Efficacy of Ankle Proprioceptive Neuromuscular Facilitation with Mulligan Mobilization Versus Conventional Therapy in Restoring Ankle Biomechanics Following Plantar Fascitis - A Comparative Study

Background: Plantar fasciitis, a common musculoskeletal condition, affects 1-2 million people annually and 10% of the general population. It is more common in active working adults aged 25-65. Pain is often triggered by loading and inactivity. Mulligan's concept approach to orthopaedic manual physical therapy posits that the plantar fascia and the subtalar joint is responsible for plantar heel pain, aiming to improve joint mobility, reduce pain, and restore biomechanical integrity whereas, PNF enhances neuromuscular stimulation, promoting muscle contraction and stretching, improving movement patterns, joint mobility, strength, flexibility, balance, and reducing pain in tight tissues. Objective: There would be very little research related to the effectiveness of ankle PNF with Mulligan mobilization. So, the purpose is to compare the impact of ankle PNF with Mulligan mobilization and conventional therapy on pain, foot biomechanical function, and functional quality of foot in individuals with plantar fasciitis. Methodology: The study was conducted at NIMS University, Jaipur, and Rajasthan. Total 60 patients with plantar fasciitis were randomly assigned into two groups, that is 30 in each group and named as Group A (Ankle PNF with Mulligan Mobilisation) and Group B (Conventional therapy), the treatment was administered over six weeks, 4 days per week. The outcomes were evaluated through using the numerical pain rating scale (NPRS), dorsiflexion range, the Weight-bearing Lunge Test (WBLT), and the Foot Function Index (FFI) before the intervention and after six weeks, again as postintervention assessments. Result: Post intervention, both groups showed clinical significant improvements (p<0.0001) in pain, ankle dorsiflexion range, weight-bearing function, and foot functionality. However, group A showed significantly greater improvements (p<0.05) across the dorsiflexion range, WBLT and functional scale, suggesting the combined PNF and Mulligan mobilization approach is superior. Conclusion- The study found that the combination of ankle PNF and Mulligan mobilization offers a holistic approach to plantar fasciitis, with significant clinical relevance. It is particularly beneficial for those with physically demanding work or hobbies, such as long-time standing work or sports.