The Journal of the American Osteopathic Association, 2005/07, 105(7):319-320. doi: 10.7556/jaoa.2005.105.7.317, type of study: ,crs,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,

Full text    (https://www.degruyter.com/document/doi/10.7556/jaoa.2005.105.7.317/html)

Keywords:

counterstrain [66]
crossover study [17]
foot [72]
plantar fasciitis [5]

Abstract:

Previous work (Cabell et al, JAOA, 98:390, 1998) suggested that counterstrain produces a decrease in the amplitude of the soleus stretch reflex in Achilles tendonitis subjects. The current study was designed to study the effects of counterstrain on stretch reflex activity and clinical outcomes in subjects with plantar fasciitis. The study compared the effects of counterstrain with placebo in a randomized, single blind study of crossover design, in which adult subjects (N=20) with plantar fasciitis were led to believe that both the counterstrain and placebo were therapeutic measures whose effects were being compared. Subjects were assigned to begin with either counterstrain or placebo. Each treatment period was three weeks in duration with a two to four week interval between treatments. Clinical outcomes were assessed with questionnaires administered daily during the study. Stretch and Hoffman (H) reflexes in the soleus muscle were assessed electromyographically twice during each lab visit, before and after treatment in the manipulation phase. No significant changes in the electrically recorded stretch or H-reflexes of the soleus muscle were observed in response to treatment. However, changes in the twitches resulting from the electrical responses were observed. Peak torque, time to peak torque, and time to half relaxation all increased (P.05) in the post-treatment measurements, the increase being more significantly pronounced in the manipulation group (P.05). A comparison of symptom severity pre- and post-treatment demonstrated significant relief of symptoms that was most pronounced immediately following treatment and lasted for at least 48 hours. These results indicate that there are significant clinical responses to counterstrain in plantar fasciitis subjects, and that mechanical changes in the lower leg accompany the clinical responses. The causative relation between the mechanical changes and the clinical responses remain to be explored.