Foot Core Stabilization Exercises Vs. Shockwave Therapy for Pain, Strength, and Function in Plantar Fasciitis

Condition(s) studied

Investigational drug(s) / intervention(s)

Foot Core Stabilization Exercise Group (FCSEG): Exercise Group (Foot Core Stabilization Exercises) Exercise Group will perform foot core stabilization exercises under the supervision of a physiotherapist, three times a week for five weeks. The exercises will include: Short foot exercise Towel curl exercise Big toe press exercise Toe splay exercise Calf raise to big toe press exercise Leg swings Backward tandem walking Each exercise will be performed in three sets of 15 repetitions.

Extracorporeal Shock Wave Therapy Group (ESWTG): Extracorporeal Shock Wave Therapy Group (ESWTG) One group will receive Extracorporeal Shock Wave Therapy (ESWT) once a week for five weeks. The ESWT sessions will be performed using the Gymna Shockmaster 500 device at a frequency of 15 Hz and a pressure of 3 bar, delivering a total of 1800 pulses per session.

Study summary

This study aims to evaluate the effectiveness and feasibility of two distinct approache extracorporeal shock wave therapy and foot core stabilization exercises in the treatment of plantar faciitis (PF) by comparing their impacts on pain, muscle strength, and functionality. The study seeks to better understand the role of innovative exercise protocols in addressing biomechanical imbalances and the contribution of ESWT to biological healing mechanisms. The anticipated results are expected to provide evidence-based treatment approaches that can enhance the quality of life in individuals with PF, guide clinical applications in physical medicine and rehabilitation, and strengthen the position of these treatment methods within the broader healthcare system. Moreover, the findings may benefit a larger patient population by improving the management of PF.

Eligibility

Primary outcome measure(s)

• Pain — through study completion, an average of 6 months.
  The digital algometer is a pressure sensor used to measure pain thresholds by applying pressure to a specific point. In plantar fasciitis, it will assess foot sensitivity by measuring the pain threshold at the most painful area, especially the heel. Pressure is applied until pain is felt, and the recorded value indicates the threshold. The Visual Analog Scale (VAS) will evaluate heel pain by asking participants to mark their pain level on a 10 cm scale, where 0 means no pain and 10 signifies severe pain, based on their experience over the past week.
• Medial longitudinal arc level — through study completion, an average of 6 months.
  The Navicular Drop Test will be used to assess participants' MLA height. Before measurements, the navicular tubercle will be marked while the individual stands barefoot. First, the distance between the navicular tubercle and the ground will be measured in millimeters while seated with the foot unloaded. Then, the individual will stand and bear full weight, and the new distance will be recorded. The difference between these two measurements will be calculated. Results will be classified as increased supination (\<5mm), neutral foot (5-9mm), and increased pronation (\>9mm).
• Muscle strength — through study completion, an average of 6 months.
  The Kinvent K-Force digital device will be used for muscle strength measurement. Individuals with PF will lie in a supine position. For dorsiflexor strength measurement, the dynamometer will be placed on the upper metatarsal region, and for plantar flexors, it will be placed on the plantar metatarsal region. Participants will be asked to push against the dynamometer with maximum force, and the results will be recorded.
• Quadriceps angle — through study completion, an average of 6 months.
  Changes in foot structure increase the Q angle, leading to genu valgum in the knee and pronation in the foot. Due to the tibia-talus relationship, foot pronation causes tibial internal rotation. Q angle measurement will be done using a plastic goniometer. Individuals with PF will lie supine with extended knees. The pivot point will be placed at the patella center. The movable arm will point to the anterior superior iliac spine, while the fixed arm will align with the tibial tuberosity. The angle between them will represent the Q angle

Trial sites (1)

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