Background: Prior research has established that regular use of high-heeled shoes significantly alters the gait pattern, impacts ankle joint motion, increases joint forces and moments in the lower extremities, modifies foot pressure distribution, and affects posture and balance. These biomechanical changes can lead to tightened calf muscles and associated discomfort in frequent high heel wearers. Objective: The main objective of this study is to compare the effect of Active Release Technique and Positional Release Therapy in female students with tightened calf muscles. Methods: A randomized clinical trial including 26 subjects by using convenient sampling technique, with subject age ranging from 20-30 years wearing high heels with minimum duration (5 hours a day, 5 times a week and for more than 1 year) with heel height minimum of 2''. The outcome measures were ankle dorsiflexion plantar flexion range of motion measured by goniometer, and pain measured by Numerical Pain Rating Scale. Data was collected for 4 months (Feb-May 2023) from The University of Faisalabad and Government College University Faisalabad. Over four weeks & 3 times per week both groups received ultrasound and traditional Physiotherapy of conventional calf muscle stretching as baseline treatment. Group 1 received Positional Release Therapy, while Group 2 received Active Release Technique. Results: Friedman test showed within-group improvements in NPRS, Dorsiflexion, Plantar flexion, and Cadence (p<0.05) for both groups. Mann Whitney U test revealed significant improvements in NPRS, Dorsiflexion, Plantar flexion, and Cadence at post-treatment (p<0.05) for Positional Release Therapy group more than Active Release Therapy.. Conclusion: Positional Release Therapy (PRT) has more significant effects for calf muscle tightness, exhibiting increased cadence, ankle dorsiflexion, and plantar flexion range of motion, along with significant pain reduction than Active Release Therapy (ART)
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