Physiotherapy Management of Dynamic Balance Impairment in an Adult with Plantar Fasciitis: A Case Report

Abstrak

Background: Plantar fasciitis may be accompanied by pain, altered weight bearing, impaired postural control, and reduced functional mobility. 
Objective: To describe clinical changes observed during a four-session physiotherapy program combining therapeutic ultrasound and progressive exercise in an adult with plantar fasciitis and dynamic balance impairment. 
Methods: This descriptive single case report was conducted at Muhammadiyah Lamongan Hospital, East Java, Indonesia. The patient was a 52-year-old woman with a two week history of plantar fasciitis and impaired dynamic balance. Outcomes included Numeric Rating Scale pain scores, Manual Muscle Testing, Foot Posture Index 6, Windlass Test, Talar Tilt Test, Berg Balance Scale, and 10 Meter Walk Test. Changes were described without inferential statistical testing. 
Results: Resting pain changed from 3/10 to 2/10, tenderness from 7/10 to 3/10, and movement pain from 4/10 to 3/10. Recorded ankle dorsiflexion strength changed from 1/5 to 2/5 on the affected side. FPI 6 scores remained 0 on the right and +2 on the left. Windlass and Talar Tilt Test results changed from positive to negative at the final recorded session. BBS increased from 25 to 44-, and 10-Meter Walk Test speed increased from 0.71 to 1.10 m/s. 
Conclusion: Positive changes in pain, recorded muscle strength, balance performance, and walking speed were observed during the four-session physiotherapy period. Because this was a single case without a comparator or long term follow up, the observed changes cannot be attributed causally to the combined intervention.