Comparative Effectiveness of Muscle Energy Technique and Trigger Point Release in Plantar Fasciitis

Sponsor

University of Faisalabad (Other)

Overall Status

Completed

CT.gov ID

NCT05050331

Collaborator

(none)

Enrollment

Location

Arms

7.8

Actual Duration (Months)

3.9

Patients Per Site Per Month

Study Details

Study Description

Brief Summary

Plantar Fasciitis (PF) causes heel pain in patients who have prolonged weight-bearing commonly, and it affects their ability to manage their routine work. By different physical therapy approaches like muscle energy technique (MET) and trigger point release, their pain and foot function would, might improve that would increase their work efficiency. This study aim towards better treatment option in treating PF. Therefore, the objective of this study was to compare the treatment effectiveness of MET and triggers point release in PF. A single blinded, randomized clinical design was conducted. Thirty patients was randomly allocated into two groups. One group received muscle energy technique and the other receive trigger point release, while both groups performed self-stretching exercises as a home plan. Their pain and foot function serve as outcome measure. Treatment was given for 4 weeks, 3 sessions per week.

Condition or Disease	Intervention/Treatment	Phase
Plantar Fasciitis	Procedure: Muscle Energy Technique Procedure: Trigger Point Release Procedure: Self-Stretching of Calf and Plantar Fascia	N/A

Study Design

Study Type:

Interventional

Actual Enrollment :

30 participants

Allocation:

Randomized

Intervention Model:

Parallel Assignment

Masking:

Single (Participant)

Primary Purpose:

Treatment

Official Title:

Effectiveness of Muscle Energy Technique and Trigger Point Release in Plantar Fasciitis: A Comparative Study

Actual Study Start Date :

Mar 3, 2020

Actual Primary Completion Date :

Aug 8, 2020

Actual Study Completion Date :

Oct 26, 2020

Arms and Interventions

Arm	Intervention/Treatment
Experimental: Muscle Energy Technique (MET) Group Post-isometric relaxation was given as the form of MET. It was applied to gastrocnemius and soleus with patient supine and foot extended, knee was flexed for soleus and extended for gastrocnemius muscle. The patient ankle was dorsiflexed by the therapist until the point of discomfort or resistance, and the patient was instructed to exert pressure using 20% force for 5-7 seconds toward plantar flexion. Relaxation was given for 5 seconds and the therapist passively dorsiflex the ankle to a new barrier. Gastrocnemius and soleus both received a single set of 5 repetitions separately. Treatment was given for 4 weeks, 3 sessions per week.	Procedure: Muscle Energy Technique Muscle energy technique (MET) is an active manipulative technique that requires patient active muscle contraction of a respective muscle from a specific position in a specific direction with 10-20 percent force exerted by the patient which is resisted by the therapist in an attempt to relax and lengthen the muscle. Procedure: Self-Stretching of Calf and Plantar Fascia Self-stretching will be done 5 times twice a day with 20 seconds of intermittent stretch and 20 seconds relaxation time.
Experimental: Trigger Point Release Group Trigger points of gastrocnemius muscle was released. The patient in prone lying with legs extended and the therapist in walk standing position, applied vertical downward pressure toward the trigger points for 90 seconds with the therapist's thumb. Three repetitions was given with 30 seconds relaxation time. After that, 3 longitudinal strokes in caudal to cranial direction was given by the therapist's thumb over the taut band. Treatment was provided for 4 weeks, 3 sessions per week.	Procedure: Trigger Point Release In trigger point release, a vertical downward pressure toward the trigger point for 90 seconds is applied with the therapist's thumb. Three repetitions needed to be done with 30 seconds relaxation time. After that, 3 longitudinal strokes in caudal to cranial direction are given by therapist's thumb over the taut band. Procedure: Self-Stretching of Calf and Plantar Fascia Self-stretching will be done 5 times twice a day with 20 seconds of intermittent stretch and 20 seconds relaxation time.

Arm

Intervention/Treatment

Experimental: Muscle Energy Technique (MET) Group

Post-isometric relaxation was given as the form of MET. It was applied to gastrocnemius and soleus with patient supine and foot extended, knee was flexed for soleus and extended for gastrocnemius muscle. The patient ankle was dorsiflexed by the therapist until the point of discomfort or resistance, and the patient was instructed to exert pressure using 20% force for 5-7 seconds toward plantar flexion. Relaxation was given for 5 seconds and the therapist passively dorsiflex the ankle to a new barrier. Gastrocnemius and soleus both received a single set of 5 repetitions separately. Treatment was given for 4 weeks, 3 sessions per week.

Procedure: Muscle Energy Technique

Muscle energy technique (MET) is an active manipulative technique that requires patient active muscle contraction of a respective muscle from a specific position in a specific direction with 10-20 percent force exerted by the patient which is resisted by the therapist in an attempt to relax and lengthen the muscle.

Procedure: Self-Stretching of Calf and Plantar Fascia

Self-stretching will be done 5 times twice a day with 20 seconds of intermittent stretch and 20 seconds relaxation time.

Experimental: Trigger Point Release Group

Trigger points of gastrocnemius muscle was released. The patient in prone lying with legs extended and the therapist in walk standing position, applied vertical downward pressure toward the trigger points for 90 seconds with the therapist's thumb. Three repetitions was given with 30 seconds relaxation time. After that, 3 longitudinal strokes in caudal to cranial direction was given by the therapist's thumb over the taut band. Treatment was provided for 4 weeks, 3 sessions per week.

Procedure: Trigger Point Release

In trigger point release, a vertical downward pressure toward the trigger point for 90 seconds is applied with the therapist's thumb. Three repetitions needed to be done with 30 seconds relaxation time. After that, 3 longitudinal strokes in caudal to cranial direction are given by therapist's thumb over the taut band.

Procedure: Self-Stretching of Calf and Plantar Fascia

Self-stretching will be done 5 times twice a day with 20 seconds of intermittent stretch and 20 seconds relaxation time.

Outcome Measures

Primary Outcome Measures

Foot Pain [Four Weeks]
Numeric Pain Rating Scale (NPRS) was the primary outcome measure. NPRS is a subjective pain rating scale that has 11 points from 0-10. "0" stands for no pain, "1-3" score indicate mild pain, "4-6" shows moderate pain and "7-10 score depicts most severe pain ever in the last 24 hours as explained or narrated by patient. It is administered via paper and pencil; it doesn't require any cost to have this scale or to score it. It doesn't require any special skills to score this scale. Furthermore, it can be used for age group 18-65 by taking time of less than three minutes to score their pain.

Secondary Outcome Measures

Foot Function [Four Weeks]
Foot function index (FFI) was the secondary outcome measure of this study. FFI measures pain and foot dysfunction due to non-traumatic injury. It is a questionnaire that only requires a paper and pencil and requires less time to score. It is 23 item questionnaire having three subscales but due to repetitive null answers to six questions, it has been modified into 17 questions. Its scoring is based on visual analogue scale having score range from 0-10, with "0" depicting no pain and "10" showing worst pain. This questionnaire was filled by the patient based on his/her pain or activity limitation due to pathology in the past week. Pain, disability and activity limitation are the three subscales of FFI.

Eligibility Criteria

Criteria

Ages Eligible for Study:

25 Years to 45 Years

Sexes Eligible for Study:

All

Accepts Healthy Volunteers:

Inclusion Criteria:

Having unilateral plantar heel pain on weight-bearing
Age 25-45
Pain aggravated by walking few steps in the morning
Having at least one identifiable trigger point in calf

Exclusion Criteria:

Bilateral heel pain
History of leg and foot tumor
Lower limb fracture
Lower limb injury,
Achilles tendentious
Ankle arthritis,
Surgery or any vascular disease

Contacts and Locations

Locations

	Site	City	State	Country	Postal Code
1	The University of Faisalabad	Faisalābad	Punjab	Pakistan	38000

Sponsors and Collaborators

University of Faisalabad

Investigators

Study Director: Dr Sidra Majeed; PT, MSPP, The University of Faisalabad

Study Documents (Full-Text)

None provided.

More Information

Publications

None provided.

Responsible Party:

Dr Izza Ayub; PT, Principal Investigator, University of Faisalabad

ClinicalTrials.gov Identifier:

NCT05050331

Other Study ID Numbers:

TUF/DR/MSPP/174

First Posted:

Sep 20, 2021

Last Update Posted:

Oct 6, 2021

Last Verified:

Sep 1, 2021

Individual Participant Data (IPD) Sharing Statement:

Plan to Share IPD:

Studies a U.S. FDA-regulated Drug Product:

Studies a U.S. FDA-regulated Device Product:

Keywords provided by Dr Izza Ayub; PT, Principal Investigator, University of Faisalabad

Muscle Energy Technique

Trigger Point Release

Additional relevant MeSH terms:

Fasciitis

Fasciitis, Plantar

Study Results

No Results Posted as of Oct 6, 2021