[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"health-study-detail:100658701":3},{"organization":4,"outcomesModule":7,"designInfo":21,"detailedDescription":29,"studyPopulation":20,"armGroups":30,"interventions":41,"overallOfficials":20,"centralContacts":51,"locations":61,"responsibleParty":78,"collaborators":20,"id":80,"slug":81,"hasResults":82,"nctId":83,"briefTitle":84,"officialTitle":84,"acronym":20,"eligibilityCriteria":85,"healthyVolunteers":82,"sex":86,"minAge":87,"maxAge":88,"enrollmentInfo":89,"targetDuration":20,"studyType":92,"phases":93,"briefSummary":95,"conditions":96,"keywords":20,"overallStatus":64,"whyStopped":20,"lastUpdateSubmitDate":98,"lastUpdatePostDateStruct":99,"startDateStruct":102,"completionDateStruct":104,"leadSponsor":106,"locationsCount":107},{"fullName":5,"class":6},"Foundation University Islamabad","OTHER",{"primaryOutcomes":8,"secondaryOutcomes":20,"otherOutcomes":20},[9,13,17],{"measure":10,"description":11,"timeFrame":12},"Foot Pain","Pain intensity will be assessed using the Numeric Pain Rating Scale (NPRS), a standardized patient-reported measure used to quantify perceived pain severity. Participants will be asked to rate the intensity of their plantar heel pain on a numerical scale from 0 to 10, where 0 represents no pain and 10 represents the worst possible pain. The participant will select the number that best represents their current pain intensity at the time of assessment. The NPRS provides a simple and reproducible method for evaluating changes in pain severity following physiotherapy intervention. Pain scores will be recorded for each participant at baseline before treatment, after two weeks, and after four weeks. Changes in NPRS scores across assessment points will be used to evaluate treatment-related improvement and compare pain outcomes between the two intervention groups.","before and at 4 weeks",{"measure":14,"description":15,"timeFrame":16},"Foot Disability","Foot disability will be assessed using the Foot Function Index (FFI), a validated patient-reported outcome measure designed to evaluate the impact of foot problems on function. The FFI consists of 23 items divided into three domains: pain, disability, and activity limitation. Participants rate each item according to the degree of difficulty or limitation experienced during daily activities. Each item is scored on a numerical scale, with higher scores indicating greater pain and disability. The FFI provides information regarding pain-related impairment, difficulty performing activities, and limitations in daily activities. It will quantify foot-related disability and functional limitations in participants with plantar fasciitis. The FFI will be recorded at baseline, after two weeks, and after four weeks to determine changes in foot disability following the intervention and compare outcomes between treatment groups.","Before and at 4 weeks",{"measure":18,"description":19,"timeFrame":16},"Ankle Range of motion","Ankle range of motion (ROM) will be assessed using a standard universal goniometer to measure dorsiflexion and plantar flexion of the involved ankle. Participants will be positioned appropriately, and the goniometer will be aligned with established anatomical landmarks to measure the angular movement of the ankle joint in degrees. Dorsiflexion will be assessed by measuring movement of the foot toward the anterior aspect of the lower leg, while plantar flexion will be assessed by measuring movement of the foot away from the lower leg. The measurements will provide an objective assessment of ankle mobility and identify limitations in ankle ROM associated with plantar fasciitis. ROM will be recorded at baseline, after two weeks, and after four weeks to determine changes following treatment and compare outcomes between the two intervention groups.",null,{"allocation":22,"interventionModel":23,"interventionModelDescription":20,"primaryPurpose":24,"observationalModel":20,"timePerspective":20,"maskingInfo":25},"RANDOMIZED","PARALLEL","TREATMENT",{"masking":26,"maskingDescription":20,"whoMasked":27},"SINGLE",[28],"OUTCOMES_ASSESSOR","Plantar fasciitis is a musculoskeletal condition of the foot. It is characterized by pain and tenderness at the medial plantar heel, particularly during first steps in the morning or after inactivity. Pain may worsen with prolonged standing or weight bearing and can affect walking, standing, occupational activities. The condition is multifactorial, with factors including prolonged standing, repetitive loading, running, reduced ankle dorsiflexion, flat-foot posture, and lower-limb biomechanical abnormalities. Physiotherapy is central to conservative management and commonly includes stretching, strengthening, orthotic interventions, taping, electrotherapy, and manual therapy. However, there is no universally accepted gold-standard intervention, and outcomes may vary because of differences in treatment protocols, dosage, and patient characteristics. Transverse Friction Massage (TFM) is a manual therapy technique involving deep transverse mechanical forces across affected tissues. It is intended to improve tissue mobility, address adhesions, stimulate local circulation, and promote tissue remodeling. Its effectiveness may depend on therapist skill, pressure, and treatment duration. Repetitive manual pressure, particularly through the therapist's thumb, may contribute to fatigue and work-related musculoskeletal strain. Instrument-Assisted Soft-Tissue Mobilization (IASTM) uses a specialized instrument to apply controlled mechanical pressure to soft tissues. It is intended to improve tissue mobility, stimulate mechanotransduction and fibroblast activity, enhance local blood flow, and promote tissue remodeling. Evidence has reported potential benefits for pain, flexibility, and functional outcomes in musculoskeletal conditions, although protocols and outcome measures vary. IASTM may also reduce repetitive loading on the therapist's thumb and hand. Comparative evidence between TFM and IASTM in plantar fasciitis remains limited, supporting the need for this study. The studyaims to compare the effectiveness of TFM and IASTM in patients with plantar fasciitis. It will be conducted as a randomized trial at Foundation University College of Physical Therapy, Islamabad, over one year after synopsis approval, from February 2026 to January 2027. Participants diagnosed with plantar fasciitis who fulfill the eligibility criteria will be recruited from Fauji Foundation Hospital after receiving information about the study. Purposive Sampling will be used for recruitment. The calculated sample size is 34 participants, with 17 participants in each group. It was calculated using G\\*Power with an effect size of 0.31, alpha error of 5%, and power of 95%, with two groups and three measurements with a 10% attrition rate. Participants will be randomly allocated to Group A or Group B through sealed opaque envelopes. A research assistant not involved in treatment will perform the allocation. The study will include males and females aged 19-44 years with plantar medial heel pain that is noticeable during initial steps after inactivity and may worsen with prolonged weight bearing. Participants must have symptoms for more than three months and a clinical diagnosis of plantar fasciitis. Clinical findings include a positive Windlass test and limited active and passive talocrural dorsiflexion. Exclusion criteria include previous plantar fasciitis surgery, congenital foot abnormalities, systemic lower-extremity disorders, peripheral neuropathy, other foot disorders, contraindications to IASTM, inability or unwillingness to follow study procedures, pregnancy, immunosuppression, peripheral vascular disease, thrombocytopenia, anticoagulant therapy, and post-mastectomy status. Demographic information including age, gender, weight, height, and medical history will be recorded. Outcomes will include pain intensity, foot-related functional impairment, and ankle range of motion. Pain will be assessed using the Numeric Pain Rating Scale (NPRS), scored from 0 to 10, withhigher scores indicating greater pain. Foot function will be assessed using the Foot Function Index (FFI). Ankle range of motion will be measured with a goniometer. Group A will receive TFM with the standardized protocol. Participants will be positioned supine, the most painful plantar fascia insertion will be identified, and the foot will be dorsiflexed. Deep friction massage will be applied using a reinforced index finger transversely and perpendicular to the tissue fibers, within participant tolerance, for approximately five minutes. Group B will receive IASTM with the same standardized protocol. Treatment will begin with a three-minute cycling or walking warm-up. Participants will be positioned prone with the involved knee flexed to 90 degrees and the ankle neutral. An emollient will be applied to the plantar surface, followed by six minutes of IASTM. Sweeping and fanning strokes will be performed from the calcaneus toward the metatarsal heads, with the instrument held at approximately 45 degrees to the skin. Pressure will be adjusted according to comfort. Both groups will receive standardized stretching, strengthening, ultrasound therapy, and home exercises. Stretching will include plantar fascia, gastrocnemius, soleus, and towel stretches. Ultrasound will use 3 MHz frequency, 1.2-1.5 W\u002Fcm² intensity for subacute or chronic presentations, continuous mode, and 5-8 minutes per session, twice weekly for four weeks. Strengthening will progress from towel scrunches, marble pickups, and short-foot exercises during weeks 1-2 to eccentric heel drops, resisted plantarflexion and dorsiflexion, supported single-leg heel raises, and toe-spreading or resisted toe-flexion exercises during weeks 3-4. Treatment will be provided twice weekly for four weeks, resulting in eight sessions. Assessments will occur at baseline, after two weeks, and after four weeks. The study will be single blinded. Because of nature of the interventions, participants and the treating physiotherapist cannot be blinded; however, the outcome assessor will remain blinded to group allocation. Data will be analyzed using IBM SPSS Version 21. The Shapiro-Wilk test will assess normality, and parametric or non-parametric statistical tests will be selected according to data distribution. Qualitative data will be presented as frequencies and percentages, while quantitative data will be summarized using mean and standard deviation or median and interquartile range, as appropriate. Statistical significance will be set at p\\\u003C0.05 with a 95% confidence interval. Ethical approval will be sought from the Ethical Review Committee of Foundation University, Islamabad. Written informed consent will be obtained from all eligible participants after explanation of the study procedures and data collection. Participants may withdraw at any stage. Confidentiality will be maintained, and study data will be securely stored. The study will compare TFM and IASTM for pain, foot function, and anklerange of motion in patients with plantar fasciitis. By evaluating outcomes at baseline, two weeks, and four weeks, the study aims to determine whether either technique produces greater improvement when combined with a standardized physiotherapy protocol. Findings may guide evidence-based management.",[31,36],{"label":32,"type":33,"description":20,"interventionNames":34},"Group A Transverse Friction Massage","ACTIVE_COMPARATOR",[35],"Procedure: Transverse Friction Massage",{"label":37,"type":38,"description":20,"interventionNames":39},"Group B Instrument-Assisted Soft-Tissue Mobilization","EXPERIMENTAL",[40],"Procedure: Instrument-Assisted Soft-Tissue Mobilization",[42,47],{"type":43,"name":44,"description":45,"armGroupLabels":46,"otherNames":20},"PROCEDURE","Transverse Friction Massage","Transverse Friction Massage (TFM) will be administered to participants in Group A as an adjunct to the standardized physiotherapy protocol.The technique is intended to address abnormal soft-tissue adhesions, improve plantar fascia mobility, reduce scar formation, and alleviate chronic pain. The participant will be positioned in supine lying, and the most painful area of the plantar fascia insertion will be identified. The foot will be dorsiflexed to facilitate stretching of the plantar fascia. Deep friction massage will then be applied using a reinforced index finger in a transverse direction, perpendicular to the tissue fibers. The therapist will perform controlled back-and-forth movements across the affected tissue within the participant's tolerance for approximately 5 minutes. TFM will be provided twice weekly for four weeks, resulting in eight treatment sessions.",[32],{"type":43,"name":48,"description":49,"armGroupLabels":50,"otherNames":20},"Instrument-Assisted Soft-Tissue Mobilization","Instrument-Assisted Soft-Tissue Mobilization (IASTM) will be administered to Group B along with the standardized physiotherapy protocol. The technique is used to facilitate soft-tissue mobility, address adhesions, stimulate local circulation, and promote tissue remodeling. It may help reduce pain, improve tissue flexibility and function. A 3-minute cycling or walking warm-up will be performed before treatment. The participant will be positioned prone with the involved knee flexed to 90° and ankle in neutral. An emollient will be applied to the plantar surface. IASTM will then be performed for approximately 6 minutes using a specialized instrument held at approximately 45° to the skin. Sweeping and fanning strokes will be applied from the calcaneus toward the metatarsal heads, with pressure adjusted according to participant tolerance. Treatment will be provided twice weekly for four weeks, totaling eight sessions.",[37],[52,57],{"name":53,"role":54,"phone":55,"phoneExt":20,"email":56},"Adeeba Afzal, DPT","CONTACT","+923341822252","adeebaafzal10888@gmail.com",{"name":58,"role":54,"phone":59,"phoneExt":20,"email":60},"Anam Rehman, MS-OMPT","+923355082299","anam.rehman@fui.edu.pk",[62],{"facility":63,"status":64,"city":65,"state":66,"zip":67,"country":68,"countryCode":69,"cosmosGeoPoint":70,"geoPoint":75,"contacts":76},"Foundation University College of Physical Therapy","RECRUITING","Islamabad","Punjab Province","44000","Pakistan","PK",{"type":71,"coordinates":72},"Point",[73,74],74.4039,31.6047,{"lat":74,"lon":73},[77],{"name":58,"role":54,"phone":59,"phoneExt":20,"email":60},{"type":79,"investigatorFullName":20,"investigatorTitle":20,"investigatorAffiliation":20,"oldNameTitle":20,"oldOrganization":20},"SPONSOR","100658701","comparison-of-transverse-friction-massage-and-instrument--assisted-soft-tissue-mobilization-in-plantar-fasciitis-100658701",false,"NCT07856147","Comparison of Transverse Friction Massage and Instrument- Assisted Soft-Tissue Mobilization in Plantar Fasciitis","Inclusion Criteria:\n\n* Age (adults 19 - 44 years).\n* Male and female both are included.\n* Pain in plantar heel lasting more than 3 months.\n* Clinically diagnosed plantar fasciitis patients in compliance with the American physical therapy association's (APTA) Orthopedic Section clinical practice guidelines.\n* Positive windlass test;\n* Negative tarsal tunnel tests;\n* Limited active and passive talocrural joint dorsiflexion range of motion;\n* Plantar medial heel pain; most noticeable with initial steps after a period of inactivity but also worse after prolonged weight bearing.\n\nExclusion Criteria:\n\n* Previous surgical intervention for plantar fasciitis.\n* Congenital abnormalities of foot.\n* Lower extremities affected by systemic disorders, such as rheumatoid arthritis, diabetes or peripheral neuropathy.\n* The presence of additional foot disorders, such as stress fractures, Achilles tendinopathy, or nerve entrapment syndromes.\n* Any contraindications to Instrument-Assisted Soft-Tissue Mobilization such as open wounds, skin infections, acute inflammation or intolerance to mechanical pressure.\n* Not willing or not capable of adhering to the study procedure and completing follow- up examinations.\n* Pregnant women, mental illness, immune suppressed patients, patients with peripheral vascular disease, thrombocytopenia patients, anti-coagulant therapy patients and post mastectomy.","ALL","19 Years","44 Years",{"count":90,"type":91},34,"ESTIMATED","INTERVENTIONAL",[94],"NA","Plantar fasciitis is a common musculoskeletal condition characterized by plantar heel pain, particularly during the first steps after waking or following prolonged rest. It can substantially affect walking, standing, daily activities, and overall functional ability. Although conservative physiotherapy management is commonly used, the relative effectiveness of different manual therapy techniques remains unclear. The present study aims to compare the effectiveness of Transverse Friction Massage (TFM) and Instrument-Assisted Soft-Tissue Mobilization (IASTM) in patients with plantar fasciitis. The study will be conducted as a single-blinded randomized controlled trial at Foundation University College of Physical Therapy, Islamabad. A total of 34 participants will be recruited using purposive sampling and subsequently randomized into two groups through a sealed opaque envelope method. Participants will be adults aged 19-44 years with clinically diagnosed plantar fasciitis and symptoms.\n\npersisting for more than three months. Group A will receive Transverse Friction Massage, while Group B will receive Instrument-Assisted Soft-Tissue Mobilization. Both groups will additionally receive a standardized physiotherapy protocol consisting of stretching exercises, strengthening exercises, ultrasound therapy, home-based exercises, and activity modification. The interventions will be administered twice weekly for four weeks, resulting in a total of eight treatment sessions. The primary clinical outcomes will include pain intensity, foot-related functional impairment, and ankle range of motion. Pain will be assessed using the Numeric Pain Rating Scale (NPRS), foot function using the Foot Function Index (FFI), and ankle range of motion using a goniometer. Assessments will be performed at baseline, after two weeks, and at the end of four weeks. Data will be analyzed using SPSS. Appropriate parametric or non-parametric statistical tests will be applied according to data distribution, with statistical significance set at p\\\u003C0.05 and a 95% confidence interval. The study is expected to provide evidence regarding the comparative effectiveness of TFM and IASTM for reducing pain, improving foot function, and enhancing ankle mobility in patients with plantar fasciitis.",[97],"Plantar Fasciitis","2026-09-28",{"date":100,"type":101},"2026-10-02","ACTUAL",{"date":103,"type":101},"2026-02-11",{"date":105,"type":91},"2027-01-18",{"name":5,"class":6},1]