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Chronic Refractory Plantar FasciopathyNCT07654660

Multimodal Conservative Intervention Versus Surgery for Chronic Refractory Plantar Fasciopathy

A study testing Multimodal Conservative Intervention and Endoscopic Plantar Fascial Release in people with Chronic Refractory Plantar Fasciopathy, run by Universidad Europea de Valencia at 1 site in Spain.

Not yet recruiting

Opening soon. The study is approved but enrolment has not started yet. Sites may already take enquiries.

Sites and contacts
Official record
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Trial summary

Chronic refractory plantar fasciopathy is a common musculoskeletal condition that can cause persistent heel pain and functional limitations despite conservative treatment. When symptoms do not improve, patients often face the decision between continuing non-surgical management or undergoing surgery. Read more about this study

Who is it for?
Ages 30 to 65 years
Conditions the study is for
Chronic Refractory Plantar Fasciopathy
What is being tested?
Multimodal Conservative Intervention and Endoscopic Plantar Fascial Release
Type of treatment
Surgery or procedure
Could I receive a placebo?
No, everyone receives an active treatment
How many people
120 participants
Where
1 siteSpain
Study dates
Dec 2026to Jan 2028
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 65 years
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • Adults aged 30 to 65 years.
  • Diagnosis of chronic refractory plantar fasciopathy with symptom duration greater than 6 months.
  • Failure of at least two previous conservative treatments, each lasting at least 12 weeks.
  • Foot Function Index (FFI) total score ≥45 points.
  • Resting pain intensity ≥4/10 on the Visual Analog Scale (VAS).
  • Plantar fascia thickness ≥4 mm at the calcaneal insertion confirmed by ultrasound.
  • Ability to provide written informed consent and comply with study procedures.

Who cannot join

  • Previous foot surgery on the affected side.
  • Calcaneal stress fracture.
  • Glycated hemoglobin (HbA1c) >7.5%.
  • Inability or unwillingness to comply with study procedures or follow-up assessments.

Trial locations and contacts

1 site in 1 country. Contact the study team or a site near you to ask about taking part.

Javier Bonastre Férez, PhD contact

+34644120315

javier.bonastre@universidadeuropea.es

Spain1 site
  • European University of Valencia

    Valencia, Valencia, 46010

    Javier Bonastre Férez, PhD, +34644120315, javier.bonastre@universidadeuropea.es

Other trials in Spain

About this study

Official title: Study Protocol for a Multicenter Controlled Trial Comparing Multimodal Conservative Intervention Versus Surgical Management in Chronic Refractory Plantar Fasciopathy

Chronic refractory plantar fasciopathy is a common musculoskeletal condition that can cause persistent heel pain and functional limitations despite conservative treatment. When symptoms do not improve, patients often face the decision between continuing non-surgical management or undergoing surgery. However, direct comparative evidence between these treatment strategies is limited.

This multicenter controlled trial aims to compare the effectiveness of a multimodal conservative intervention consisting of manual therapy and ultrasound-guided percutaneous neuromodulation with endoscopic plantar fascial release followed by standard postoperative rehabilitation in adults with chronic refractory plantar fasciopathy.

A total of 120 participants will be allocated to treatment groups according to their informed treatment preference within a shared decision-making process. The primary outcome will be the change in the Foot Function Index (FFI) after 6 weeks. Secondary outcomes include pain intensity, health-related quality of life, treatment adherence, adverse events, and exploratory neurophysiological measures. The results are expected to provide evidence to support clinical decision-making and optimize the management of patients with chronic refractory plantar fasciopathy.

Read the detailed description

Chronic refractory plantar fasciopathy is one of the most common causes of persistent heel pain and is associated with substantial disability, reduced quality of life, and limitations in daily and occupational activities. Although most patients respond to conservative management, a subgroup continues to experience symptoms despite prolonged treatment and may be considered for surgical intervention. However, evidence directly comparing optimized multimodal conservative care with surgical management remains limited.

This multicenter, non-randomized controlled trial has been designed to evaluate the comparative effectiveness of these two therapeutic strategies under real-world clinical conditions. Participants will be allocated to treatment groups according to their informed treatment preference following a standardized shared decision-making process.

The experimental group will receive a 6-week multimodal conservative intervention consisting of manual therapy techniques and ultrasound-guided percutaneous neuromodulation delivered in 12 supervised sessions. The control group will undergo endoscopic plantar fascial release followed by a standardized postoperative rehabilitation program.

The primary outcome measure is the change in the Foot Function Index (FFI) at 6 weeks after treatment initiation. Secondary outcomes include pain intensity measured using the Visual Analog Scale (VAS), health-related quality of life assessed with the EuroQol 5-Dimension 5-Level questionnaire (EQ-5D-5L), treatment adherence, adverse events, and exploratory neurophysiological assessment through electromyography.

To minimize the effects of treatment selection bias inherent to the non-randomized design, analyses will include adjusted analysis of covariance (ANCOVA) and inverse probability of treatment weighting (IPTW). The findings of this study are expected to provide clinically relevant evidence to support shared decision-making and optimize treatment selection for patients with chronic refractory plantar fasciopathy.

Being tested
Multimodal Conservative Intervention, Endoscopic Plantar Fascial Release
Keywords
Plantar Fasciopathy, Plantar Fasciitis, Manual Therapy, Percutaneous Neuromodulation, Endoscopic Plantar Fasciotomy, Foot Function Index, Heel Pain, Conservative Treatment, Rehabilitation, Comparative Effectiveness
Medical subject headings
Fasciitis, Plantar

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Multimodal Conservative InterventionProcedure or surgery

    A 6-week multimodal conservative treatment including manual therapy techniques (gastrocnemius stretching, transverse friction massage, and tibial nerve neurodynamic mobilization) combined with ultrasound-guided percutaneous neuromodulation of the posterior tibial nerve using low-frequency electrical stimulation.

  • Endoscopic Plantar Fascial ReleaseProcedure or surgery

    Endoscopic plantar fascial release performed using a standardized surgical technique followed by a standardized postoperative rehabilitation program.

Study groups in NCT07654660
Study groupRoleWhat they receive
Multimodal Conservative InterventionExperimentalParticipants assigned to this arm will receive a 6-week multimodal conservative intervention consisting of manual therapy techniques combined with ultrasound-guided percutaneous neuromodulation, delivered in 12 supervised sessions (2 sessions per week).
Receives: Procedure: Multimodal Conservative Intervention
Surgical ManagementActive comparatorParticipants assigned to this arm will undergo endoscopic plantar fascial release followed by a standardized postoperative rehabilitation program, including manual therapy during the rehabilitation period.
Receives: Procedure: Endoscopic Plantar Fascial Release

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Change in Foot Function Index (FFI) total score

    The primary outcome is the change in the total Foot Function Index (FFI) score from baseline to 6 weeks after treatment initiation. The FFI is a validated patient-reported outcome measure assessing pain and functional disability related to foot disorders.

    Measured: Baseline and 6 weeks

Secondary outcomes (4)
  1. Change in pain intensity measured by the Visual Analog Scale (VAS)

    Pain intensity will be assessed using a 10-cm Visual Analog Scale (VAS).

    Measured: Baseline, 3 weeks, 6 weeks, and 12 weeks

  2. Change in health-related quality of life assessed by the EQ-5D-5L

    Health-related quality of life will be evaluated using the EuroQol 5-Dimension 5-Level questionnaire (EQ-5D-5L).

    Measured: Baseline, 6 weeks, and 12 weeks

  3. Treatment adherence

    Treatment adherence will be assessed as the proportion of scheduled sessions attended by participants.

    Measured: During the 6-week intervention period

  4. Incidence of adverse events

    Adverse events will be recorded and classified according to Common Terminology Criteria for Adverse Events (CTCAE) version 5.0.

    Measured: From baseline through 12 weeks

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted17 Jun 2026
  2. Study startDec 2026 (estimated)
  3. Primary completionSep 2027 (estimated)
  4. Study completionJan 2028 (estimated)

Resources

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
Non-randomised
Intervention model
Parallel groups
Model description
Participants will be assigned to one of two parallel intervention groups according to their informed treatment preference following a standardized shared decision-making process. One group will receive a multimodal conservative intervention consisting of manual therapy and ultrasound-guided percutaneous neuromodulation, while the other group will undergo endoscopic plantar fascial release followed by standardized postoperative rehabilitation.
Masking
Single blind
Who is masked
Outcomes assessor
Enrolment
120 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT07654660
Sponsor's protocol ID
UEV-PF-MTPNM-2026-01
Status last verified
Jun 2026
First submitted
12 Jun 2026
Last updated
17 Jun 2026
Results posted
No
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
Undecided: At the time of study registration, no final decision has been made regarding the sharing of individual participant data (IPD). Any future data sharing will be considered in accordance with institutional policies, ethical approvals, participant consent, and applicable data protection regulations. If data sharing is approved, only de-identified data will be made available.

Publications

  • Loudon K, Treweek S, Sullivan F, Donnan P, Thorpe KE, Zwarenstein M. The PRECIS-2 tool: designing trials that are fit for purpose. BMJ. 2015 May 8;350:h2147. doi: 10.1136/bmj.h2147. No abstract available.

    PubMed 25956159
  • Austin PC. The performance of different propensity-score methods for estimating differences in proportions (risk differences or absolute risk reductions) in observational studies. Stat Med. 2010 Sep 10;29(20):2137-48. doi: 10.1002/sim.3854.

    PubMed 20108233
  • Baxter DE, Thigpen CM. Heel pain--operative results. Foot Ankle. 1984 Jul-Aug;5(1):16-25. doi: 10.1177/107110078400500103.

    PubMed 6479759
  • Morrissey D, Cotchett M, Said J'Bari A, Prior T, Griffiths IB, Rathleff MS, Gulle H, Vicenzino B, Barton CJ. Management of plantar heel pain: a best practice guide informed by a systematic review, expert clinical reasoning and patient values. Br J Sports Med. 2021 Oct;55(19):1106-1118. doi: 10.1136/bjsports-2019-101970. Epub 2021 Mar 30.

    PubMed 33785535
  • Roy J. Applied Longitudinal Analysis , Second Edition, by G. M. Fitzmaurice, N. M. Laird, and J. H. Ware. J Biopharm Stat 2013; 23: 491-492.

  • Steyerberg EW, Vergouwe Y. Towards better clinical prediction models: seven steps for development and an ABCD for validation. Eur Heart J. 2014 Aug 1;35(29):1925-31. doi: 10.1093/eurheartj/ehu207. Epub 2014 Jun 4.

    PubMed 24898551
  • Vickers AJ, Altman DG. Statistics notes: Analysing controlled trials with baseline and follow up measurements. BMJ. 2001 Nov 10;323(7321):1123-4. doi: 10.1136/bmj.323.7321.1123. No abstract available.

    PubMed 11701584
  • Carroll C, Patterson M, Wood S, Booth A, Rick J, Balain S. A conceptual framework for implementation fidelity. Implement Sci. 2007 Nov 30;2:40. doi: 10.1186/1748-5908-2-40.

    PubMed 18053122
  • Borrelli B. The assessment, monitoring, and enhancement of treatment fidelity in public health clinical trials. J Public Health Dent. 2011 Winter;71 Suppl 1:S52-63.

    PubMed 21656954
  • Al-Ashhab ME, Elbegawy HEA, Hasan HAA. Endoscopic Plantar Fasciotomy Through Two Medial Portals for the Treatment of Recalcitrant Plantar Fasciopathy. J Foot Ankle Surg. 2018 Mar-Apr;57(2):264-268. doi: 10.1053/j.jfas.2017.09.004. Epub 2017 Dec 7.

    PubMed 29224949
  • Cottom JM, Wolf JR, Sisovsky CA. Midterm Outcomes of Endoscopic Plantar Fascia Debridement in 125 Patients: A 5-Year Follow-Up. J Foot Ankle Surg. 2023 May-Jun;62(3):444-447. doi: 10.1053/j.jfas.2022.11.001. Epub 2022 Nov 10.

    PubMed 36443168
  • Chou AC, Ng SY, Koo KO. Endoscopic Plantar Fasciotomy Improves Early Postoperative Results: A Retrospective Comparison of Outcomes After Endoscopic Versus Open Plantar Fasciotomy. J Foot Ankle Surg. 2016 Jan-Feb;55(1):9-15. doi: 10.1053/j.jfas.2015.02.005. Epub 2015 May 23.

    PubMed 26007627
  • Eckenrode BJ, Kietrys DM, Parrott JS. Effectiveness of Manual Therapy for Pain and Self-reported Function in Individuals With Patellofemoral Pain: Systematic Review and Meta-analysis. J Orthop Sports Phys Ther. 2018 May;48(5):358-371. doi: 10.2519/jospt.2018.7243. Epub 2018 Jan 6.

    PubMed 29308698
  • De-la-Cruz-Torres B, Abuin-Porras V, Navarro-Flores E, Calvo-Lobo C, Romero-Morales C. Ultrasound-Guided Percutaneous Neuromodulation in Patients with Chronic Lateral Epicondylalgia: A Pilot Randomized Clinical Trial. Int J Environ Res Public Health. 2021 May 3;18(9):4877. doi: 10.3390/ijerph18094877.

    PubMed 34063673
  • Rayo-Perez AM, Juarez-Jimenez JM, Ortiz-Romero M, Gordillo-Fernandez LM, Garcia-De-La-Pena R. Comparative Effectiveness of Conservative Therapies for Plantar Fasciitis: A Retrospective Observational Study. Sports (Basel). 2025 Sep 5;13(9):306. doi: 10.3390/sports13090306.

    PubMed 41003612

Questions about this trial

What is this clinical trial studying?

A study testing Multimodal Conservative Intervention and Endoscopic Plantar Fascial Release in people with Chronic Refractory Plantar Fasciopathy, run by Universidad Europea de Valencia at 1 site in Spain.

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 4 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 17 Jun 2026. 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 Spain. 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 Javier Bonastre Férez, PhD (+34644120315, javier.bonastre@universidadeuropea.es), or a site near the patient. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Change in Foot Function Index (FFI) total score (time frame: Baseline and 6 weeks). 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 NCT07654660, which also lists 35 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 17 Jun 2026.

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