Effects of Foot Rehabilitation And Minimalist Shoes on Pain, Strength, and Function in Adults With Plantar Fasciopathy

NCT ID: NCT06106958

Last Updated: 2025-07-16

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

Get a concise snapshot of the trial, including recruitment status, study phase, enrollment targets, and key timeline milestones.

Recruitment Status

COMPLETED

Clinical Phase

NA

Total Enrollment

37 participants

Study Classification

INTERVENTIONAL

Study Start Date

2024-02-14

Study Completion Date

2025-01-20

Brief Summary

Review the sponsor-provided synopsis that highlights what the study is about and why it is being conducted.

The goal of this clinical trial is to compare the effects of 8 weeks of foot rehabilitation exercises in conjunction with wearing minimalist shoes in individuals with plantar fasciopathy, compared to only performing foot rehabilitation exercises. The main questions it aims to answer are:

* Will individuals with plantar fasciopathy be able to reduce their pain and improve their self-reported function by performing rehabilitation exercises and wearing minimalist shoes, compared to those only performing rehabilitation exercises?
* Will individuals with plantar fasciopathy be able to increase their intrinsic foot muscle strength and size, their balance, and gait biomechanics by performing rehabilitation exercises and wearing minimalist shoes, compared to those only performing rehabilitation exercises?
* What characteristics of individuals with plantar fasciopathy make them most suited to succeed in a protocol of performing rehabilitation exercises and wearing minimalist shoes?

Participants will be asked to come into the lab at the start of the intervention and after 8 weeks, where the following will be assessed:

* Patient-reported outcomes
* Foot morphology
* Intrinsic foot muscle strength
* Balance
* Gait biomechanics

For the intervention, participants in both groups will perform the same rehabilitation exercises, including:

* Massage to the bottom of the foot
* Calf-raises
* Calf and foot stretches

Detailed Description

Dive into the extended narrative that explains the scientific background, objectives, and procedures in greater depth.

The purpose of the study is to determine the effects of 8-weeks of wearing minimalist shoes and performing a home exercise program (intervention group) on pain, self-reported function, intrinsic foot muscle strength and size, balance, and gait biomechanics, as opposed to receiving a home exercise program alone (control group).

All participants will report to the Exercise and Sport Injury Laboratory for a baseline clinical assessment performed by a blinded assessor to determine their level of pain and their self-reported function using a variety of patient-reported outcomes. These include pain levels on a Visual Analog Scale (VAS), Global Rating of Change to assess perceived changes in function, Foot Health Status Questionnaire (FHSQ) to gather general and foot-related health information, and a variety of scales that assess kinesiophobia, fear-avoidance belief, self-efficacy, and activity level. Functional measures include intrinsic foot muscle strength via diagnostic ultrasound, intrinsic foot muscle size via two different types of handheld dynamometer, balance via a single-leg balancing task on a force plate, and gait biomechanics via a walking task with insoles that can obtain measures of force and loading rate.

At the end of the first baseline visit, all participants will be taught how to perform the home rehabilitation exercise routine, and handed an informational sheet that will have pictures and links to supplemental videos to ensure that they understand the exercises and have the resources to review.

Immediately following the first baseline visit, participants will meet with another member of the study team to ensure assessor blinding. They will be randomly assigned to one of two groups: the intervention group of foot rehabilitation and minimalist shoes (intervention), or the control group of just rehabilitation exercises (control). The randomization sequence will be created a priori with a random-number generator stratified by sex, placed in sealed opaque envelopes by another member of the study team to blind the assessor. Participants in the intervention group will have a pair of shoes ordered for them, and they will begin the protocol when the shoes have arrived.

Participants in both groups will be instructed to fill out a daily survey that will be sent via text and stored in a secure server (REDCap), that will indicate if they have completed their rehabilitation exercises. Participants will also all wear Fitbit smart watches that will track their step count and some other health-related metrics. They will not be able to see their own data during the protocol.

At the 4-week mark of the study, all individuals will be sent a link to take surveys of patient-reported outcomes, including pain levels, self-reported function, kinesiophobia, fear-avoidance belief, self-efficacy, and activity level. They will also complete a phone call with a member of the study team (not the assessor, to maintain blinding) as a check-in to discuss pain levels and any other questions and concerns they have.

At the end of the 8-weeks, individuals will return to the lab to have the same measures as the baseline session completed. The investigators will then be able to determine if performing foot rehabilitation exercises and wearing minimalist shoes reduces pain, improves self-reported function, and increases intrinsic foot muscle strength and size, balance, and gait biomechanics, compared to baseline and to the control group.

Conditions

See the medical conditions and disease areas that this research is targeting or investigating.

Plantar Fascitis Plantar Fasciopathy Plantar Fasciitis of Both Feet Plantar Fasciitis of Right Foot Plantar Fasciitis of Left Foot Plantar Fasciitis, Chronic

Study Design

Understand how the trial is structured, including allocation methods, masking strategies, primary purpose, and other design elements.

Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

There will be two groups:

1. Performing foot rehabilitation exercises and wearing minimalist shoes (intervention group)
2. Only performing foot rehabilitation exercises (control group)
Primary Study Purpose

TREATMENT

Blinding Strategy

SINGLE

Outcome Assessors
The investigator assessing laboratory-based outcome measures will be blinded to group allocation and will not be the member of the study team communicating with participants about their intervention protocols.

Study Groups

Review each arm or cohort in the study, along with the interventions and objectives associated with them.

Foot Rehabilitation And Minimalist Shoes (FRAMES)

The intervention group will receive a pair of minimalist shoes along with a home exercise program and a protocol that indicates how to slowly adjust to wearing the shoes.

Group Type EXPERIMENTAL

Home Exercise Program

Intervention Type BEHAVIORAL

Participants will receive a home exercise program that consists of 2 exercises and 3 stretches. The exercises include:

* Massage on the bottom of the foot with a ball
* Calf-raises
* Lunge calf-stretch with the knee straight
* Calf-stretch with the knee bent
* Stretch for the bottom of the foot

These exercises are intended to be performed daily.

Minimalist Shoes

Intervention Type BEHAVIORAL

Participants will receive a pair of minimalist shoes. They will wear them for an allotted amount of time per day each week, in order to allow for a slow adjustment into the shoes. The protocol is as follows:

* Week 1: 1 hour per day
* Week 2: 2 hours per day
* Week 3: 4 hours per day
* Week 4: 6 hours per day
* Week 5: 8 hours per day
* Week 6: 8 hours per day
* Week 7: 8 hours per day
* Week 8: 8 hours per day

Home Exercise Program (Control)

The intervention group will receive a home exercise program.

Group Type ACTIVE_COMPARATOR

Home Exercise Program

Intervention Type BEHAVIORAL

Participants will receive a home exercise program that consists of 2 exercises and 3 stretches. The exercises include:

* Massage on the bottom of the foot with a ball
* Calf-raises
* Lunge calf-stretch with the knee straight
* Calf-stretch with the knee bent
* Stretch for the bottom of the foot

These exercises are intended to be performed daily.

Interventions

Learn about the drugs, procedures, or behavioral strategies being tested and how they are applied within this trial.

Home Exercise Program

Participants will receive a home exercise program that consists of 2 exercises and 3 stretches. The exercises include:

* Massage on the bottom of the foot with a ball
* Calf-raises
* Lunge calf-stretch with the knee straight
* Calf-stretch with the knee bent
* Stretch for the bottom of the foot

These exercises are intended to be performed daily.

Intervention Type BEHAVIORAL

Minimalist Shoes

Participants will receive a pair of minimalist shoes. They will wear them for an allotted amount of time per day each week, in order to allow for a slow adjustment into the shoes. The protocol is as follows:

* Week 1: 1 hour per day
* Week 2: 2 hours per day
* Week 3: 4 hours per day
* Week 4: 6 hours per day
* Week 5: 8 hours per day
* Week 6: 8 hours per day
* Week 7: 8 hours per day
* Week 8: 8 hours per day

Intervention Type BEHAVIORAL

Eligibility Criteria

Check the participation requirements, including inclusion and exclusion rules, age limits, and whether healthy volunteers are accepted.

Inclusion Criteria

* Between ages of 18 - 55 years old
* First-step pain in the morning over past week - Visual Analog Score between 30-70 mm
* Heel pain for at least a month with an insidious onset

Exclusion Criteria

* Other current lower extremity neuromusculoskeletal injury
* Other lower extremity neuromusculoskeletal injuries other than the foot in the past 3 months
* Previous history of foot/ankle fractures or surgeries
* Current participation in formal rehab for plantar fasciopathy
* Previous minimalist shoe experience
Minimum Eligible Age

18 Years

Maximum Eligible Age

55 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

Meet the organizations funding or collaborating on the study and learn about their roles.

University of Virginia

OTHER

Sponsor Role lead

Responsible Party

Identify the individual or organization who holds primary responsibility for the study information submitted to regulators.

Jen Xu

Doctoral Student

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

Learn about the lead researchers overseeing the trial and their institutional affiliations.

Jennifer Xu, MS

Role: PRINCIPAL_INVESTIGATOR

University of Virginia

Susan Saliba, PhD

Role: PRINCIPAL_INVESTIGATOR

University of Virginia

Locations

Explore where the study is taking place and check the recruitment status at each participating site.

University of Virginia

Charlottesville, Virginia, United States

Site Status

Countries

Review the countries where the study has at least one active or historical site.

United States

References

Explore related publications, articles, or registry entries linked to this study.

Barnes A, Sullivan J, Pappas E, Adams R, Burns J. Clinical and Functional Characteristics of People With Chronic and Recent-Onset Plantar Heel Pain. PM R. 2017 Nov;9(11):1128-1134. doi: 10.1016/j.pmrj.2017.04.009. Epub 2017 Apr 28.

Reference Type BACKGROUND
PMID: 28461226 (View on PubMed)

Allen RH, Gross MT. Toe flexors strength and passive extension range of motion of the first metatarsophalangeal joint in individuals with plantar fasciitis. J Orthop Sports Phys Ther. 2003 Aug;33(8):468-78. doi: 10.2519/jospt.2003.33.8.468.

Reference Type BACKGROUND
PMID: 12968860 (View on PubMed)

Cheung RT, Sze LK, Mok NW, Ng GY. Intrinsic foot muscle volume in experienced runners with and without chronic plantar fasciitis. J Sci Med Sport. 2016 Sep;19(9):713-5. doi: 10.1016/j.jsams.2015.11.004. Epub 2015 Nov 22.

Reference Type BACKGROUND
PMID: 26655866 (View on PubMed)

Chang R, Rodrigues PA, Van Emmerik RE, Hamill J. Multi-segment foot kinematics and ground reaction forces during gait of individuals with plantar fasciitis. J Biomech. 2014 Aug 22;47(11):2571-7. doi: 10.1016/j.jbiomech.2014.06.003. Epub 2014 Jun 11.

Reference Type BACKGROUND
PMID: 24992816 (View on PubMed)

Wearing SC, Smeathers JE, Urry SR, Hennig EM, Hills AP. The pathomechanics of plantar fasciitis. Sports Med. 2006;36(7):585-611. doi: 10.2165/00007256-200636070-00004.

Reference Type BACKGROUND
PMID: 16796396 (View on PubMed)

Jaffri AH, Koldenhoven R, Saliba S, Hertel J. Evidence for Intrinsic Foot Muscle Training in Improving Foot Function: A Systematic Review and Meta-Analysis. J Athl Train. 2023 Nov 1;58(11-12):941-951. doi: 10.4085/1062-6050-0162.22.

Reference Type BACKGROUND
PMID: 35724360 (View on PubMed)

Newsham K. Exploring Workload Associated With Learning Foot Core Exercises. International Journal of Athletic Therapy and Training. 2022;27(3):120-128.

Reference Type BACKGROUND

Ridge ST, Olsen MT, Bruening DA, Jurgensmeier K, Griffin D, Davis IS, Johnson AW. Walking in Minimalist Shoes Is Effective for Strengthening Foot Muscles. Med Sci Sports Exerc. 2019 Jan;51(1):104-113. doi: 10.1249/MSS.0000000000001751.

Reference Type BACKGROUND
PMID: 30113521 (View on PubMed)

Warne JP, Gruber AH. Transitioning to Minimal Footwear: a Systematic Review of Methods and Future Clinical Recommendations. Sports Med Open. 2017 Sep 15;3(1):33. doi: 10.1186/s40798-017-0096-x.

Reference Type BACKGROUND
PMID: 28916956 (View on PubMed)

Ribeiro AP, Joao SMA. The Effect of Short and Long-Term Therapeutic Treatment with Insoles and Shoes on Pain, Function, and Plantar Load Parameters of Women with Plantar Fasciitis: A Randomized Controlled Trial. Medicina (Kaunas). 2022 Oct 28;58(11):1546. doi: 10.3390/medicina58111546.

Reference Type BACKGROUND
PMID: 36363506 (View on PubMed)

Yeasmin Lipa L, Kalita A, Dutta A. A Comparative Study To Find Out The Effectiveness Of Myofascial Release Technique Along With Stretching Versus Myofascial Release Technique In Patients With Plantar Fasciitis. Int J Life Sci Pharm Res. Published online January 31, 2022. doi:10.22376/ijpbs/lpr.2022.12.1.L183-193

Reference Type BACKGROUND

Rathleff MS, Molgaard CM, Fredberg U, Kaalund S, Andersen KB, Jensen TT, Aaskov S, Olesen JL. High-load strength training improves outcome in patients with plantar fasciitis: A randomized controlled trial with 12-month follow-up. Scand J Med Sci Sports. 2015 Jun;25(3):e292-300. doi: 10.1111/sms.12313. Epub 2014 Aug 21.

Reference Type BACKGROUND
PMID: 25145882 (View on PubMed)

Campitelli NA, Spencer SA, Bernhard K, Heard K, Kidon A. Effect of Vibram FiveFingers Minimalist Shoes on the Abductor Hallucis Muscle. J Am Podiatr Med Assoc. 2016 Sep 2;106(5):344-351. doi: 10.7547/14-084.

Reference Type BACKGROUND
PMID: 27762613 (View on PubMed)

Kamonseki DH, Goncalves GA, Yi LC, Junior IL. Effect of stretching with and without muscle strengthening exercises for the foot and hip in patients with plantar fasciitis: A randomized controlled single-blind clinical trial. Man Ther. 2016 Jun;23:76-82. doi: 10.1016/j.math.2015.10.006. Epub 2015 Oct 30.

Reference Type BACKGROUND
PMID: 26654252 (View on PubMed)

Other Identifiers

Review additional registry numbers or institutional identifiers associated with this trial.

HSR230045

Identifier Type: -

Identifier Source: org_study_id

More Related Trials

Additional clinical trials that may be relevant based on similarity analysis.