EFFECTS OF KALTONBORN JOINT MOBILIZATION ALONG WITH GRASTON TECHNIQUE ON PAIN AND GAIT IN PATIENTS WITH PLANTER FASCIITIS

Abstract

Background: Plantar fasciitis is a common musculoskeletal condition causing persistent heel pain and functional limitations. Conservative management, including stretching and orthotic interventions, remains the first line of treatment; however, many patients continue to experience chronic symptoms. Manual therapy techniques such as the Graston Technique and Kaltenborn Joint Mobilization have been introduced as promising interventions for improving pain and mobility. This study investigates the combined effects of these techniques in enhancing range of motion (ROM), reducing pain, and improving gait in individuals with plantar fasciitis.

Objective: This study aimed to evaluate the effectiveness of the Graston Technique combined with Kaltenborn Joint Mobilization in reducing pain, improving ROM, and enhancing gait function in patients with plantar fasciitis.

Methods: A randomized clinical trial was conducted with 42 participants diagnosed with plantar fasciitis, assigned into two groups using a lottery method. Group A (n=21) received therapeutic ultrasound and the Graston Technique, while Group B (n=21) received the same baseline treatment along with Kaltenborn Joint Mobilization. Pain intensity was assessed using the Visual Analog Scale (VAS), ROM was measured with a goniometer, and gait function was evaluated using the Rivermead Visual Gait Analysis (RVGA). Baseline measurements were recorded before treatment, and post-treatment assessments were conducted after 12 therapy sessions over four weeks. Statistical analysis was performed using SPSS version 20.

Results: Significant improvements were observed in both groups, with Group B demonstrating superior post-treatment outcomes (p<0.05). Dorsiflexion improved from 15.26±1.43 to 31.71±1.75 in Group B, compared to 13.19±1.20 to 16.81±1.43 in Group A. Plantarflexion increased from 21.29±0.94 to 39.48±1.75 in Group B, while Group A improved from 30.76±0.94 to 30.76±1.20. Pain levels on the VAS decreased significantly in both groups, with a more pronounced reduction in Group B (pre: 21.38±0.57; post: 13.26±0.43). RVGA scores showed a marked improvement in Group B (pre: 22.00±0.57; post: 11.00±0.30), indicating better gait function.

Conclusion: Both the Graston Technique and Kaltenborn Joint Mobilization effectively reduced pain and improved ROM and gait in plantar fasciitis patients. However, the combined intervention demonstrated superior therapeutic benefits, suggesting that an integrated manual therapy approach may enhance clinical outcomes in plantar fasciitis management.