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Extracorporeal Shockwave Therapy Versus Graston Instrument-Assisted Soft-Tissue Mobilization in Chronic Plantar Heel Pain a Randomized Controlled Trial
(Amer Podiatric Med Assoc, 2022) Pisirici, Pelin; Cil, Elif Tugce; Coskunsu, Dilber Karagozoglu; Sayli, Ugur; Subasi, Feryal
Background: Although there are studies showing that extracorporeal shockwave therapy (ESWT) and instrument-assisted soft-tissue mobilization methods are effective in chronic plantar heel pain (CPHP) treatment, there is a need for studies comparing these techniques. We com-pared the effectiveness of ESWT versus instrument-assisted soft-tissue mobilization using Graston Technique (GT) instruments in addition to stretching exercises (SEs) in CPHP. Methods: Sixty-nine patients were randomly assigned to three groups: ESWT+SEs (group 1), GT+SEs (group 2), and SEs only (control group) (ratio, 1:1:1). The SEs, twice daily for 8 weeks, were standard for all. Group 1 received low-intensity ESWT; in group 2, GT was the selected method. Visual analog scales (for initial step and activity pain), the Foot Function Index (FFI), the 12-item Short-Form Health Survey (SF-12), and the Tampa Scale for Kinesiophobia were used pretreatment, posttreatment, and at 8-week and 6-month follow-up. Results: Visual analog scale and FFI scores improved posttreatment and during follow-up in all groups (P , .001). Although effect sizes were greater in groups 1 and 2 than in the control group in initial step pain posttreatment and at 8-week follow-up, group 2 had the highest effect size at 6 months. Mean SF-12 scores in groups 1 and 2 improved on the post-treatment assessment. Furthermore, group 2 showed significant improvements in FFI scores compared with the other groups at 6-month follow-up (F = 6.33; P = .003).Conclusions: Although ESWT+SEs and GT+SEs seem to have similar effects on initial step pain posttreatment and at 8-week follow-up, GT+SEs was found most effective for improving functional status at 6 months in the management of CPHP.
The Effect of Sportive Latin American Ballroom Dance on Foot and Ankle Posture
(Amer Podiatric Med Assoc, 2025) Kayiskiran, Onurcan; Coskunsu, Dilber Karagozoglu; Isiklar, Cagdas
Background: Correct use of the feet, step techniques, and positions constitute significant factors in the success of a dancer. Moreover, the type of dance has crucial effects on the posture of the foot and ankle. Therefore, the primary aim of our study was to determine whether there was a relationship between dancesport, dance experience (years), shoe-wearing time (hours), and shoe heel height (centimeters) in dance athletes performing Sportive Latin American Ballroom (SLAB) dance. Second, we aimed to compare the foot posture of SLAB dancers and nondancers with similar demographic characteristics. Methods: Twenty-six professional SLAB dancers and 26 nondancers who had similar demographic characteristics and did not use high-heeled shoes volunteered to take part in this study. Foot posture (using the Foot Posture Index [FPI]), foot pronation (using the navicular drop test [NDT]), tibiocalcaneal angle, hallux valgus angle (HVA) (using a goniometer), and ankle dorsiflexion range of motion (ROM) (using the weightbearing lunge test) were evaluated. Results: There was a positive moderate correlation between FPI score and shoe-wearing time on the dominant (P = .041; r = 0.40) and nondominant (P = .026; r = 0.43) sides. A positive very good correlation was found between shoe heel height and HVA (P < .001; r = 0.75). A negative good correlation was observed between years of dancing and nondominant ankle dorsiflexion ROM (P = .027; r =-0.43). When dancers and nondancers were compared, a statistically significant difference was found between FPI and NDT scores (P < .001). The FPI and NDT scores, tibiocalcaneal angle, HVA, and ankle dorsiflexion ROM were significantly greater in the dancer group compared with the nondancer group (P < .001) in all measurements of the dominant and nondominant sides. Conclusions: Revealing the relationship between dance experience and shoe-wearing time and the difference between the foot posture and deformities of athletes who perform SLAB dance and those of nondancers constitutes a pivotal endeavor that will increase awareness and knowledge among dancers and clinicians. (J Am Podiatr Med Assoc 115(6), 2025; doi:10.7547/24-030)
Citation - WoS: 4
Citation - Scopus: 6
Effects of Balance and Strength Training for Ankle Proprioception in People With Chronic Ankle Instability: a Randomized Controlled Study
(Amer Podiatric Med Assoc, 2024) Yekdaneh, Asena; Mutlu, Cigdem Yazici
Background: After an ankle sprain, the ligament and joint capsule are damaged, and as a result, proprioceptive sense is damaged, causing a feeling of giving away in the ankle and resulting in recurrent sprains. Given the relevant studies, it has been seen that people with chronic ankle instability (CAI) commonly have deficits in joint position sense and reinjury risks. Joint position sense plays an important role in ankle control, thereby reducing the risk of injury. Therefore, this study aims to compare the effects of balance and strength training on ankle proprioception in people with CAI. Methods: This single-blind randomized controlled study included 29 volunteer participants (21 women and eight men) aged 18 to 30 years. Participants with a Cumberland ankle instability scale score less than or equal to 24 were randomly divided into two treatment groups: strength training (n = 14) and balance training (n = 15). Y balance test, joint position, and vibration sense were evaluated at the beginning and end of the treatment. "Hop to stabilization" exercises were applied to the balance group and resistive bands exercises to the strength group, which were performed for 6 weeks, 35 minutes per day, two times per week. Results: There was no significant difference between the two groups in the anterior, posterolateral, and posteromedial directions of the Y balance test (P = .89, P = .50, and P = .34, respectively), but the strength training group showed significant improvement in ankle proprioception (140 degrees) and vibration sense (fifth finger) (P < .001), and the post hoc Cohen's d effect size values were medium (.52) and small (.25), respectively. Conclusions: The findings of this study show that strengthening and balance exercises have similar effects on dynamic balance, but strengthening exercises are more effective in improving joint position and vibration sense. Given the positive effects of both exercise programs, it is recommended to implement the two interventions separately or together for CAI rehabilitation.

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