Plantar Fascitis Clinical Trial
Official title:
The Effectiveness of Ultrasound Treatment in the Management of Plantar Fasciitis: A Randomized, Placebo-Controlled Study
The purpose of this study is to examine the effectiveness of ultrasound treatment in addition to a program consisting of manual therapy and exercise (stretching and strengthening exercises) to improve pain and function in individuals with plantar fasciitis. Our primary hypothesis is individuals with plantar fasciitis will show a greater improvement in pain and function with ultrasound, manual therapy and an exercise program compared to manual therapy and exercise program alone.
Plantar fasciitis (PF) is a common cause of foot pain, affecting an estimated 2 million
people per year.1 Although there are large numbers of people seeking medical attention for
this condition, there remains some confusion among health care providers as to the most
efficacious treatment and some authors conclude that no data solidly supports effectiveness
of treatment.2
Several randomized control studies have been published with respect to treatment of PF with
ultrasound. The current literature on the effectiveness of US in individuals with PF is
largely inconsistent in the parameters. One study by Crawford and Snaith,3 found the true
ultrasound was no more effective than sham ultrasound and the authors concluded that future
studies need to clarify ultrasound parameters. In contrast, a recent study that utilized
different parameters,4 concluded that the US group showed significant changes in pain and
function. Strengthening and stretching exercises are well documented through the literature
to improve function and decrease pain in patients with PF.5-8 It has been reported within the
literature that patients with PF have subtalar, tarsometatarsal, and first metatarsalphangeal
(MTP) joint hypo mobility into dorsiflexion, which reduces dorsiflexion range of motion (ROM)
and places the windlass mechanism at a mechanical disadvantage which has been theorized to
place increased stress on the plantar fascia.9-12 A variety of studies have explored the
effects of manual therapy in conjunction with exercises to address the limitations in ankle
dorsiflexion ROM.9-12
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