Effects of Radial Shockwave Therapy Versus Graston Instrument Assisted Soft Tissue Mobilization for Adult Plantar Fasciitis
DOI:
https://doi.org/10.61919/jhrr.v5i7.1930Keywords:
plantar fasciitis; plantar fasciopathy; radial shockwave therapy; instrument-assisted soft tissue mobilization; Graston technique; Foot Function Index.Abstract
Background: Chronic plantar fasciitis is increasingly recognized as a degenerative fasciopathy that can cause persistent heel pain and functional limitation, and adjunct non-invasive treatments are commonly used when stretching alone is insufficient. Objective: To compare the effectiveness of radial shockwave therapy (RST) versus Graston instrument-assisted soft tissue mobilization (GIASTM), each combined with standardized stretching, in adults with chronic unilateral plantar fasciitis. Methods: In this randomized controlled trial, 42 participants were allocated to RST+stretching or GIASTM+stretching (21/group); 38 completed the 8-week protocol (19/group). Outcomes were assessed at baseline and week 8 using the Foot Function Index (FFI), Visual Analogue Scale (VAS), and ankle dorsiflexion (goniometry). Between-group comparisons used independent-samples t-tests for FFI and Mann–Whitney U tests for non-normal outcomes. Results: Baseline FFI was comparable (73.95±6.89 vs 73.14±7.72). At week 8, GIASTM achieved a substantially better post-FFI than RST (50.71±2.41 vs 70.57±6.20), mean difference −19.86 (95% CI −22.95 to −16.77; p<0.001), with greater functional gain (Δ difference +19.04; 95% CI 17.00 to 21.08; p<0.001). Post-treatment VAS favored GIASTM (Z=−5.03; p<0.001), while dorsiflexion showed a trend favoring GIASTM (Z=−1.79; p=0.073). Conclusion: Over 8 weeks, GIASTM plus stretching produced markedly greater disability reduction and superior pain outcomes compared with RST plus stretching in chronic plantar fasciitis.
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