The effectiveness of exercises, myofascial releasing and mobilization techniques in plantar fasciitis

The aim of the study is to investigate the Effectiveness of Exercises, Myofascial Releasing and Mobilization Techniques in Plantar Fasciitis (PF). The study included 41 volunteers with PF (29F, 12M; 49,78±11,24 years) who were admitted Orthopedics and Traumatology department of Yeditepe University Istanbul, Turkey between November 2017 and May 2018. The sociodemographic features of participants were recorded by using a structured questionnare. The range of motion (ROM) of the ankle and the flexibility of gastrocnemius-soleus muscles were measured by using a goniometer. Proprioception assessment was applied with angle reproduction test in direction of dorsiflexion and plantar flexion by using electronic goniometer. The dynamic balance was evaluated by Y balance test while foot sense was assessed with monofilament test from specific areas of each foot. Foot Function Index (FFI) was used for pain, disability and activity restriction while Visual Analogue Scale (VAS) for first step morning pain. The patients were randomly divided into Outpatient Rehabilitation group (Group1, n=19) and Home Rehabilitation group (Group2, n=22). All subjects were participated in patient education program. Foot and ankle-hip exercises program, myofascial releasing, joint and soft tissue mobilization were applied to Group1 (twice a week totally 8 week) and foot and ankle exercises program were given for Group2 (8 weeks). The main results of our study revealed that the measurements of ROM, balance, proprioception, foot sense, flexibility, FFI and VAS were improved at 4th and 8th week in both groups(p<0.05). The other result indicated that the means of plantar flexion ROM, balance, proprioception (dorsiflexion), foot sense, flexibility (gastrocnemius), FFI and VAS in Group1 had more significant improvement than Group2 (p<0.05). Consistent with hypothesis, Group1 which were applied exercises, myofascial releasing, joint and soft tissue mobilization by physiotherapist had statistically differences in terms of functional capacity, balance, proprioception, foot sense than Group2. In conclusion, we can recommend the combined protocol including foot and ankle-hip exercises program, myofascial releasing, joint and soft tissue mobilization than the only foot and ankle-hip exercises program in the management of PF. Key Words: exercises, foot, foot function index, mobilization, myofascial releasing, physiotherapy, plantar fasciitis, proprioception