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Plantar Fasciitis, ChronicNCT07754214

Outcomes of the Proprioception and Strengthening Exercise Program in Chronic Plantar Fasciitis

A study testing Stretching, Proprioception and Stretching Exercises and Knee Strengthening and Stretching Exercises in people with Plantar Fasciitis, Chronic, run by Karamanoğlu Mehmetbey University at 1 site in Turkey (Türkiye).

Recruiting

Looking for participants now. Contact the study team or a site below to ask about taking part.

Sites and contacts
Official record
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Trial summary

Plantar fasciitis is a common cause of heel pain, and although stretching exercises are a standard first-line treatment, current evidence on adding proprioception or knee-strengthening exercises remains limited. Read more about this study

Who is it for?
Ages 18 to 65 years
Conditions the study is for
Plantar Fasciitis, Chronic
What is being tested?
Stretching, Proprioception and Stretching Exercises and Knee Strengthening and Stretching Exercises
Could I receive a placebo?
No, everyone receives an active treatment
How many people
105 participants
Where
1 siteTurkey (Türkiye)
Study dates
1 Aug 2026to 31 Dec 2026
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 18 to 65 years
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • Age between 18 and 65 years.
  • Formal diagnosis of plantar fasciitis, characterized by sharp pain during the first steps in the morning, pain that increases with prolonged activity, localized tenderness on palpation of the medial calcaneal tubercle or proximal fascia, and a positive Windlass test.
  • Symptom duration of at least 3 months.
  • Heel pain intensity score of Visual Analog Scale (VAS) > 3.
  • Voluntary agreement to participate, evidenced by signing the written informed consent form.

Who cannot join

  • History of acute lower-extremity trauma.
  • History of prior foot or ankle surgery.
  • Corticosteroid injection to the affected heel within the preceding 6 months.
  • Presence of systemic inflammatory or rheumatologic disease.
  • Uncontrolled systemic disease (e.g., uncontrolled hypertension, uncontrolled diabetes mellitus).
  • Current or past history of malignancy.
Show all 10Show fewer
  • Current pregnancy.
  • Body mass index (BMI) ≥ 30 kg/m².
  • Any musculoskeletal, neuromuscular, ocular, or vestibular disorder that could impair balance or limit the ability to stand unsupported.
  • Neurocognitive or psychiatric conditions precluding adherence to the exercise protocols or outcome assessments.

Trial locations and contacts

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

Aynur Basaran, Prof. MD contact

+90 537 562 06 66

aynurbasaran@gmail.com

Turkey (Türkiye)1 site, 1 recruiting
  • Karaman Training and Research Hospital

    Karaman, Karaman, 70100

    Sule Kosar, MD, +90 506 145 9656, sulekosar@kmu.edu.tr

    Aynur Basaran, Prof.MD, +90 537 562 06 66, aynurbasaran@gmail.com

    Recruiting

Other trials in Turkey (Türkiye)

About this study

Plantar fasciitis is a common cause of heel pain, and although stretching exercises are a standard first-line treatment, current evidence on adding proprioception or knee-strengthening exercises remains limited. This study investigates whether adding knee strengthening or proprioception exercises to a standard stretching program improves pain, function, and disability in patients with chronic plantar fasciitis, and whether these interventions produce measurable changes in the biomechanical and kinesiological properties of the foot, ankle, and knee.

Read the detailed description

Plantar fasciitis is a degenerative condition of the plantar fascia and one of the most common musculoskeletal disorders affecting the foot, with an estimated prevalence of approximately 10% in the general population. It is diagnosed clinically based on history and physical examination, typically presenting as sharp heel pain during the first steps in the morning or after rest, tenderness on palpation of the medial calcaneal tuberosity, and a positive Windlass test. Risk factors include reduced ankle and first metatarsophalangeal joint range of motion, obesity, prolonged weight-bearing, and inappropriate footwear.

Stretching of the plantar fascia and gastrocnemius-soleus complex is a well-established, evidence-based treatment for plantar fasciitis. However, the underlying mechanism of the condition cannot be fully explained by tissue shortening and mechanical loading alone; impaired neuromuscular control and balance also appear to play a contributory role. Prior research has found that adding hip- and ankle-directed strengthening exercises to a stretching program provides no additional benefit over stretching alone in patients with plantar fasciitis, while other studies have reported reduced hamstring and quadriceps muscle strength in this population. Individuals with plantar fasciitis have also been shown to exhibit impaired postural balance and an increased risk of falls. While proprioception exercises have demonstrated benefit in the rehabilitation of ankle injuries, their effectiveness has not yet been established in plantar fasciitis. Given these gaps, this study aims to evaluate whether knee-strengthening and proprioception exercises, when added to a standard stretching program, provide additional benefit in reducing pain and disability and improving the biomechanical and kinesiological properties of the foot, ankle, and knee in patients with plantar fasciitis.

Being tested
Stretching, Proprioception and Stretching Exercises, Knee Strengthening and Stretching Exercises
Keywords
plantar fasciitis, strengthening, stretching, proprioception, chronic plantar fasciitis
Medical subject headings
Fasciitis, Plantar

What participants receive

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

  • StretchingOther

    Participants will perform standardized plantar fascia and gastrocnemius-soleus stretching exercises. The protocol consists of stretching twice daily, 7 days per week, for 6 weeks.

  • Proprioception and Stretching ExercisesOther

    In addition to the standard stretching protocol, participants in this group will perform a supervised, 6-week progressive proprioception exercise program administered by a physiotherapist three times per week. Exercises will be performed under both eyes-open and eyes-closed conditions on progressively less stable surfaces with task difficulty advanced on a weekly basis.

  • Knee Strengthening and Stretching ExercisesOther

    In addition to the standard stretching protocol, participants in this group will perform a supervised, 6-week progressive knee-strengthening program administered by a physiotherapist three times per week.

Study groups in NCT07754214
Study groupRoleWhat they receive
Stretching OnlyActive comparatorThis group will perform plantar fascia-gastrocnemius-soleus stretching exercises alone (twice daily, 7 days per week, for 6 weeks).
Receives: Other: Stretching
Stretching and ProprioceptionExperimentalIn addition to the standard stretching program, this group will receive supervised proprioception exercises three times per week for 6 weeks.
Receives: Other: Proprioception and Stretching Exercises
Stretching and Knee StrengtheningExperimentalIn addition to the standard stretching program, this group will receive supervised knee strengthening exercises three times per week for 6 weeks.
Receives: Other: Knee Strengthening and Stretching Exercises

What is being measured

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

  1. Pain Intensity (First-Step Morning, Evening, and Overall Daily Pain)

    Pain intensity during the first steps in the morning, before going to bed, and overall daily pain will be assessed using the Visual Analog Scale (VAS). The scale consists of a 10-cm horizontal line ranging from 0 (no pain) to 10 (worst imaginable pain), on which participants mark the point corresponding to their perceived pain level.

    Measured: Baseline (Week 0), post-intervention (Week 6), and follow-up (Week 12).

  2. Pressure Pain Threshold (PPT)

    PPT will be assessed using a Baseline® 12-1442 dolorimeter (22-lb sensitivity range; Fabrication Enterprises Inc., USA) to evaluate deep-tissue mechanical sensitivity. With the participant positioned prone and the feet hanging off the table, gradually increasing pressure will be applied to the midpoint of the plantar fascia insertion at the calcaneus. The pressure at which the participant first perceives pain will be recorded. Three measurements will be taken at 30-second intervals, and the mean value will be used for analysis.

    Measured: Baseline (Week 0), post-intervention (Week 6), and follow-up (Week 12).

  3. Foot Function and Health Status (Revised Foot Function Index, FFI-R)

    The FFI-R is a self-reported, multidimensional questionnaire comprising 68 items across four subscales: pain and stiffness, social and emotional consequences, dysfunction, and activity limitation. Each item is scored from 1 to 4, with higher scores indicating poorer foot health and greater functional limitation.

    Measured: Baseline (Week 0), post-intervention (Week 6), and follow-up (Week 12).

  4. Foot and Ankle Function (Foot and Ankle Outcome Score, FAOS)

    The FAOS is a 42-item self-reported questionnaire assessing five subscales: pain, other symptoms, activities of daily living, sports and recreation, and foot-and-ankle-related quality of life. Each item is scored from 0 to 4.

    Measured: Baseline (Week 0), post-intervention (Week 6), and follow-up (Week 12).

Secondary outcomes (8)
  1. Myofascial Tissue Biomechanical Properties

    The biomechanical and viscoelastic properties of the plantar fascia, Achilles tendon, gastrocnemius medialis, soleus, biceps femoris, semitendinosus, tibialis anterior, vastus lateralis, vastus medialis, and rectus femoris will be assessed non-invasively using the MyotonPRO device (Myoton AS, Tallinn, Estonia). The device will be positioned perpendicular to the anatomical landmark of each muscle; upon delivery of a mechanical impulse, it automatically calculates muscle tone (Hz), stiffness (N/m), and elasticity (logarithmic decrement). The mean of three consecutive measurements will be recorded.

    Measured: Baseline (Week 0), post-intervention (Week 6), and follow-up (Week 12).

  2. Plantar Fascia Ultrasonographic Parameters

    Musculoskeletal ultrasonography (GE Logiq® P5 system; GE Healthcare, USA) will be used to evaluate structural changes. Plantar fascia thickness will be measured longitudinally at 0.5 cm, 1 cm, and 3 cm distal to the calcaneal insertion. Qualitative parameters, including tissue echogenicity, perifascial fluid accumulation, and calcifications, will also be recorded.

    Measured: Baseline (Week 0), post-intervention (Week 6), and follow-up (Week 12).

  3. Ankle Dorsiflexion Range of Motion (ROM)

    Weight-bearing ankle dorsiflexion ROM will be measured in degrees using a Baseline® 12-1057 digital inclinometer (0.1° resolution; Fabrication Enterprises Inc., USA), positioned parallel to the long axis of the tibia over the tibial tuberosity during a weight-bearing lunge test. The mean of three measurements will be recorded.

    Measured: Baseline (Week 0), post-intervention (Week 6), and follow-up (Week 12).

  4. First Metatarsophalangeal (MTP) Joint Range of Motion

    Maximum active dorsiflexion and flexion angles of the first MTP joint will be measured in degrees using a finger goniometer with the participant in a supine position. The mean of three measurements will be recorded.

    Measured: Baseline (Week 0), post-intervention (Week 6), and follow-up (Week 12).

  5. Joint Position Sense (JPS) (Ankle-Knee and Hip)

    Proprioceptive accuracy will be assessed at the ankle, knee, and hip joints via active joint position reproduction testing using a Baseline® 12-1057 digital inclinometer. For the ankle, participants will actively reproduce target dorsiflexion/plantarflexion angles. For the knee, participants will actively reproduce a target angle starting from 90° of flexion, with the inclinometer fixed to the middle third of the leg. For the hip, participants will actively reproduce target angles for flexion (assessed in supine position) and abduction (assessed in side-lying position), with the inclinometer fixed to the lateral aspect of the thigh. For each joint, the absolute error angle (the difference between the target angle and the actively reproduced angle) will be recorded across three trials, and the mean absolute error angle will be calculated as the outcome value. Lower values indicate better proprioceptive accuracy.

    Measured: Baseline (Week 0), post-intervention (Week 6), and follow-up (Week 12).

  6. Isometric Muscle Strength of the Lower Extremity

    Isometric muscle strength for ankle (dorsiflexion, plantarflexion) and knee (extension, flexion) movements will be measured using a Lafayette® Hand-Held Dynamometer (Model 01165; Lafayette Instrument Company, USA), with standardized testing positions and stabilization protocols. Peak force will be recorded in Newtons (N) as the mean of three maximal isometric contractions.

    Measured: Baseline (Week 0), post-intervention (Week 6), and follow-up (Week 12).

  7. Static Balance

    Static postural control will be assessed using the Single-Leg Stance Test (SLST) under eyes-open and eyes-closed conditions. The duration (in seconds) for which the participant maintains single-leg balance without touching the ground or the supporting leg will be recorded. Mean durations of three trials will be analyzed.

    Measured: Baseline (Week 0), post-intervention (Week 6), and follow-up (Week 12).

  8. Dynamic Balance

    Dynamic balance and lower-extremity postural control will be evaluated using the Y-Balance Test (YBT). Maximum reach distances in the anterior, posteromedial, and posterolateral directions will be measured in centimeters and normalized to lower-limb length (LL). The composite score (%) will be calculated as: [(Anterior + Posteromedial + Posterolateral) / (3 × LL)] × 100.

    Measured: Baseline (Week 0), post-intervention (Week 6), and follow-up (Week 12).

Timeline

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

  1. First posted10 Aug 2026
  2. Study start1 Aug 2026
  3. Primary completion31 Dec 2026 (estimated)
  4. Study completion31 Dec 2026 (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
Randomised
Intervention model
Parallel groups
Masking
Single blind
Who is masked
Outcomes assessor
Enrolment
105 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT07754214
Sponsor's protocol ID
05-2026/01
Status last verified
Aug 2026
First submitted
4 Aug 2026
Last updated
20 Aug 2026
Results posted
No
Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No

Questions about this trial

What is this clinical trial studying?

A study testing Stretching, Proprioception and Stretching Exercises and Knee Strengthening and Stretching Exercises in people with Plantar Fasciitis, Chronic, run by Karamanoğlu Mehmetbey University at 1 site in Turkey (Türkiye).

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 5 inclusion and 10 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: looking for participants now, as of the sponsor's last update on 20 Aug 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 Turkey (Türkiye). 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 Sule Kosar, MD (+90 506 145 9656, sulekosar@kmu.edu.tr), or a site near the patient. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Pain Intensity (First-Step Morning, Evening, and Overall Daily Pain) (time frame: Baseline (Week 0), post-intervention (Week 6), and follow-up (Week 12).). 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?
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 20 Aug 2026.

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