COMPARISON OF TALONAVICULAR JOINT MOBILISATION AND FIRST METATARSOPHALANGEAL JOINT MOBILISATION ON PES CAVUS SUBJECTS WITH PLANTAR FASCIITIS ALONG WITH FOOTWEAR MODIFICATION- SIX MONTH FOLLOW UP

BACKGROUND: Idiopathic pes cavusis a structural foot deformity characterized by rigid high and medial longitudinal arch which frequently occurs due to muscle imbalance. About 60% of the deformed individuals report with persistent foot pain due to high plantar pressures leading to important functional limitations. AIM& OBJECTIVE: To find out the effectiveness of mobilization on talonavicular joint and first metatarsophalangeal joint mobilization on pes cavussubjects with plantar fasciitis along with footwear modification of metatarsal bar and medial cushioned padding depending on the joint mobilised. PROCEDURE: An experimental study was conducted on subjects with pes cavus foot between 17-38 years of age. Total 28 subjects were divided equally into two groups 14 each. Group A was given talonavicular joint mobilization along with medial cushioned paddingand Group B was given first metatarsophalangeal joint mobilization along with metatarsal bar, TENS and plantar fascia stretch in common for both groups. Pre and post test measures were done using NPRS for pain, Goniometer for reduced dorsiflexion ROM, Musculoskeletal Ultrasonogram (Fascia thickness) and FAAM Questionnaire for ADL. In addition, a follow up measure was taken as second outcome measure after 6 months. RESULT: Statistical analysis was done using the paired t test(intra group) and unpaired t test (inter group). Both groups showed a significant improvement (p-0.05) in NPRS, Goniometer, faam questionnaire, whereas; group B (first MTP joint) showed significant improvement in plantar fascia with reduction in thickness using Musculoskeletal ultrasonogram. CONCLUSION: It is concluded that there was a significant improvement in reduction of pain and improving the functional ability of subjects with first MTP joint mobilizationalong with footwear modification on pes cavus subjects with plantar fasciitis.