Effectiveness of the Graston Technique on Pain and General Foot Health in Patients with Chronic Plantar Fasciitis: A Randomized Clinical Trial

Background center dot Chronic plantar fasciitis has been historically treated with conventional physical therapy. The use of the Garston Technique (R) (GT) is a new intervention for the management of chronic plantar fascitis, but there is lack of evidence in the literature regarding its efficacy. Study Objective center dot To evaluate the effectiveness of the GT on pain, foot function and general foot health in patients with plantar fasciitis. Methods center dot This was a randomized clinical trial conducted from November 2020 to March 2021. The non-probability purposive sampling technique was used to select 30 patients. Setting center dot Madinah Teaching Hospital, Faisalabad, Pakistan. Participants center dot A total of 30 patients of both genders with a 6-week history of planter fasciitis and the presence of a calcaneus everted >= 2 degrees were included in this study and randomly assigned to one of two groups. Intervention center dot Both groups received conventional physical therapy (CPT) for 4 weeks and the experimental group in addition received GT. Primary outcome measures center dot The primary outcome measures were pain, measured at baseline, after the second week and after the end of treatment (ie, the fourth week) on the visual analog scale (VAS); and general foot health and foot function, measured at baseline and after the end of treatment with the Modified Foot Health Status Questionnaire (FHSQ). Results center dot The mean age of the study patients was 34.1 +/- 6.67 years. There was significant improvement in pain in the GT group compared with the CPT group after the second (P =.005; partial eta(2) = 0.263) and the 4th (P =.000; partial eta(2) = 0.535) week of intervention. Foot function was also significantly improved (P < .05) in the GT group compared with the CPT group with a large effect size (Cohen's d = 0.080). But in the case of general foot health, no significant difference was observed between the groups at the end of the fourth week. Conclusion center dot The use of the GT combined with CPT shows significant results compared with CPT alone; ie, GT speeds up the recovery from heel pain and foot function in patients with chronic plantar fasciitis.