Effectiveness of Soft Tissue Mobilization versus Therapeutic Ultrasound on Pain in Adults with Plantar Fasciitis.
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Presenter(s)
Wyatt Taylor
Abstract
Effectiveness of Soft Tissue Mobilization versus Therapeutic Ultrasound on Pain in Adults with Plantar Fasciitis.
Clinical Scenario: Plantar Fasciitis (PF) is an overuse condition resulting in inflammation of the plantar fascia on the sole of the foot which can refer pain to the heel. PF is present in 10% of the United States general population and mostly affects adults from ages 25 to 65 years old.If PF is treated poorly, symptoms can last up to a few months before subsiding and longer if the patient continues activity. Many studies test the effectiveness of treatments for function, such as custom orthotics, heel cups, corticosteroid injections, anti-inflammatory drugs. However, the effectiveness of pain reduction for common soft tissue treatment styles like soft tissue mobilization (STM) and ultrasound (US) can range differently for patients. Focused Clinical Question: Therefore, the purpose of this critical appraisal is to identify in adults over age 18, who have PF, what is the effect of soft tissue mobilization (STM) vs. therapeutic ultrasound (US) on pain? Search Strategy: Databases such as PubMed and Cochrane Library were used to collect data. Search terms were “plantar fasciitis”, “plantar heel pain”, “soft tissue mobilization”, “myofascial release technique”, and “therapeutic ultrasound”. Inclusion criteria were adult general population patients (18+ years of age), complaints of plantar heel pain, or painful first step in the morning, patients referred to a physiotherapist for PF or recently diagnosed with PF. Exclusion criteria included patients who previously received corticosteroid injections for plantar heel pain (PHP), patients who received US treatment previously for PF, currently taking steroidal or nonsteroidal anti-inflammatory medications, and currently using custom orthotics. Evidence Quality Assessment: Average PEDro was 5/10 to 7/10, 1a-1b research. Results and Summary of Search: Six of the seven studies that used STM saw a statistically significant decrease in pain (p < 0.05 to p <0.001), up to an 82% decrease (p < 0.05 to p <0.001), reported on multiple pain scales (p = 0.05 to 0.001), over US between 10 days to 6 weeks when combined with foot intrinsic strengthening and stretching (FISS). One study resulted in no significant reduction in pain after 4 weeks after only US (P > 0.05). Study strengths include consistently frequent treatment throughout the study, thorough description of STM methods listed, similar pain scale measurements between studies. Weakness includes limited data about the effectiveness of STM, lacked long-term follow up data, and small sample sizes n=30 to n=32. Clinical Bottom Line: STM reduces pain for adults experiencing PF when combined with FISS over the use of US (Level-A study quality). STM should be used consistently with FISS to treat PF for at least 10 days to reduce pain. Implications: Athletic trainers should favor the use of STM over US for treating US. However, more research needs to be done to identify the effects of only STM on reducing pain and the long-term effects. In every study that included STM, FISS was also used in combination with both treatments.
College
College of Nursing & Health Sciences
Department
Health, Exercise & Rehabilitative Sciences
Campus
Winona
First Advisor/Mentor
Dr. Nora Kraemer PhD, LAT, ATC, CSCS
Presentation Type
Oral Presentation
Format of Presentation or Performance
Pre-Recorded Video
2024-RCADay-WyattTaylor-ClosedCaptions
Effectiveness of Soft Tissue Mobilization versus Therapeutic Ultrasound on Pain in Adults with Plantar Fasciitis.
Effectiveness of Soft Tissue Mobilization versus Therapeutic Ultrasound on Pain in Adults with Plantar Fasciitis.
Clinical Scenario: Plantar Fasciitis (PF) is an overuse condition resulting in inflammation of the plantar fascia on the sole of the foot which can refer pain to the heel. PF is present in 10% of the United States general population and mostly affects adults from ages 25 to 65 years old.If PF is treated poorly, symptoms can last up to a few months before subsiding and longer if the patient continues activity. Many studies test the effectiveness of treatments for function, such as custom orthotics, heel cups, corticosteroid injections, anti-inflammatory drugs. However, the effectiveness of pain reduction for common soft tissue treatment styles like soft tissue mobilization (STM) and ultrasound (US) can range differently for patients. Focused Clinical Question: Therefore, the purpose of this critical appraisal is to identify in adults over age 18, who have PF, what is the effect of soft tissue mobilization (STM) vs. therapeutic ultrasound (US) on pain? Search Strategy: Databases such as PubMed and Cochrane Library were used to collect data. Search terms were “plantar fasciitis”, “plantar heel pain”, “soft tissue mobilization”, “myofascial release technique”, and “therapeutic ultrasound”. Inclusion criteria were adult general population patients (18+ years of age), complaints of plantar heel pain, or painful first step in the morning, patients referred to a physiotherapist for PF or recently diagnosed with PF. Exclusion criteria included patients who previously received corticosteroid injections for plantar heel pain (PHP), patients who received US treatment previously for PF, currently taking steroidal or nonsteroidal anti-inflammatory medications, and currently using custom orthotics. Evidence Quality Assessment: Average PEDro was 5/10 to 7/10, 1a-1b research. Results and Summary of Search: Six of the seven studies that used STM saw a statistically significant decrease in pain (p < 0.05 to p <0.001), up to an 82% decrease (p < 0.05 to p <0.001), reported on multiple pain scales (p = 0.05 to 0.001), over US between 10 days to 6 weeks when combined with foot intrinsic strengthening and stretching (FISS). One study resulted in no significant reduction in pain after 4 weeks after only US (P > 0.05). Study strengths include consistently frequent treatment throughout the study, thorough description of STM methods listed, similar pain scale measurements between studies. Weakness includes limited data about the effectiveness of STM, lacked long-term follow up data, and small sample sizes n=30 to n=32. Clinical Bottom Line: STM reduces pain for adults experiencing PF when combined with FISS over the use of US (Level-A study quality). STM should be used consistently with FISS to treat PF for at least 10 days to reduce pain. Implications: Athletic trainers should favor the use of STM over US for treating US. However, more research needs to be done to identify the effects of only STM on reducing pain and the long-term effects. In every study that included STM, FISS was also used in combination with both treatments.
