Plantar FascitisNCT07078539
Effect of Kaltenborn vs Mulligan Mobilization With Intrinsic Foot Strengthening in Plantar Fasciitis
A study testing Kaltenborn Mobilization Group and Mulligan Mobilization Group in people with Plantar Fascitis and Heel Pain Syndrome, run by Riphah International University at 1 site in Pakistan.
Trial summary
This study will compare the effects of Kaltenborn and Mulligan ankle mobilization techniques, combined with intrinsic foot muscle strengthening, on pain, functional status, and dorsiflexion range of motion in patients with plantar fasciitis. Read more about this study
- Who is it for?
- Ages 30 to 60 years
- Conditions the study is for
- Plantar Fascitis, Heel Pain Syndrome
- What is being tested?
- Kaltenborn Mobilization Group and Mulligan Mobilization Group
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 74 participants
- Where
- 1 sitePakistan
- Study dates
- Jul 2025to 30 Nov 2025
- Phase
- Interventional
- Are there results?
- Not yet: the study is under way
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages 30 to 60 years
- All sexes
- No healthy volunteers
- Adult
Who may be able to join
- Age group between 30-60.
- Both genders (male and female) included.
- Subjects with the ankle and heel pain complain especially morning or after rest and limited ankle ROM due to pain
- Positive Windlass test: Pain increase upon toe standing and decreases upon walking.
- Duration of pain in 4 weeks or more.
- Tenderness on medial calcaneal tuberosity.
- NPRS score of 4 or more
Who cannot join
- Patients contraindicated to manual therapy (tumor, fracture or osteoporosis). Any history of knee, tibia, fibula, ankle or foot surgery or stress fracture of calcaneum.
- Previously received physiotherapy treat.
- History of non-steroidal anti-inflammatory medications or corticosteroid injection in last 3 weeks prior to surgery.
- Pregnancy (because of sudden weight changes and pedal edema which causes heel pain).
- Conditions like rheumatoid arthritis, ankylosing spondylitis, systematic lupus erythematous, peripheral neuropathy, sever's disease, severe vascular disease or tarsal tunnel.
Trial locations and contacts
1 site in 1 country. Contact the study team or a site near you to ask about taking part.
Pakistan1 site
Bashir Health Services
Sialkot, Punjab Province
Bilal Abbas, 03327414440
About this study
Official title: Comparative Effect of Kaltenborn and Mulligan Mobilization With Intrinsic Foot Muscle Strengthening on Pain, Functional Status, and Windlass Mechanism in Patients With Plantar Fasciitis
This study will compare the effects of Kaltenborn and Mulligan ankle mobilization techniques, combined with intrinsic foot muscle strengthening, on pain, functional status, and dorsiflexion range of motion in patients with plantar fasciitis. Eighty-two participants with chronic heel pain will be randomly allocated into two groups. Both groups will receive standard care including ultrasound therapy, stretching, and cryotherapy, while Group A will receive Kaltenborn mobilization and Group B will receive Mulligan mobilization. Pain, function, and ankle range of motion will be assessed at baseline and after three weeks of treatment.
Read the detailed description
This prospective randomized clinical trial will aim to evaluate and compare the effectiveness of two manual therapy techniques-Kaltenborn and Mulligan mobilizations-combined with intrinsic foot muscle strengthening in the treatment of plantar fasciitis. The study will be conducted at two physiotherapy clinics in Sialkot, Pakistan. A total of 82 eligible participants aged 30-60 years, diagnosed with plantar fasciitis, will be enrolled using non-probability convenience sampling and then randomised into two equal groups through the lottery method.
Group A will receive Kaltenborn mobilization techniques applied to the talocrural and subtalar joints, in addition to conventional treatment (therapeutic ultrasound, plantar fascia and calf stretching, intrinsic foot muscle strengthening, and cryotherapy). Group B will receive Mulligan mobilization with movement (MWM) applied to the same joints, alongside the same conventional treatment.
Interventions will be delivered twice weekly for three weeks (total six sessions). The primary outcomes will include changes in pain intensity (Numeric Pain Rating Scale), functional disability (Foot Function Index), and ankle dorsiflexion range of motion (measured using a goniometer). Measurements will be taken at baseline and at the end of the third week. It is hypothesised that Kaltenborn mobilization may demonstrate superior outcomes in pain reduction and functional improvement compared to Mulligan MWM when combined with strengthening exercises.
- Conditions
- Plantar Fascitis, Heel Pain Syndrome
- Being tested
- Kaltenborn Mobilization Group, Mulligan Mobilization Group
- Keywords
- Manual Therapy, Intrinsic Foot Muscle Strengthening, Heel Pain, Kaltenborn Mobilization, Mulligan Mobilization
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
Kaltenborn Mobilization GroupOther
Participants in this group will receive Kaltenborn mobilization techniques applied to the talocrural and subtalar joints. Mobilizations will be performed as Grade III passive accessory glides for 10 repetitions per joint, each sustained for 15 seconds with a 10-second rest interval
Conventional treatment includs therapeutic ultrasound (3 MHz, 1.5 W/cm², continuous mode for 5 minutes), plantar fascia and calf stretching (10 minutes, 1 set of 10 reps), intrinsic foot muscle strengthening exercises (toe curls and towel curls for 10 minutes, 2 sets of 10 reps), and cryotherapy at home for 10 minutes daily. The intervention will be delivered twice weekly for 3 weeks.
Mulligan Mobilization GroupOther
Participants in this group will receive Mulligan mobilization with movement (MWM) techniques applied to the talocrural and subtalar joints. Mobilizations will be applied as 3 sets of 10 repetitions per joint with 1-minute rest between sets.
Conventional treatment includs therapeutic ultrasound (3 MHz, 1.5 W/cm², continuous mode for 5 minutes), plantar fascia and calf stretching (10 minutes, 1 set of 10 reps), intrinsic foot muscle strengthening exercises (toe curls and towel curls for 10 minutes, 2 sets of 10 reps), and cryotherapy at home for 10 minutes daily. The intervention will be delivered twice weekly for 3 weeks.
| Study group | Role | What they receive |
|---|---|---|
| Kaltenborn Mobilization Group | Experimental | Participants in this group will receive Kaltenborn mobilization techniques applied to the talocrural and subtalar joints. Mobilizations will be performed as Grade III passive accessory glides for 10 repetitions per joint, each sustained for 15 seconds with a 10-second rest interval Receives: Other: Kaltenborn Mobilization Group |
| Mulligan Mobilization Group | Experimental | Participants in this group will receive Mulligan mobilization with movement (MWM) techniques applied to the talocrural and subtalar joints. Mobilizations will be applied as 3 sets of 10 repetitions per joint with 1-minute rest between sets. Receives: Other: Mulligan Mobilization Group |
What is being measured
The primary outcome is the main question the study is designed to answer.
Numeric Pain Rating Scale
Pain intensity will be assessed using the Numeric Pain Rating Scale (NPRS), a validated 11-point scale ranging from 0 (no pain) to 10 (worst imaginable pain).
Measured: Baseline and at the end of Week 3 (post-intervention)
Foot Function Index - FFI
Functional disability will be evaluated using the Foot Function Index (FFI), a validated questionnaire assessing foot pain, disability, and activity limitation. It comprises 23 items scored on a visual analogue scale, with higher scores indicating greater impairment.
Measured: Baseline and at the end of Week 3 (post-intervention)
Ankle Dorsiflexion Range of Motion
Ankle dorsiflexion will be measured using a universal goniometer to assess changes in passive range of motion.
Measured: Baseline and at the end of Week 3 (post-intervention)
Windlass Test
The Windlass Test will be used as a clinical indicator of plantar fascia integrity and responsiveness. The test will be performed in a weight-bearing position by passively dorsiflexing the great toe while the patient stands on the affected foot. A positive result is defined by reproduction of heel or arch pain during the manoeuvre.
Measured: Baseline and at the end of Week 3 (post-intervention)
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted22 Jul 2025
- Study startJul 2025 (estimated)
- Primary completion15 Nov 2025 (estimated)
- Study completion30 Nov 2025 (estimated)
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Publications (5)Papers the sponsor has linked to this study.
- Other trials for Plantar FascitisStudies of the same condition, open and under way.
- More trials run by Riphah International UniversityThe sponsor's other registered studies.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Interventional
- Phase
- Phase N/A
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Double blind
- Who is masked
- Participant, Outcomes assessor
- Enrolment
- 74 participants (estimated)
Sponsor and investigators
- Lead sponsor
- Riphah International University
- Sponsor type
- University, hospital or other
- Responsible party
- Sponsor
- Investigators
- Amna Zia, Phd Scholar, Principal investigator, Riphah International University / Mayo Hospital, LahoreAdeena Nazim, MSc Student, Principal investigator, Riphah International University
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT07078539
- Sponsor's protocol ID
- REC/RCR & AHS/24/0164 -Adeena
- Status last verified
- Jul 2025
- First submitted
- 14 Jul 2025
- Last updated
- 22 Jul 2025
- Results posted
- No
- Data monitoring committee
- No
- FDA-regulated drug
- No
- FDA-regulated device
- No
- Individual data sharing
- No
Publications
Szajkowski S, Pasek J, Cieslar G. Dose Escalation Can Enhance the Therapeutic Potential of Radial Extracorporeal Shock-Wave Therapy in the Treatment of Plantar Fasciitis in Runners. Medicina (Kaunas). 2024 May 6;60(5):766. doi: 10.3390/medicina60050766.
PubMed 38792948Boob MA Jr, Phansopkar P, Somaiya KJ. Physiotherapeutic Interventions for Individuals Suffering From Plantar Fasciitis: A Systematic Review. Cureus. 2023 Jul 31;15(7):e42740. doi: 10.7759/cureus.42740. eCollection 2023 Jul.
PubMed 37654968Rathleff MS, Molgaard CM, Fredberg U, Kaalund S, Andersen KB, Jensen TT, Aaskov S, Olesen JL. High-load strength training improves outcome in patients with plantar fasciitis: A randomized controlled trial with 12-month follow-up. Scand J Med Sci Sports. 2015 Jun;25(3):e292-300. doi: 10.1111/sms.12313. Epub 2014 Aug 21.
PubMed 25145882Maheta U, Thakarar S, Thakarar J, Pandita V, Patel SB, Ranu A, et al. EFFECTIVENESS OF MAITLAND MOBILIZATION VERSUS MULLIGAN MOBILIZATION FOR FLATFOOT IN THE MIDTARSAL JOINT.
Shabbir S, Ahmad A, Munawar A, Siddique K, Perwaiz S. Comparison of mobilization with movement and dorsiflexion night splint with and without routine exercises in patients with plantar fasciitis. Rawal Medical Journal. 2022;47(3):650-.
Study at a glance
From the registry record, last updated by the sponsor on 22 Jul 2025. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Comparative Effect of Kaltenborn and Mulligan Mobilization With Intrinsic Foot Muscle Strengthening on Pain, Functional Status, and Windlass Mechanism in Patients With Plantar Fasciitis
- ClinicalTrials.gov ID
- NCT07078539
- Acronym / sponsor ID
- REC/RCR & AHS/24/0164 -Adeena
- Conditions
- Plantar Fascitis, Heel Pain Syndrome
- Keywords
- Manual Therapy, Intrinsic Foot Muscle Strengthening, Heel Pain, Kaltenborn Mobilization, Mulligan Mobilization
- Study type
- Interventional
- Recruitment status
- Not yet recruiting
- Enrolment
- 74 participants (estimated)
- Lead sponsor
- Riphah International UniversityUniversity, hospital or other
- Study start
- Jul 2025 (estimated)
- Primary completion
- 15 Nov 2025 (estimated)
- Study completion
- 30 Nov 2025 (estimated)
- First posted
- 22 Jul 2025 (actual)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
This study will compare the effects of Kaltenborn and Mulligan ankle mobilization techniques, combined with intrinsic foot muscle strengthening, on pain, functional status, and dorsiflexion range of motion in patients with plantar fasciitis. Eighty-two participants with chronic heel pain will be randomly allocated into two groups. Both groups will receive standard care including ultrasound therapy, stretching, and cryotherapy, while Group A will receive Kaltenborn mobilization and Group B will receive Mulligan mobilization. Pain, function, and ankle range of motion will be assessed at baseline and after three weeks of treatment.
Detailed description
This prospective randomized clinical trial will aim to evaluate and compare the effectiveness of two manual therapy techniques-Kaltenborn and Mulligan mobilizations-combined with intrinsic foot muscle strengthening in the treatment of plantar fasciitis. The study will be conducted at two physiotherapy clinics in Sialkot, Pakistan. A total of 82 eligible participants aged 30-60 years, diagnosed with plantar fasciitis, will be enrolled using non-probability convenience sampling and then randomised into two equal groups through the lottery method.
Group A will receive Kaltenborn mobilization techniques applied to the talocrural and subtalar joints, in addition to conventional treatment (therapeutic ultrasound, plantar fascia and calf stretching, intrinsic foot muscle strengthening, and cryotherapy). Group B will receive Mulligan mobilization with movement (MWM) applied to the same joints, alongside the same conventional treatment.
Interventions will be delivered twice weekly for three weeks (total six sessions). The primary outcomes will include changes in pain intensity (Numeric Pain Rating Scale), functional disability (Foot Function Index), and ankle dorsiflexion range of motion (measured using a goniometer). Measurements will be taken at baseline and at the end of the third week. It is hypothesised that Kaltenborn mobilization may demonstrate superior outcomes in pain reduction and functional improvement compared to Mulligan MWM when combined with strengthening exercises.
Study design
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Double blind (participant, outcomes assessor)
- Number of arms
- 2
| Arm | Type | Receives |
|---|---|---|
| Kaltenborn Mobilization Group | Experimental | Other: Kaltenborn Mobilization GroupParticipants in this group will receive Kaltenborn mobilization techniques applied to the talocrural and subtalar joints. Mobilizations will be performed as Grade III passive accessory glides for 10 repetitions per joint, each sustained for 15 seconds with a 10-second rest interval |
| Mulligan Mobilization Group | Experimental | Other: Mulligan Mobilization GroupParticipants in this group will receive Mulligan mobilization with movement (MWM) techniques applied to the talocrural and subtalar joints. Mobilizations will be applied as 3 sets of 10 repetitions per joint with 1-minute rest between sets. |
Who may qualify
- Ages
- 30 to 60 years
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult
Key inclusion criteria (7 listed)
- Age group between 30-60.
- Duration of pain in 4 weeks or more.
- Tenderness on medial calcaneal tuberosity.
- NPRS score of 4 or more
Key exclusion criteria (5 listed)
- Patients contraindicated to manual therapy (tumor, fracture or osteoporosis). Any history of knee, tibia, fibula, ankle or foot surgery or stress fracture of calcaneum.
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| Kaltenborn Mobilization GroupParticipants in this group will receive Kaltenborn mobilization techniques applied to the talocrural and subtalar joints. Mobilizations will be performed as Grade III passive accessory glides for 10 repetitions per joint, each sustained for 15 seconds with a 10-second rest interval Conventional treatment includs therapeutic ultrasound (3 MHz, 1.5 W/cm², continuous mode for 5 minutes), plantar fascia and calf stretching (10 minutes, 1 set of 10 reps), intrinsic foot muscle strengthening exercises (toe curls and towel curls for 10 minutes, 2 sets of 10 reps), and cryotherapy at home for 10 minutes daily. The intervention will be delivered twice weekly for 3 weeks. | Other | Kaltenborn Mobilization Group |
| Mulligan Mobilization GroupParticipants in this group will receive Mulligan mobilization with movement (MWM) techniques applied to the talocrural and subtalar joints. Mobilizations will be applied as 3 sets of 10 repetitions per joint with 1-minute rest between sets. Conventional treatment includs therapeutic ultrasound (3 MHz, 1.5 W/cm², continuous mode for 5 minutes), plantar fascia and calf stretching (10 minutes, 1 set of 10 reps), intrinsic foot muscle strengthening exercises (toe curls and towel curls for 10 minutes, 2 sets of 10 reps), and cryotherapy at home for 10 minutes daily. The intervention will be delivered twice weekly for 3 weeks. | Other | Mulligan Mobilization Group |
Primary outcome
Numeric Pain Rating Scale
Time frame: Baseline and at the end of Week 3 (post-intervention)
Pain intensity will be assessed using the Numeric Pain Rating Scale (NPRS), a validated 11-point scale ranging from 0 (no pain) to 10 (worst imaginable pain).
Foot Function Index - FFI
Time frame: Baseline and at the end of Week 3 (post-intervention)
Functional disability will be evaluated using the Foot Function Index (FFI), a validated questionnaire assessing foot pain, disability, and activity limitation. It comprises 23 items scored on a visual analogue scale, with higher scores indicating greater impairment.
Ankle Dorsiflexion Range of Motion
Time frame: Baseline and at the end of Week 3 (post-intervention)
Ankle dorsiflexion will be measured using a universal goniometer to assess changes in passive range of motion.
Windlass Test
Time frame: Baseline and at the end of Week 3 (post-intervention)
The Windlass Test will be used as a clinical indicator of plantar fascia integrity and responsiveness. The test will be performed in a weight-bearing position by passively dorsiflexing the great toe while the patient stands on the affected foot. A positive result is defined by reproduction of heel or arch pain during the manoeuvre.
Results and safety
This study is still under way. Results are not available in the source record yet.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 22 Jul 2025.
- Background: PubMed 38792948Szajkowski S, Pasek J, Cieslar G. Dose Escalation Can Enhance the Therapeutic Potential of Radial Extracorporeal Shock-Wave Therapy in the Treatment of Plantar Fasciitis in Runners. Medicina (Kaunas). 2024 May 6;60(5):766. doi: 10.3390/medicina60050766.
- Background: PubMed 37654968Boob MA Jr, Phansopkar P, Somaiya KJ. Physiotherapeutic Interventions for Individuals Suffering From Plantar Fasciitis: A Systematic Review. Cureus. 2023 Jul 31;15(7):e42740. doi: 10.7759/cureus.42740. eCollection 2023 Jul.
- Background: PubMed 25145882Rathleff MS, Molgaard CM, Fredberg U, Kaalund S, Andersen KB, Jensen TT, Aaskov S, Olesen JL. High-load strength training improves outcome in patients with plantar fasciitis: A randomized controlled trial with 12-month follow-up. Scand J Med Sci Sports. 2015 Jun;25(3):e292-300. doi: 10.1111/sms.12313. Epub 2014 Aug 21.
- BackgroundMaheta U, Thakarar S, Thakarar J, Pandita V, Patel SB, Ranu A, et al. EFFECTIVENESS OF MAITLAND MOBILIZATION VERSUS MULLIGAN MOBILIZATION FOR FLATFOOT IN THE MIDTARSAL JOINT.
- BackgroundShabbir S, Ahmad A, Munawar A, Siddique K, Perwaiz S. Comparison of mobilization with movement and dorsiflexion night splint with and without routine exercises in patients with plantar fasciitis. Rawal Medical Journal. 2022;47(3):650-.
- Individual participant dataSharing planned: No
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part.
Amna Zia, Phd Scholar principal investigator
Riphah International University / Mayo Hospital, Lahore
Adeena Nazim, MSc Student principal investigator
Riphah International University
1 site in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A study testing Kaltenborn Mobilization Group and Mulligan Mobilization Group in people with Plantar Fascitis and Heel Pain Syndrome, run by Riphah International University at 1 site in Pakistan.
The full registered description is in the About this study section and the official record.
Who may be eligible to take part?
The sponsor lists 7 inclusion and 5 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.
Is this clinical trial currently recruiting?
The record says: opening soon, as of the sponsor's last update on 22 Jul 2025. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 1 site in Pakistan. Whether a site is taking part right now should be confirmed with that site. See every site.
What are the possible benefits and risks?
They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
Are results available for this study?
This study is still under way. Results are not available in the source record yet.
How can a doctor refer a patient or contact the research team?
Contact Samrood Akram (03324806143, samood.akram@riphah.edu.pk), or a site near the patient. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
Numeric Pain Rating Scale (time frame: Baseline and at the end of Week 3 (post-intervention)). The study lists 4 primary outcomes in all. It is what the study was designed to measure, not a finding.
Where can I read the original study information?
On the ClinicalTrials.gov record for NCT07078539, which also lists 5 linked publications.
Does a listing mean the treatment is approved or proven to work?
No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.
How often is this information updated?
AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 22 Jul 2025.