Immediate Effect of Instrument-Assisted Soft Tissue Mobilization Treatment in Patients with Plantar Fasciopathy and...

The purpose of this study was to investigate differences in immediate effects of a warm-up and Instrument-Assisted Soft Tissue Mobilization (IASTM) treatment in patients with symptomatic plantar fasciopathy (PF) and asymptomatic groups.

Twenty five subjects with PF and 25 asymptomatic subjects were recruited. Symptomatic subjects experienced plantar heel pain greater than 3 months, heel palpation discomfort, and pain with the first-morning step. Both groups received a warm-up and IASTM. Pre- and post-treatment measurements included visual analog scale (VAS) pain scores in the PF group, stiffness at the origin and navicular levels, origin thickness, ankle and 1^st metatarsal phalangeal joint (first MTPJ) weight-bearing ROM, and Foot Health Status Questionnaire (FHSQ). Two-way mixed ANOVAs determined group and intervention effects. The Wilcoxon Signed-Rank test was performed to examine PF group VAS changes, and correlations identified the association between tissue properties and clinical presentations.

The intervention group showed significance in 1) reduced PF pain level (P < .001; d = 0.801), 2) increased weight-bearing 1st MTPJ (P = .039; η_p² = 0.08) and ankle ROM (P < .001; η_p² = 0.41) in both groups, and 3) decreased PF origin thickness between-group differences (P = .001; η_p² = 0.20). For all subjects, 1) the higher FHSQ pain level was associated with lesser origin stiffness and greater thickness, 2) higher origin stiffness was correlated with lesser ankle ROM, and 3) greater thickness was associated with less 1^st MTPJ ROM.

An IASTM treatment with warm-up immediately reduced PF symptoms, increased weight-bearing 1st MTPJ and ankle ROM in both groups, and decreased group differences in origin thickness.