thickness), and functional outcomes (foot function and quality of life) in patients with plantar fasciitis.
調査の概要
詳細な説明
Heel pain caused by plantar fasciitis is one of the common reasons for visits to Physical Medicine and Rehabilitation outpatient clinics.
Plantar fasciitis is characterized by throbbing medial plantar heel pain that occurs especially with the first step in the morning or after long periods of rest and is a musculoskeletal disorder.
The diagnosis of plantar fasciitis is usually determined clinically.
In ultrasound, findings such as thickening of the plantar fascia and hypoechogenicity in the fascia are advantageous in diagnosis.
Although the mechanical aspect of pain has often been emphasized in the treatment of plantar fasciitis, recent studies have gained momentum in suggesting that central sensitization is also among the pain mechanisms of plantar fasciitis.
In addition, as with many chronic musculoskeletal pains, the role of psychological factors such as kinesiophobia, catastrophizing pain, depressive symptoms, and anxiety has been investigated in plantar fasciitis.
However, data on the relationship between factors such as pressure pain sensitivity, central sensitization, catastrophizing pain, and kinesiophobia in plantar fasciitis are limited.
The aim of this study is to contribute to the increasing literature in this field by investigating the relationship between psychological (catastrophizing pain, kinesiophobia, anxiety, and depression), ultrasonographic findings (plantar fascia thickness), and functional status (foot functional index, quality of life) variables with neurophysiological (pressure pain threshold, central sensitization, pain) variables in plantar fasciitis.
研究の種類
観察的
入学 (推定)
128
連絡先と場所
このセクションには、調査を実施する担当者の連絡先の詳細と、この調査が実施されている場所に関する情報が記載されています。
研究連絡先
- 名前：Feyza Nur Yücel, Assoc. Prof.
- 電話番号：+90 2165422000
- メール：dr.fny28@gmail.com
研究場所
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Istanbul、トルコ（Türkiye）
- 募集
- Sultan Abdulhamid Han Training and Research Hospital
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コンタクト：
- Feyza Nur Yücel
- 電話番号：0216 542 20 00
- メール：dr.fny28@gmail.com
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-
参加基準
研究者は、適格基準と呼ばれる特定の説明に適合する人を探します。これらの基準のいくつかの例は、人の一般的な健康状態または以前の治療です。
適格基準
就学可能な年齢
- 大人
- 高齢者
健康ボランティアの受け入れ
はい
サンプリング方法
非確率サンプル
調査対象母集団
Individuals applying to the Physical Medicine and Rehabilitation Outpatient Clinic of Sultan 2. Abdülhamid Han Training and Research Hospital will be evaluated, and those who meet the inclusion criteria for the groups and sign the voluntary consent form will be included in the study.
説明
Plantar Fasciitis Group
Inclusion criteria
- Be between the ages of 18-65
- Have unilateral heel pain that has been ongoing for at least 3 months, particularly worsening with the first few steps in the morning and increasing with weight-bearing activities throughout the day
- Have tenderness on palpation of the medial calcaneal tubercle
- Have read and signed the volunteer consent form (VCF)
Exclusion criteria
- Being under 18 years old or over 65 years old
- Having a history of physical therapy, injection, radiation, or surgery targeting the plantar fascia within the last 6 months
- Calcaneus fracture, tumor, or cyst related to the plantar fascia
- Foot deformity (club foot, pes cavus, calcaneovalgus, etc.)
- Lumbosacral radiculopathy, tarsal tunnel syndrome, peripheral neuropathy
- Rheumatic diseases such as rheumatoid arthritis, ankylosing spondylitis, gout
- Foot and ankle osteoarthritis
- Presence of osteomyelitis or skin infection in the foot
- Systemic diseases such as kidney and liver failure, diabetes, peripheral arterial vascular disease
Healthy Control
Inclusion criteria
- Being completely healthy
- Being between the ages of 18 - 65
- Having read and signed the volunteer consent form (BGOF)
Exclusion criteria
- Being under 18 or over 65 years old
- Having any acute or chronic illness
- Being illiterate and not giving consent to participate in the study
研究計画
このセクションでは、研究がどのように設計され、研究が何を測定しているかなど、研究計画の詳細を提供します。
研究はどのように設計されていますか？
デザインの詳細
コホートと介入
グループ/コホート |
介入・治療 |
|---|---|
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Plantar fasciitis group
Participants with clinically diagnosed plantar fasciitis.
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Pressure pain threshold measurements will be performed using a pressure algometer to assess pain sensitivity.
Ultrasonographic evaluation will be performed to measure plantar fascia thickness and assess plantar fascia morphology.
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Healthy Volunteers (control group)
Age- and sex-matched healthy adults without plantar fasciitis.
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Pressure pain threshold measurements will be performed using a pressure algometer to assess pain sensitivity.
Ultrasonographic evaluation will be performed to measure plantar fascia thickness and assess plantar fascia morphology.
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この研究は何を測定していますか？
主要な結果の測定
結果測定 |
メジャーの説明 |
時間枠 |
|---|---|---|
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Forearm Pressure Pain Threshold (PPT)
時間枠：Baseline
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Pressure pain threshold is defined as the minimal pressure level that causes pain. The measurement will be applied twice for each region with a 1-minute interval, and the average of these applications will be recorded. A trial test will be conducted on the patient before the actual test. Pressure will be applied to selected points with a pressure algometer until pain is induced, and the test for that area will be terminated when the patient feels pain. The measurement will be taken from the calcaneus bone (the starting point of the plantar fascia) and from the forearm, which is a distant, painless, and unrelated area, using the Wagner manual pressure algometer (1 cm² probe-10 kg/20 lb). The reliability of the measurement in these areas has been demonstrated. |
Baseline
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二次結果の測定
結果測定 |
メジャーの説明 |
時間枠 |
|---|---|---|
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Numeric Pain Rating Scale, NPRS
時間枠：Baseline
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Pain severity will be evaluated using a scale rated from 0 (no pain) to 10 (unbearable pain).
Participants will be asked to rate the pain felt with the first step after waking up in the morning and the average pain level over the past week.
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Baseline
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Short Form-12 (SF-12)
時間枠：Baseline
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Physical Component Summary and Mental Component Summary
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Baseline
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Foot Function Index
時間枠：Baseline
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The Foot Function Index is a self-report-based scale developed to evaluate the effects of foot and ankle-related problems on pain, functional limitation, and daily life activities in individuals, with its validity and reliability demonstrated.
AFI consists of three sub-dimensions: pain, disability (functional limitation), and activity limitation.
The scale allows individuals to evaluate foot-related problems they have experienced recently in the context of daily life activities.
Each sub-dimension and total score reflect the level of impairment in foot functions.
Increasing AFI scores indicate that the severity of foot pain and the limitations in foot functions have increased, thereby negatively affecting foot-related quality of life.
AFI is widely used in clinical and research settings to evaluate the functional effects of foot pathologies.
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Baseline
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Pain Catastrophizing Scale
時間枠：Baseline
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It is a valid and reliable self-report scale developed to assess individuals' exaggerated negative thoughts and emotional responses toward their pain experience.
The scale measures cognitive and emotional responses that occur during or following pain and consists of three sub-dimensions: rumination (excessive focus on pain), magnification (exaggeration of the threatening consequences of pain), and helplessness.
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Baseline
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Tampa Scale for Kinesiophobia
時間枠：Baseline
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It is a valid and reliable self-report scale developed to assess individuals' fear and avoidance behaviors toward movement and physical activity.
The scale measures the level of fear of movement (kinesiophobia) that develops based on the belief that pain will reoccur or worsen.
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Baseline
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Central Sensitization Inventory
時間枠：Baseline
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The central sensitization scale is a tool used to assess the hypersensitivity of the central nervous system.
This scale includes questions that examine individuals' pain perception and its effects on daily life to detect the effects of central sensitization, which are generally observed in chronic pain conditions.
The scale evaluates how individuals perceive pain in response to physical contact or other stimuli (pain sensitivity), changes in their sensitivity to heat, cold, or pressure (sensory changes), how the persistence of pain affects their daily activities, and the impact of pain on their emotional state (anxiety, depression, etc.).
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Baseline
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Thickness of the plantar fascia in ultrasonographic imaging
時間枠：Baseline
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In the study, the evaluation with ultrasound will be conducted while the participants are in a prone position on the examination table, with their feet hanging off the table and in a dorsiflexed position.
A linear probe will be placed longitudinally over the medial tubercle of the calcaneus to ultrasonographically examine the plantar fascia thickness (PFT).
PFK will be measured 1 cm distal to the calcaneus attachment point.
A PFK of 4 mm or greater will be considered evidence of fasciitis.
It has been shown that this measurement technique has good intra-rater reliability.
The Sonosite M-Turbo device will be used for ultrasonography and will be performed by a physical therapy and rehabilitation specialist with 10 years of experience.
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Baseline
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Hospital Anxiety and Depression Scale
時間枠：CROSS-SECTIONAL
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It is a 14-item self-report scale that quickly, reliably, and independently of medical conditions assesses patients' anxiety and depression symptoms over the past week.
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CROSS-SECTIONAL
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Weight-Bearing Lunge Test
時間枠：Baseline
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The range of motion of ankle dorsiflexion will be evaluated under load.
The participant will be asked to keep their heel in contact with the ground and move their knee toward the wall, and the maximum distance between the thumb and the wall will be recorded in centimeters.
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Baseline
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FOOT POSTURE INDEX
時間枠：Baseline
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The participant's foot will be observationally scored based on six anatomical criteria in a standing natural posture, and the total score will be recorded.
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Baseline
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協力者と研究者
ここでは、この調査に関係する人々や組織を見つけることができます。
捜査官
- 主任研究者：Feyza Nur Yücel、Saglik Bilimleri Universitesi
出版物と役立つリンク
研究に関する情報を入力する責任者は、自発的にこれらの出版物を提供します。これらは、研究に関連するあらゆるものに関するものである可能性があります。
一般刊行物
- Bennell KL, Talbot RC, Wajswelner H, Techovanich W, Kelly DH, Hall AJ. Intra-rater and inter-rater reliability of a weight-bearing lunge measure of ankle dorsiflexion. Aust J Physiother. 1998;44(3):175-180. doi: 10.1016/s0004-9514(14)60377-9.
- Sabir N, Demirlenk S, Yagci B, Karabulut N, Cubukcu S. Clinical utility of sonography in diagnosing plantar fasciitis. J Ultrasound Med. 2005 Aug;24(8):1041-8. doi: 10.7863/jum.2005.24.8.1041.
- Redmond AC, Crosbie J, Ouvrier RA. Development and validation of a novel rating system for scoring standing foot posture: the Foot Posture Index. Clin Biomech (Bristol). 2006 Jan;21(1):89-98. doi: 10.1016/j.clinbiomech.2005.08.002. Epub 2005 Sep 21.
- Nijs J, Malfliet A, Nishigami T. Nociplastic pain and central sensitization in patients with chronic pain conditions: a terminology update for clinicians. Braz J Phys Ther. 2023 May-Jun;27(3):100518. doi: 10.1016/j.bjpt.2023.100518. Epub 2023 Jun 14. No abstract available.
- Jayaseelan DJ, Fernandez-de-Las-Penas C, Blattenberger T, Bonneau D. Altered Central Pain Processing in Patients With Chronic Plantar Heel Pain: A Critically Appraised Topic. J Sport Rehabil. 2021 Feb 16;30(5):812-817. doi: 10.1123/jsr.2020-0371.
- Plaza-Manzano G, Rios-Leon M, Martin-Casas P, Arendt-Nielsen L, Fernandez-de-Las-Penas C, Ortega-Santiago R. Widespread Pressure Pain Hypersensitivity in Musculoskeletal and Nerve Trunk Areas as a Sign of Altered Nociceptive Processing in Unilateral Plantar Heel Pain. J Pain. 2019 Jan;20(1):60-67. doi: 10.1016/j.jpain.2018.08.001. Epub 2018 Aug 16.
- Cotchett M, Lennecke A, Medica VG, Whittaker GA, Bonanno DR. The association between pain catastrophising and kinesiophobia with pain and function in people with plantar heel pain. Foot (Edinb). 2017 Aug;32:8-14. doi: 10.1016/j.foot.2017.03.003. Epub 2017 Mar 20.
研究記録日
これらの日付は、ClinicalTrials.gov への研究記録と要約結果の提出の進捗状況を追跡します。研究記録と報告された結果は、国立医学図書館 (NLM) によって審査され、公開 Web サイトに掲載される前に、特定の品質管理基準を満たしていることが確認されます。
主要日程の研究
研究開始 (実際)
2026年4月7日
一次修了 (推定)
2026年9月20日
研究の完了 (推定)
2026年9月20日
試験登録日
最初に提出
2026年6月1日
QC基準を満たした最初の提出物
2026年6月5日
最初の投稿 (実際)
2026年6月11日
学習記録の更新
投稿された最後の更新 (実際)
2026年6月11日
QC基準を満たした最後の更新が送信されました
2026年6月5日
最終確認日
2026年6月1日
詳しくは
本研究に関する用語
その他の研究ID番号
- E-54230385-929-301089224
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いいえ
IPD プランの説明
Individual participant data collected during this study will not be made available to other researchers.
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