A reduction of intrinsic foot muscle sizes has been identified in patients with chronic plantar fasciitis. Weaker intrinsic foot muscles has been suggested to decrease the medial longitudinal arch height and subsequently increase extra tensile stress in the plantar fascia, resulting in the chronicity of the condition. Therefore, it is speculated that atrophic intrinsic foot muscles may be a significant risk factor of developing chronic plantar fasciitis. The purpose of this study is to investigate the effect of an 8-week targeted intrinsic foot muscles exercise regimen on the intrinsic foot muscle size, symptomatic relief, and foot function improvement in long-distance runners with chronic plantar fasciitis.
Distance runners are defined as running with more than 20km per week for more than 2 years. All recruited participants have \> 1 year of plantar fasciitis. The diagnosis were made based on clinical symptoms and the thickness of plantar fasciitis \> 4.0mm at the medial tubercle of heel by ultrasound imaging. Arm 1: The purpose of this arm of the study is to determine if a 8-week targeted foot muscle exercise regimen, instructed with real-time ultrasound, affect the intrinsic foot muscle size, symptomatic relief, and foot function improvement of distance runners with plantar fasciitis. 32 participants will be recruited in this arm. Arm 2: This group will not engage in any training, but will serve as a comparator for the intervention arm.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
DOUBLE
Enrollment
64
4 targeted intrinsic foot muscle exercises
CUHK-ORT Sports Injury Research Laboratory
Shatin, Hong Kong
RECRUITINGmuscle thickness (MT) of Abductor Hallucis (AbH), Flexor hallucis brevis (FHB), Flexor digitorum brevis (FDB), quadratus plantae (QP)
ultrasound measurement
Time frame: baseline
muscle thickness (MT) of Abductor Hallucis (AbH), Flexor hallucis brevis (FHB), Flexor digitorum brevis (FDB), quadratus plantae (QP)
ultrasound measurement
Time frame: week 4
muscle thickness (MT) of Abductor Hallucis (AbH), Flexor hallucis brevis (FHB), Flexor digitorum brevis (FDB), quadratus plantae (QP)
ultrasound measurement
Time frame: week 8
muscle thickness (MT) of Abductor Hallucis (AbH), Flexor hallucis brevis (FHB), Flexor digitorum brevis (FDB), quadratus plantae (QP)
ultrasound measurement
Time frame: week 12
cross sectional area (CSA) of Abductor Hallucis (AbH), Flexor hallucis brevis (FHB), Flexor digitorum brevis (FDB), quadratus plantae (QP)
ultrasound measurement
Time frame: Baseline
cross sectional area (CSA) of Abductor Hallucis (AbH), Flexor hallucis brevis (FHB), Flexor digitorum brevis (FDB), quadratus plantae (QP)
ultrasound measurement
Time frame: week 4
cross sectional area (CSA) of Abductor Hallucis (AbH), Flexor hallucis brevis (FHB), Flexor digitorum brevis (FDB), quadratus plantae (QP)
ultrasound measurement
Time frame: week 8
cross sectional area (CSA) of Abductor Hallucis (AbH), Flexor hallucis brevis (FHB), Flexor digitorum brevis (FDB), quadratus plantae (QP)
ultrasound measurement
Time frame: week 12
Visual Analog Scale (VAS) pain at first steps in the morning
measuring 100 mm in length marked from 0 (absence of pain) to 100 mm (worst imaginable pain)
Time frame: baseline
Visual Analog Scale (VAS) pain at first steps in the morning
measuring 100 mm in length marked from 0 (absence of pain) to 100 mm (worst imaginable pain)
Time frame: week 4
Visual Analog Scale (VAS) pain at first steps in the morning
measuring 100 mm in length marked from 0 (absence of pain) to 100 mm (worst imaginable pain)
Time frame: week 8
Visual Analog Scale (VAS) pain at first steps in the morning
measuring 100 mm in length marked from 0 (absence of pain) to 100 mm (worst imaginable pain)
Time frame: week 12
Visual Analog Scale (VAS) worst pain of the day
measuring 100 mm in length marked from 0 (absence of pain) to 100 mm (worst imaginable pain)
Time frame: baseline
Visual Analog Scale (VAS) worst pain of the day
measuring 100 mm in length marked from 0 (absence of pain) to 100 mm (worst imaginable pain)
Time frame: 4
Visual Analog Scale (VAS) worst pain of the day
measuring 100 mm in length marked from 0 (absence of pain) to 100 mm (worst imaginable pain)
Time frame: 8
Visual Analog Scale (VAS) worst pain of the day
measuring 100 mm in length marked from 0 (absence of pain) to 100 mm (worst imaginable pain)
Time frame: 12
Foot and Ankle Ability Measure (FAAM)
Higher scores represent higher levels of function, with 100% representing no dysfunction.
Time frame: baseline
Foot and Ankle Ability Measure (FAAM)
Higher scores represent higher levels of function, with 100% representing no dysfunction.
Time frame: week 4
Foot and Ankle Ability Measure (FAAM)
Higher scores represent higher levels of function, with 100% representing no dysfunction.
Time frame: week 8
Foot and Ankle Ability Measure (FAAM)
Higher scores represent higher levels of function, with 100% representing no dysfunction.
Time frame: week 12
Foot posture index
Pronated postures are given a positive value, the higher the value the more pronated. Supinated features are given a negative value, the more negative the value the more supinated. For a neutral foot the final score should lie somewhere around zero
Time frame: baseline
Foot posture index
Pronated postures are given a positive value, the higher the value the more pronated. Supinated features are given a negative value, the more negative the value the more supinated. For a neutral foot the final score should lie somewhere around zero
Time frame: week 4
Foot posture index
Pronated postures are given a positive value, the higher the value the more pronated. Supinated features are given a negative value, the more negative the value the more supinated. For a neutral foot the final score should lie somewhere around zero
Time frame: week 8
Foot posture index
Pronated postures are given a positive value, the higher the value the more pronated. Supinated features are given a negative value, the more negative the value the more supinated. For a neutral foot the final score should lie somewhere around zero
Time frame: week 12
Navicular Drop test
Supinated foot (\<5mm); Neutral foot (5-9mm); pronated foot (\>9mm)
Time frame: baseline
Navicular Drop test
Supinated foot (\<5mm); Neutral foot (5-9mm); pronated foot (\>9mm)
Time frame: week 4
Navicular Drop test
Supinated foot (\<5mm); Neutral foot (5-9mm); pronated foot (\>9mm)
Time frame: week 8
Navicular Drop test
Supinated foot (\<5mm); Neutral foot (5-9mm); pronated foot (\>9mm)
Time frame: week 12
Postural control
three 10-seconds eyes opened trials and three 10-seconds eyes closed trials with single-leg stance
Time frame: baseline
Postural control
three 10-seconds eyes opened trials and three 10-seconds eyes closed trials with single-leg stance
Time frame: week 4
Postural control
three 10-seconds eyes opened trials and three 10-seconds eyes closed trials with single-leg stance
Time frame: week 8
Postural control
three 10-seconds eyes opened trials and three 10-seconds eyes closed trials with single-leg stance
Time frame: week 12
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