Education in Pain Neuroscience associated with Gait Retraining in elderly women with Plantar Fasciitis

• Grant number: 25/00403-5
• Support Opportunities: Scholarships in Brazil - Scientific Initiation
• Start date: August 01, 2025
• End date: July 31, 2026
• Field of knowledge: Health Sciences - Medicine
• Principal Investigator: Ana Paula Ribeiro
• Grantee: Maria Soraia Mendes Cavalcante
• Host Institution: Universidade de Santo Amaro (UNISA). São Paulo , SP, Brazil

Abstract

Introduction: Plantar fasciitis is a musculoskeletal dysfunction that mainly affects elderly women, causing loss of functionality and decreased quality of life. The high recurrence rates suggest that current treatment options may not address all potentially modifiable factors associated with the disease, such as intrinsic muscular atrophy of the foot, changes in the plantar load of the feet and body balance. However, recent studies have shown how chronic pain arising from musculoskeletal disorders is associated with the presence of kinesiophobia and exercise catastrophization, along with psychosomatic symptoms. Given this challenging context, it is imperative to evaluate studies with an intervention strategy with therapeutic exercises with gait retraining combined with educational strategies in pain neuroscience in elderly women with plantar fasciitis. Education in pain neuroscience has already been well evidenced in the literature and has positive effects for patients with chronic low back pain and knee osteoarthritis. Objective: Verify the effect of neuroscience education on pain associated with gait retraining in elderly women with plantar fasciitis. Methods: A controlled, randomized clinical trial with a blinded evaluator will be carried out, in which 30 elderly women will be recruited by convenience sample and divided into two groups: plantar fasciitis group (n=15) and control group (n=15). The intervention will be pain neuroscience education combined with a treadmill gait re-training exercise program. The intervention program will last for three consecutive months, twice a week, with a total of 24 sessions, each session lasting 45 minutes, followed by reassessment after the end of the intervention. The primary outcomes will be: pain intensity verified by the Visual Analogue Scale, foot functionality by the foot function index (FFI) questionnaire and pain neurophysiology questionnaire. Secondary outcomes will be: foot health through the foot health status questionnaire (FHSQ), as well as psychosocial factors addressed by the pain catastrophizing scale, the kinesiophobia scale, the six-minute walk test, the FRAQ questionnaire -Brazil of balance perception, the Timed Get Up and Go Test and patient satisfaction with the intervention protocol. Statistical Analysis: The dependent and independent Student t test will be used for intra and inter-group comparisons. Effect size by Cohen's D test. For all analyzes p<0.05 will be considered significant.