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IRCT20210704051785N3 IRCT 2023-08-05 sharif medical and dental college surgery versus physiotherapy which treatment is better for heel pain. RCT Effects of Gastrocnemius recession versus physical therapy in chronic plantar fasciitis 2023-07-01 anticipated 40 Complete https://irct.ir/trial/71384 interventional Randomization: Randomized, Blinding: Single blinded, Placebo: Not used, Assignment: Parallel, Purpose: Treatment, Other design features: no, Randomization description: The sealed envelope method will be used for random allocation. 40 sealed envelopes (20 for Group A and 20 for Group B) will be prepared. 20 envelopes will contain the letter A, and 20 will include the letter B on a card. The patient will be asked to choose one envelope. Treatment will be given according to treatment group (Group A: control, Group B: experiment), Blinding description: Senior physiotherapists will assess the patient before and after treatment. Senior physiotherapist/assessor will be blinded entirely about patient allocation group (control/intervention). N/A Plantar fasciitis, heel pain. Intervention 1: Intervention group: Phonophoresis with ketoprofen gel will reduce pain on alternate days for 4 weeks. Stretching Calf muscle and plantar fascia–specific stretching will be used to relieve pain and improve calf muscle flexibility 3 times a day (3 minutes) stretching time, for three months in the home plan. Manual therapy procedures include talocrural joint posterior glide, subtalar joint lateral glide, anterior and posterior glides of the first tarsometatarsal joint, and subtalar joint distraction manipulation, done on alternate days for 4 weeks. Intervention 2: Intervention group: Patients randomized to surgery will be operated with a proximal medial gastrocnemius recession(PMGR) as described by Barouk(17)(Figure 1). No additional procedures will be performed. The operation will be performed with the patients in a prone position under local anesthetic or general anesthesia. A 3-cm transverse skin incision was made in the popliteal fossa, the fascia was opened, and the medial gastrocnemius with its tendon was located. The tendon was then cut while lifting the gastrocnemius with clamps, and care was taken to cut only the white tendon while sparing the underlying muscle. While performing a dorsiflexion movement of the ankle, careful palpation of the muscle was done to ensure that all tendon strands were cut completely. The incision was closed in layers, and only soft dressings were applied. Patients were instructed to continue the stretching exercises and fully weight-bear from the first postoperative day. If needed, the patients were allowed to use crutches during the first 2 weeks after surgery. Sutures were removed 2 weeks after surgery.Calf muscle and plantar fascia–specific stretching will be used to relieve pain and improve calf muscle flexibility 3 times a day (3 minutes) stretching time, for three months in the home plan. Undecided - It is not yet known if there will be a plan to make this available Justification or reason for indecision in sharing IPD is there is no further information
public Sarwat Anees
Sharif Polyclinic, near Doce Bakers, Railway Road, Raiwind
Lahore Pakistan 55150 +92 303 4846498 sarwatasifmehmood@gmail.com Punjab Social Security Health Management Company Hospital scientific Sarwat Anees
Sharif polyclinic, near Muzammil Mart, railway road, raiwind
Raiwind Pakistan 55150 +92 303 4846498 sarwatasifmehmood@gmail.com Sharif medical and dental college Pakistan Pakistan Heel pain lasting > 3 months Pain in morning(morning stiffness) Tenderness over medial plantar fascia insertion Positive Silfverskiöld test not recieved physiotherapy session 30 years 50 years Both Degenerative arthritis of the hindfoot joints Systemic joint disease Previous injury or surgery to the foot or ankle Inoperable due to comorbidity M72.2 Plantar fascial fibromatosis Treatment - Other Treatment - Surgery Intervention group: Phonophoresis with ketoprofen gel will reduce pain on alternate days for 4 weeks. Stretching Calf muscle and plantar fascia–specific stretching will be used to relieve pain and improve calf muscle flexibility 3 times a day (3 minutes) stretching time, for three months in the home plan. Manual therapy procedures include talocrural joint posterior glide, subtalar joint lateral glide, anterior and posterior glides of the first tarsometatarsal joint, and subtalar joint distraction manipulation, done on alternate days for 4 weeks Intervention group: Patients randomized to surgery will be operated with a proximal medial gastrocnemius recession(PMGR) as described by Barouk(17)(Figure 1). No additional procedures will be performed. The operation will be performed with the patients in a prone position under local anesthetic or general anesthesia. A 3-cm transverse skin incision was made in the popliteal fossa, the fascia was opened, and the medial gastrocnemius with its tendon was located. The tendon was then cut while lifting the gastrocnemius with clamps, and care was taken to cut only the white tendon while sparing the underlying muscle. While performing a dorsiflexion movement of the ankle, careful palpation of the muscle was done to ensure that all tendon strands were cut completely. The incision was closed in layers, and only soft dressings were applied. Patients were instructed to continue the stretching exercises and fully weight-bear from the first postoperative day. If needed, the patients were allowed to use crutches during the first 2 weeks after surgery. Sutures were removed 2 weeks after surgery.Calf muscle and plantar fascia–specific stretching will be used to relieve pain and improve calf muscle flexibility 3 times a day (3 minutes) stretching time, for three months in the home plan Pain intensity. Timepoint: numeric pain rating scale will be measured at basline and at 3 months and at 6 months. Method of measurement: measured by numeric pain rating scale. Foot and ankle function involving a range of daily activities. Timepoint: foot and ankle function involving a range of daily activities will be assessed at baseline and at 3 months and at 6 months. Method of measurement: foot and ankle function involving a range of daily activities(FAAM-ADL) scale used. The american orthopedic foot and ankle society ANKLE-HINDFOOT scale. Timepoint: will be assessed at baseline and at 3 months and at 6 months. Method of measurement: AOFAS ankle hindfoot scale used. Health related quality of life. Timepoint: will be assessed at baseline and at 3 months and at 6 months. Method of measurement: the short form SF-36 used. funding Approved 2023-06-10 the superior university ethics committee raiwind road, lahore lahore punjab Pakistan