The investigator then palpated and marked the tender point over the origin of the plantar fascia at the medial tuberosity of the calcareous. To assess heel tenderness, the investigator directed the patient to recline in a supine position with the affected leg fully extended. The PA is a force gauge equipped with a rubber tip and calibrated in kg/cm 2 (Model FDX, Algometer, WAGNER instruments, Greenwich, CT). The threshold is defined as the minimum force required to produce the sensation of pain. No follow-up was conducted after the study was over.Ī handheld pressure algometer (PA) was used to measure each patient’s heel tenderness threshold. All subjects were instructed to not use NSAIDS or other analgesics during the 4 weeks the study was conducted. Data analysis was based on the remaining 44 patients who provided written consent to continue with the study. Four participants never retuned beyond the baseline evaluation session due to scheduling conflicts. Exclusion criteria were: (1) previous fracture or surgery of the foot and (2) specific metabolic and connective tissue disorders associated with or contributing to the diagnosis of PF (e.g., rheumatoid arthritis, gout, and lupus).įorty-eight participants with a clinical diagnosis of plantar fasciitis met the inclusion criteria of this randomized clinical trial and underwent baseline evaluation. Inclusion criteria were: (1) participants of both sexes diagnosed with PF, (2) participant age range was 18–65 years and (3) the diagnosis was made upon the finding of tenderness to pressure at the origin of the plantar fascia on the medial tubercle of the calcaneus, as well as complaint of heel pain greater than or equal to 3 on a 1–10 VAS scale. The following inclusion/exclusion criteria were used to determine eligibility for enrollment in this clinical trial. This prospective randomized clinical trial was approved by the Institutional Review Board (IRB) at Loma Linda University (LLU) and conducted in the Physical Fitness Laboratory at the School of Allied Health Professions (SAHP), Department of Physical Therapy between March and September 2013. Two groups of subjects were tested – 1 with electrical stimulation alone and 1 with electrical stimulation and stretching – to see if the 2 therapy modalities were synergistic. Therefore, the hypothesis to be tested here is that electrical stimulation may also help reduce pain and promote healing in people with plantar fasciitis. Fibroblasts make the collagens, glycosaminoglycans, elastin fibers, and glycoproteins found in the extracellular matrix. ![]() Fibroblasts are the key cells during the proliferation phase of fascia healing. ![]() The plantar fascia is a connective tissue, and the main function of fibroblast cells is to maintain structural integrity. Delivery of electrical current using electrodes to the wound bed is presumed to induce cellular actions and histological responses such as collagen and deoxyribonucleic acid synthesis and adenosine triphosphate production, as well as increasing the number of growth factor receptors and enhancing calcium influx. Įlectrical stimulation (MPC) is used to promote wound and pressure ulcer healing processes. These modalities include iontophoresis, manual therapy, night splinting, prefabricated and customized inserts, shoe modification, stretching exercises of calf muscles and plantar fascia, taping, and orthotic devices, which can be used to suit patient needs. Many physical therapy regimens are available that may mitigate and relieve heel pain associated with PF. The sharp pain is usually localized to the plantar-medial aspect of the heel or over a small area near the proximal insertion of the plantar fascia at the medial tuberosity of the calcaneus. The onset of inferior heel pain is insidious and may worsen over time. Symptoms are resolved in approximately 90% of cases and resolution of symptoms occurs in the majority of patients within 10 months of conservative treatment. PF constitutes approximately 15% of foot dysfunctions in the United States and accounts for more than 1 million outpatient visits each year. PF is a common diagnostic entity affecting more than 2 million Americans every year. It can cause other foot disorders such as Baxter’s neuropathy. ![]() PF can be defined as a localized inflammation of perifascial structures and plantar fascia at the proximal attachment on the medial tuberosity of the calcaneus resulting from chronic repetitive microtears and degeneration secondary to overuse or mechanical and congenital disorders. ![]() Plantar fasciitis (PF) is a soft tissue disorder first described by William Wood in 1812 and is known by many pseudonyms such as jogger’s heel, heel spur syndrome, plantar fascial insertitis, calcaneal enthesopathy, subcalcaneal bursitis, subcalcaneal pain, stone bruise, calcaneal periostitis, neuritis and calcaneodynia.
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