Mohsenipour Seyed Mehdi, Amiri Ali, Sarrafzadeh Javad, Bahrpeyma Farid
Rehabilitation Research Center, Department of Physiotherapy, School of Rehabilitation Sciences, Iran University of Medical Sciences, Tehran, Iran.
Physical Therapy Department, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran.
Med J Islam Repub Iran. 2025 Apr 28;39:60. doi: 10.47176/mjiri.39.60. eCollection 2025.
Myofascial tissues are interconnected, and fascia connects them to forming a web of myofascial chains. This research investigated whether incorporating myofascial release along the superficial backline offers additional benefits compared to a localized gastrocnemius release in managing clinical symptoms and plantar fascia thickness in individuals with chronic plantar fasciitis.
This was an add-on design a single-blind randomized clinical trial that was conducted with 30 chronic plantar fasciitis patients. Subjects were randomized into two groups: the Gastrocnemius Myofascial Release (G-MFR) group and the Chain Myofascial Release (C-MFR) group. Each participant underwent four MFR sessions over two weeks. Outcome measures included the Numeric Pain Rating Scale (NPRS), the Foot Function Index (FFI), and ultrasound-based evaluations of plantar fascia thickness. Due to the non-normal distribution of change scores, between-group comparisons were performed using the Mann-Whitney test with the Hodges-Lehmann estimator, and effect sizes were reported using r values.
Both groups exhibited significant improvements in NPRS and FFI scores post-intervention (<0.001), with the C-MFR group showing greater reductions in both measures (for NPRS: =0.004, r=0.686 and for FFI: =0.004, r=0.518). However, while plantar fascia thickness decreased significantly in the C-MFR group (=0.001, r=0.829), no significant change was observed in the G-MFR group (=0.422, r=0.206). The reduction in thickness for C-MFR compared to G-MFR was not statistically significant (=0.233, r=0.222).
This study suggests that myofascial release in the superficial backline chain is more effective than isolated gastrocnemius release for improving NPRS and FFI scores in chronic plantar fasciitis. Future studies with longer follow-ups may clarify the long-term effects of these interventions on plantar fascia thickness.
肌筋膜组织相互连接，筋膜将它们连接起来形成肌筋膜链网络。本研究调查了与局部腓肠肌放松相比，沿背部浅线进行肌筋膜放松在管理慢性足底筋膜炎患者的临床症状和足底筋膜厚度方面是否具有额外益处。
这是一项附加设计的单盲随机临床试验，对30名慢性足底筋膜炎患者进行。受试者被随机分为两组：腓肠肌肌筋膜放松（G-MFR）组和链式肌筋膜放松（C-MFR）组。每位参与者在两周内接受四次肌筋膜放松治疗。结果测量包括数字疼痛评分量表（NPRS）、足部功能指数（FFI）以及基于超声的足底筋膜厚度评估。由于变化分数的分布不呈正态分布，组间比较采用带有霍奇斯-莱曼估计量的曼-惠特尼检验，并使用r值报告效应量。
两组在干预后NPRS和FFI评分均有显著改善（<0.001），C-MFR组在两项测量中的降低幅度更大（NPRS：=0.004，r=0.686；FFI：=0.004，r=0.518）。然而，虽然C-MFR组的足底筋膜厚度显著降低（=0.001，r=0.829），但G-MFR组未观察到显著变化（=0.422，r=0.206）。C-MFR组与G-MFR组相比厚度的降低无统计学意义（=0.233，r=0.222）。
本研究表明，在慢性足底筋膜炎中，背部浅线链的肌筋膜放松在改善NPRS和FFI评分方面比单独的腓肠肌放松更有效。未来进行更长随访期的研究可能会阐明这些干预措施对足底筋膜厚度的长期影响。
