Effects of Foot-Core Strengthening and Sensorimotor Re-training With Routine Physical Therapy on Pain, Function, and Plantar Pressure in Patients With Plantar Fasciitis.

Overview

This study aims to compare the effects of foot core strengthening and sensorimotor re-training, each combined with routine physical therapy, on pain, functional ability, and plantar pressure in patients with Plantar Fasciitis. Participants will be divided into two groups: one receiving foot core strengthening with routine physical therapy and the other receiving sensorimotor re-training with routine physical therapy. The study will evaluate which intervention is more effective in reducing pain, improving function, and normalizing plantar pressure distribution.

Detailed description

Plantar Fasciitis is a common musculoskeletal disorder characterized by heel pain, reduced functional capacity, and altered plantar pressure distribution. It is often associated with overuse, poor biomechanics, and weakness of intrinsic foot muscles.

Routine physical therapy management includes stretching exercises ( plantar fascia and calf stretching), strengthening, manual therapy, and physical modalities. However, recent rehabilitation approaches emphasize the importance of intrinsic muscle strengthening and sensorimotor control.

This study is designed to compare two active rehabilitation approaches combined with routine physical therapy:

Group A: Foot Core Strengthening + Routine Physical Therapy

Participants in this group will receive:

Intrinsic foot muscle strengthening exercises ( short foot exercise, toe curls) Routine physical therapy (stretching, manual therapy, modalities) This approach aims to improve medial longitudinal arch support, enhance foot stability, and reduce mechanical stress on the plantar fascia.

Group B: Sensorimotor Re-training + Routine Physical Therapy

Participants in this group will receive:

Sensorimotor and proprioceptive training ( balance exercises, unstable surface training) Routine physical therapy (stretching, manual therapy, modalities) This approach focuses on improving neuromuscular control, proprioception, and dynamic stability of the foot and ankle.

Interventions

• Other Foot Core Strengthening with Routine Physical Therapy
  Participants will receive a structured foot core strengthening program targeting intrinsic foot muscles, including exercises such as short foot exercise, toe curls, toe spreading, and marble pickup. These exercises aim to improve medial longitudinal arch stability and reduce stress on the plantar fascia. In addition, routine physical therapy will be provided, including plantar fascia stretching, gastrocnemius-soleus stretching, manual therapy techniques, and appropriate physical modalities. Ses
• Other Sensorimotor Re-training with Routine Physical Therapy
  Participants will receive a structured sensorimotor re-training program focusing on proprioception, balance, and neuromuscular control. Exercises will include single-leg stance, balance training on stable and unstable surfaces, wobble board exercises, and gait training. Routine physical therapy will also be provided, including plantar fascia stretching, gastrocnemius-soleus stretching, manual therapy techniques, and appropriate physical modalities. Sessions will be conducted 3-5 times per week

Primary outcome measures

• Pain Intensity [Time frame: Baseline and at the end of 4-8 weeks of intervention]

Secondary outcome measures (2)

• Plantar Pressure Distribution [Time frame: Baseline and at the end of 4-8 weeks of intervention]
• Foot Function [Time frame: Baseline and at the end of 4-8 weeks of intervention]

Eligibility criteria

Inclusion criteria

Age 35-60 Years Sharp and worsen pain with the first few steps out of bed in morning. Clinical diagnosis of plantar fasciitis of at least three months duration -

Exclusion criteria

History of ankle and foot surgery Diagnosis for Peripheral neuropathy, Tarsal tunnel syndrome Corticosteroid injection into heel within the last three months. Diagnosed neurological and rheumatological disease calcaneal fractures Pregnant Women-

Criteria are shown verbatim from the registry (in English). Final eligibility is always assessed by the study center.

Healthy volunteers: No

Study design

Allocation

Randomized

Model

Parallel assignment

Masking

Open label

Primary purpose

Treatment

Study locations

Pakistan · 1 center

• Lahore University of Biological and Applied Sciences — Lahore

Publications

• Hamstra-Wright KL, Huxel Bliven KC, Bay RC, Aydemir B. Risk Factors for Plantar Fasciitis in Physically Active Individuals: A Systematic Review and Meta-analysis. Sports Health. 2021 May-Jun;13(3):296-303. doi: 10.1177/1941738120970976. Epub 2021 Feb 3. PMID 33530860
• Kamonseki DH, Goncalves GA, Yi LC, Junior IL. Effect of stretching with and without muscle strengthening exercises for the foot and hip in patients with plantar fasciitis: A randomized controlled single-blind clinical trial. Man Ther. 2016 Jun;23:76-82. doi: 10.1016/j.math.2015.10.006. Epub 2015 Oct 30. PMID 26654252
• Scherger JE. Consider Muscle Strengthening for Plantar Fasciitis. Am Fam Physician. 2018 Oct 1;98(7):407. No abstract available. PMID 30252428
• Tahririan MA, Motififard M, Tahmasebi MN, Siavashi B. Plantar fasciitis. J Res Med Sci. 2012 Aug;17(8):799-804. PMID 23798950

Identifiers

NCT: NCT07703111 · UBS/ERB/26/04/029

Primary sources (government registries)

• ClinicalTrials.gov (US NIH)

View this study on ClinicalTrials.gov ↗