Introduction: The Hand Behind Back (HBB) test is often used in clinical practice to evaluate shoulder internal rotation; yet, additional clarification regarding its measurement reliability using a tape measure is required. Aim: To identify the HBB test’s intra-rater and inter-rater reliability and its psychometric qualities such as Standard Error of Measurement (SEM), Minimum Detectable Changes (MDC) at the 95% Confidence level (MDC95), Coefficient of Variation (CV%) and Smallest Worthwhile Change (SWC) using tape measurement in healthy adults. Materials and Methods: A prospective observational cross-sectional test-retest study was conducted at the Outpatient Physiotherapy Department of Maharishi Markandeshwar Deemed to be University, Ambala, Haryana, India, between March 2025 to November 2025 on total of 60 healthy individuals which were evaluated by two physiotherapists. Each rater completed two measurement sessions under uniform conditions. The inter-rater and intra-rater reliability were assessed by analysing Cronbach’s alpha and interclass correlation coefficients. Cohen’s Kappa was used to assess agreement for the categorical variable of gender. SEM, MDC95, CV%, and SWC were analysed for evaluation of absolute reliability and psychometric qualities. Bland-Altman analysis was further used to investigate the agreement. Results: Both raters showed excellent intra-rater reliability, with ICC values of 0.988 and 0.953, respectively. With an ICC of 0.967, it showed excellent inter-rater reliability. Cohen’s Kappa showed excellent agreement for gender classification with a value of κ=1.00, while Cronbach’s alpha values revealed high internal consistency (≥0.97). The MDC95 value was 0.69 cm, and the SEM values were low (0.25 cm). The SWC (0.46 cm) was higher than the SEM, and the CV% was 5.92%. There was no indication of proportional bias, and Bland-Altman plots showed narrow Limits of Agreement (LoA) and small mean biases. Conclusion: In healthy adults, the tape measure hand behind the back test showed good psychometric qualities with low measurement error, and excellent intra-rater and inter-rater reliability. The results obtained indicate that it can be applied as a sensitive and trustworthy clinical outcome measure for evaluating internal rotation of the shoulder joint.

Diabetic peripheral neuropathy (DPN), a common type 2 diabetes complication, leads to significant morbidity and mortality. Limited knowledge, negative attitudes, poor practices, and inadequate healthcare services hinder effective treatment and quality care. This qualitative systematic review identifies treatment challenges in DPN management and explores strategies to enhance treatment outcomes. Following PRISMA and enhancing transparency in reporting the synthesis of qualitative research guidelines, searches across electronic databases and quality assessment using the Joanna Briggs Institute checklist led to the analysis of five studies. Findings highlight the benefits of exercise in improving mobility, pain management, and overall wellbeing, while also addressing barriers to physical activity. The review underscores the importance of education, counseling, and empowerment, alongside standardized guidance on exercise duration and type, to enhance the understanding and adherence of people with diabetes (PWD). Integrating these strategies into clinical practice can significantly improve treatment effectiveness and quality of life of PWD.

Background: Diabetic Peripheral Neuropathy (DPN) is a multifaceted complication characterized by pain, numbness, tingling, gait and balance impairments, and autonomic dysfunction, all of which compromise functional independence and quality of life. Existing quantitative tools, though widely used, often fail to capture the complexity of patients' lived experiences and the nuanced effects of therapeutic interventions. To address this gap, this study aimed to develop and validate a semi-structured interview guide that explores the functional and psychosocial domains most affected in individuals with DPN, with a particular emphasis on physiotherapy advancements. Methodology: A six-domain interview guide was constructed using a Delphi survey method. The identified domains were: (1) Pain and Other Symptoms, (2) Activities of Daily Living, (3) Balance, (4) Walking, (5) Autonomic Changes, and (6) Social Participation. Each domain comprised an open-ended lead question supported by probes to facilitate rich, detailed narratives. Content validation was undertaken by a panel of seven experts using a structured validation form. Based on expert feedback, iterative refinements were made until consensus was achieved. Results: The finalized interview guide demonstrated excellent content validity, with a Scale-Level Content Validity Index (S-CVI/Ave) of 0.975 and Item-Level Content Validity Index (I-CVI) scores ranging from 0.85 to 1.0, indicating strong agreement on relevance and clarity across all domains. Conclusion: This interview guide offers a culturally sensitive and scientifically sound tool for capturing patient perspectives on physiotherapy in DPN. By bridging the limitations of quantitative measures, it provides valuable insights for clinical practice, research, and policy, advancing person-centered and holistic care. CTRI/2023/12/060929 (Registered on: 29/12/2023).

Diabetic peripheral neuropathy (DPN), a common complication of diabetes, leads to neuropathic pain, reduced nerve conduction, impaired balance, and abnormal plantar pressure, increasing the risk of falls and ulceration. Conventional therapies often provide limited relief, leaving persistent pain and dysfunction. Class IV laser therapy offers potent photobiomodulation to enhance nerve regeneration and conduction, while neural mobilization restores nerve dynamics. This case report highlights the therapeutic potential of class IV laser therapy as a key intervention for neurorehabilitation in DPN, used in conjunction with neural mobilization to enhance outcomes. The laser intervention resulted in marked alleviation of neuropathic pain and significant improvement in nerve conduction, balance, and proprioceptive control. Plantar pressure analysis demonstrated a more balanced load distribution, indicating optimized foot biomechanics and reduced ulceration risk. Overall, the findings underscore class IV laser therapy, particularly when integrated with neural mobilization, as a powerful, non-invasive physiotherapeutic approach capable of accelerating neural recovery and enhancing functional restoration in patients with DPN.

BackgroundChronic low back pain (CLBP) is a prevalent musculoskeletal disorder, affecting up to 80% of people in their lifetime. Approximately 70% of CLBP patients report significant sleep disruptions, indicating an important but under-recognized element of their condition. Existing evaluation tools rarely account for this population's unique issues in assessing chronic pain and sleep problems.MethodsThis study involves two parts. We will design and evaluate the CLBP-specific Sleep Disability Questionnaire (SDQ) in Phase 1. Through expert discussions, patient interviews, and extensive literature analysis, domain identification is achieved. The Delphi technique will ensure content validity, followed by pilot testing to assess questionnaire usefulness and efficacy. Exploratory factor analysis will evaluate construct validity. Phase 2 will assess SDQ reliability and psychometric features, including internal consistency and inter/intra-rater reliability, in 51 CLBP patients with sleep disorder.ResultsPsychometric examination will establish content validity using kappa statistics, I-CVI, and S-CVI. Kolmogorov-Smirnov and Shapiro-Wilk tests will determine normality. Regression, Cronbach's alpha, Pearson or Spearman correlations, Bland-Altman plots, and intraclass correlation coefficients are reliability analyses.ConclusionThis work develops and validates a novel, robust SDQ for CLBP patients. The SDQ should help physicians and researchers diagnose and manage sleep disorders in this patient group, improving clinical outcomes and quality of life.

Hemiplegic shoulder pain is one of the common complication post-strokes resulting in reduced upper limb function. Conventional treatment approaches remain inadequate for the pain management. High Intensity Laser Therapy (HILT) has gained attention as a promising treatment approach in various musculoskeletal and neurological conditions its effectiveness in hemiplegic patients has not been extensively evaluated. To thoroughly examine randomized controlled trials assessing how high-intensity laser therapy affects shoulder-related outcomes and pain in people who have hemiplegic shoulder pain after a stroke. The 2020 PRISMA guidelines were followed in the search of the electronic databases (PubMed, Scopus, Web of Science, PEDro, and Cochrane Library). Randomized controlled trials with hemiplegic shoulder pain in adult stroke patients were taken into consideration. HILT was contrasted with therapeutic ultrasound and traditional physical therapy. Technique quality was evaluated using the PEDro scale, and bias risk was evaluated using the Cochrane RoB 2 assessment tool. There were 222 participants in four randomized controlled trials. In every study, the HILT groups’ shoulder pain decreased considerably more than that of the control groups. Additionally, HILT was found to improve functional outcomes and shoulder range of motion. With some issues with blinding, PEDro scores ranged from 6 to 8, indicating moderate to high methodological quality. According to available data, high-intensity laser therapy is a safe and effective addition to traditional rehabilitation for stroke patient’s hemiplegic shoulder pain and shoulder function. To improve clinical recommendations, larger trials with standardized treatment protocols and long-term follow-up are required.

Achilles tendinopathy is a common musculoskeletal occurrence primarily affecting athletes, but the general population is also prone to develop this pathology. Shear-wave elastography serves as a complement to traditional ultrasound imaging in assessing tendon properties in patients with Achilles tendinopathy. High Intensity Laser therapy (HILT) is a non-invasive and painless treatment option, exhibiting anti-inflammatory, analgesic, and bio-stimulant characteristics. However, limited evidence exists on the effectiveness of high-intensity laser therapy on shear-wave elastography parameters in patients with Achilles tendinopathy. This case study examines the case of a 22-year-old male with a complaint of pain in the Achilles region. He reported stiffness in the morning and difficulty with weight-bearing activities. To assess patient numeric pain rating scale, range of motion (using goniometer) and shear-wave elastography were used. High-intensity laser therapy was administered to the patient for three sessions alternately. Outcome measures were assessed at baseline and after the commencement of treatment. HILT demonstrated positive effects in reducing pain and improving tissue elasticity in patients with Achilles tendinopathy, as observed through shear-wave elastography. These results indicate that HILT may serve as a valuable complement in the conservative treatment of Achilles tendinopathy.

Introduction: The Iliotibial Band Friction Syndrome (ITBFS) diagnosis is based on clinical reasoning. Ober’s test and the Noble compression test are examples of diagnostic techniques, but there is no specific diagnostic standard assessment questionnaire for ITBFS. Neither the original nor the modified Ober’s test appears to accurately measure ITB tightness. To the best of our understanding there is no tool available to diagnose the patients with ITBFS. Aim: To develop and validate an index tool for ITBFS. Materials and Methods: The present cross-sectional content validation study was conducted at Maharishi Markandeshwar Super Speciality Hospital, Mullana, Ambala, Haryana, India, from August 2025 to December 2025. The study was conducted in two sequential phases to ensure a systematic and scientifically rigorous approach: Phase I: Questionnaire development and Phase II: Content validity assessment. Based on the findings from the literature, an initial pool of items was generated. The generated items were reviewed through focused discussions with two experts in musculoskeletal and sports physiotherapy. A panel of seven physiotherapy experts participated in the validation process. The Scale Content Validity Index (S-CVI) {S-CVI/UA (Universal agreement) and S-CVI/A(Average)} was also computed to determine the overall content validity of the questionnaire. Results: The developed tool possesses excellent content validity, supported by strong agreement among expert panelists with item-level content validity that was greater than 0.8 for every tool item. The S-CVI/A of the created Iliotibial Band Friction Syndrome Index (ITBFSI) tool was 0.985. Additionally, the S-CVI/UA value of 0.9 further supports strong universal agreement across the included items. Conclusion: ITBFSI is a valid tool which can help to diagnose the patients with ITBFS.

Oxygen utilization is important for studies of brain metabolism, alongside other measurements such as for glucose metabolism. Oxygen and other measurements with [ 15 O] tracers and PET, however, are significantly more challenging than measurements of [ 18 F]fluorodeoxyglucose, the standard for probing tissue glucose metabolism in vivo, in part due to the much shorter radioactive half-life of [ 15 O]. This work examines details of precision measurement of [ 15 O] tracers and their kinetics. Investigations of arterial input functions (AIFs) and image-derived input functions (IDIFs) have figured prominently for PET, but [ 15 O] tracers are rarely studied given the small numbers of PET facilities equipped to work with these tracers, particularly in their inhaled form. Estimates of IDIFs and AIFs for [ 15 O] tracers have demonstrably distinct characteristics arising from instrumentation as well as circulatory physiology. To reconcile IDIFs and AIFs, we developed a generalizable model for bolus tracer transport, corrected for known effects of instrumentation for measuring IDIFs and AIFs, and found intravascular[ 15 O]CO to be especially suited for constructing a robust recovery coefficient for IDIFs compared against AIFs. Within a Bayesian framework for posterior estimation and estimating data evidence, IDIFs provide parameter estimates compatible with AIFs in the setting of biological variability. IDIFs also provide data evidence that exceeds that of results from AIFs. These suggest that scalar recovery coefficients may be adequate to estimate partial volume effects, and that the circulatory consistency of internal carotid IDIFs with brain tissue perfusion provides greater precision than what can be estimated using radial artery AIFs, which exhibit greater variability of recirculation wave forms.

Prolapsed intervertebral disc (PIVD) of the lumbar region is a major cause of low back pain, accounting for a large proportion of morbidity and healthcare expenditure. While MRI is the gold standard for diagnosis, its unavailability and high cost in developing nations require a clinical method for the identification of PIVD. Artificial intelligence (AI) based diagnostic systems provide an alternative, but current models are based largely on radiological rather than clinical parameters. Therefore, this study aims to identify key clinical determinants for diagnosing lumbar PIVD, forming the basis for an AI-driven diagnostic model. Prospective cross-sectional research was performed between October 2023 and January 2024 at a Haryana-based tertiary care hospital. The three-stage methodology adopted for the study included: (1) thorough review of the literature, (2) patient interviews (n = 12) with established lumbar PIVD, and (3) a survey of expert opinion (n = 12) among physiotherapists, neurologists, and neurosurgeons with special interest in spinal disorders. The data were analyzed based on frequency distribution and descriptive statistics. Clinical determinants were grouped into four categories: demographic (age 25-50 years), anthropometric (height, Body Mass Index > 25 kg/m2), symptomatic (low back pain, radiating pain, neurological deficits, abnormal posture, limited lumbar range of motion), and occupational (sitting > 6 h, heavy lifting). Expert verification attested to their relevance in PIVD diagnosis. The identification of these clinical determinants allows for a transition from MRI-dependent diagnosis to AI-assisted clinical evaluation. Incorporating these tested parameters within AI algorithms can improve diagnostic accuracy, maximize patient management, and decrease the dependency on expensive imaging methods.

Cervical spondylosis, a degenerative condition of the cervical spine, significantly impacts quality of life through debilitating neck pain, stiffness, and disrupted sleep. While various treatments exist, the role of pillow selection in maintaining cervical lordosis during sleep remains under-explored and often overlooked by most healthcare practitioners. This study investigates the efficacy of a novel cervical pillow designed with optimal parameters, in conjunction with postural reeducation exercises only, in improving pain, disability, and sleep quality in individuals with cervical spondylosis. Four patients (three females and one male) with confirmed radiological evidence of cervical spine degeneration and clinical symptoms of neck pain and disturbed sleep persisting for over three months were recruited for the study.Outcome measures, including pain, disability, and sleep quality, were evaluated using the Numeric Pain Rating Scale (NPRS), the Neck Disability Index (NDI), and the Pittsburgh Sleep Quality Index (PSQI), respectively, with baseline and post-intervention scores recorded after a four-week period. During the intervention, patients were provided with a novel cervical firm pillow, measuring 10–12 cm in height, to use exclusively during sleep. Additionally, self-directed postural re-education exercises were demonstrated, with specified repetitions and sets prescribed for practice throughout the study duration.The study demonstrated statistically significant improvements across all outcome measures compared to baseline. The Numerical Pain Rating Scale (NPRS) showed a reduction from 7.33±0.51 to 2.17±0.40 (p<0.01, 95% CI), the Neck Disability Index (NDI) decreased from 55.68±5.78 to 10.54±1.11 (p<0.01, 95% CI), and the Pittsburgh Sleep Quality Index (PSQI) improved from 12.17±0.40 to 4.67±1.36 (p<0.01, 95% CI). This study underscores the clinical significance of appropriate pillow selection in managing the multifaceted symptoms of chronic cervical spine degeneration, including pain, disability, and disrupted sleep.

Alzheimer's Disease (AD) is a neurodegenerative disorder with the hallmark of neuropsychiatric symptoms and neurodegenerative dysregulation. Recent researches have suggested that gut microbiome can influence the pathological pathways and progression of AD. All qualitative and quantitative alteration in gut microbial composition can potentially contribute in progression of the AD. Physical Activity (PA) has become a potent strategy for preventing cognitive decline and lowering chronic inflammation. PA also causes notable alterations in gut microbiota composition, functionality, diversity, and Short-chain Fatty Acid (SCFA) production. Physical stress and cognitive abilities are positively correlated in both AD patients and the elderly. Physical activities can be carried out with relatively easy and affordable methods, and even brief interventions that occur seldom appear to have beneficial effects. This review aims to examine the existing evidence to find the effect of physical activity on modulating gut microbiome and its implication for the progression of AD. The literature search was conducted from various databases including PubMed, PEDro, and Cochrane. This review includes findings from 8 studies which suggest that exerciseinduced alterations for the treatment of gut dysbiosis can alleviate the symptoms of AD and improves physical health and psychological wellbeing of patient. Furthermore, exercise has a major impact on gut microbiota.

Diabetic peripheral neuropathy (DPN) is the most common complication resulting from type 2 diabetes mellitus (T2DM), with a prevalence rate of 42% in rural north India. The clinical manifestations include progressive weakness, numbness, dysesthesia, and burning pains in DPN patients. This study evaluates the effectiveness of physiotherapy interventions, including physical exercises and electrotherapy, on managing pain, quality of life, and nerve conduction velocity in patients with painful DPN associated with T2DM. A systematic review and meta-analysis were conducted by searching PubMed, Scopus, and PEDro databases up to March 23, 2020, and analyzing the data using RevMan software. The analysis included ten randomized controlled trials, with nine studies undergoing meta-analysis. The results indicate that a combination of exercises and electrotherapy is more effective than control interventions (details are discussed in the methodology) in reducing pain, with an odds ratio (OR) of 0.59, although the improvement was not statistically significant (P = 0.56). The effectiveness of exercise therapy alone on nerve conduction velocity and quality of life was not significant compared to the control group (OR = 1.21, P = 0.63). Electrotherapy also did not show a statistically significant effect on pain and quality of life when compared to the controls (OR = 0.80, P = 0.70). The study concludes that a combination of exercise and electrotherapy (transcutaneous electrical nerve stimulation and micro-currents) can alleviate pain in DPN patients more effectively when compared to controls, but the overall effectiveness on the other outcomes remains inconclusive. The presence of heterogeneity in the included studies suggests the need for further clinical trials to better understand the benefits of physiotherapy interventions in managing DPN symptoms.

Introduction: Climbing steps up and down remain difficult in individual with knee Osteoarthritis (OA). To evaluate the functional capacity in patient with knee OA, several tests have been recorded such as 6 min walk test, Time Up and Go (TUG) test Chair Stand Test (CST) and Stair Climb Test (SCT). Being quick to execute and inexpensive, 2 Minute Step Test (2MST) presents more feasible to conduct in clinical settings as compared to 6 min walk test, TUG, CST and SCT which requires larger space and specific infrastructure. Two minutes step test is a valid and reliable test in patients with knee OA. By measuring how many steps a person can take in two minutes, it provides valuable insight into their aerobic capacity and overall fitness level. Even though 2MST is a promising method for examining functional capacity, there is currently a dearth of information in the literature about the concurrent validity and reliability of its use in individual with knee OA. Need for this study: The 2MST will be a valid, reliable and established tool for analysing knee OA patients and their functional capacity with outstanding validity and reliability. Aim: The study objective is to evaluate concurrent validity and test intra-rater reliability of 2MST in patients with knee OA. Materials and Methods: Patients will be recruited based on the principle of inclusion and exclusion standards. Fifty-one patients of each grade will be recruited on the basis of Lynn criteria. The sample will be recruited from orthopaedic physiotherapy lab on the basis of grading of OA according to Kellegren-Lawrence grading (Grade I, II, III) and individuals will be further divide on the basis of grade I, II, III. One examiner will assess the patients at two times with interval between the test and retest from 7 to 14 days.

The brain’s resting-state energy consumption is expected to be driven by spontaneous activity. We previously used 50 resting-state fMRI (rs-fMRI) features to predict [ 18 F]FDG SUVR as a proxy of glucose metabolism. Here, we expanded on our effort by estimating [ 18 F]FDG kinetic parameters K i (irreversible uptake), K 1 (delivery), k 3 (phosphorylation) in a large healthy control group (n = 47). Describing the parameters’ spatial distribution at high resolution (216 regions), we showed that K 1 is the least redundant (strong posteromedial pattern), and K i and k 3 have relevant differences (occipital cortices, cerebellum, thalamus). Using multilevel modeling, we investigated how much spatial variance of [ 18 F]FDG parameters could be explained by a combination of a) rs-fMRI variables, b) cerebral blood flow (CBF) and metabolic rate of oxygen (CMRO 2 ) from 15 O PET. Rs-fMRI-only models explained part of the individual variance in K i (35%), K 1 (14%), k 3 (21%), while combining rs-fMRI and CMRO 2 led to satisfactory description of K i (46%) especially. K i was sensitive to both local rs-fMRI variables ( ReHo ) and CMRO 2 , k 3 to ReHo , K 1 to CMRO 2 . This work represents a comprehensive assessment of the complex underpinnings of brain glucose consumption, and highlights links between 1) glucose phosphorylation and local brain activity, 2) glucose delivery and oxygen consumption.

Background: Neural mobilization and Laser therapy are proven to be effective in improving functional impairments in Chronic Sensorimotor Diabetic Peripheral Neuropathy (CSMDPN). Still, there is hardly any qualitative study that has investigated the experiences and outcomes of patients with CSMDPN regarding Neural mobilization and High Intensity Laser therapy as therapeutic interventions. So, this study aims to estimate and explore the experiences and outcomes of Neural mobilization and High Intensity Laser therapy in patients with Chronic Sensorimotor Diabetic Peripheral Neuropathy. Methodology: A mixed-method approach will be conducted on 16 patients with CSMDPN. Group-1 and group-2 will undergo Neural mobilization of the tibial and common peroneal nerve, and High Intensity Laser therapy for 4 times/week for 3 weeks and after a washout period of 1 week, intervention will be reversed in both groups. Prepost assessment will be taken after completion of each intervention with quantitative outcome measures S-LANSS for neuropathic pain, static balance & proprioception by Pedalo-Sensamove Balance Test Pro with Miniboard, Plantar pressure distribution by using Harris mat, Nerve Conduction Velocity of tibial and common peroneal nerve, Sympathetic Skin Response (SSR), and NeuroQoL-H questionnaire for quality of life. After the completion of each intervention depth face to face, semi-structured interviews will be conducted to explore the experiences of patients having CSMDPN about Neural Mobilization and High Intensity Laser therapy. Discussion: The results achieved after the completion of this study may provide both quantitative and qualitative information which helps in collecting broad information about the facilitators and barriers of interventions for the benefit of CSMDPN patients for future implementation in clinical practice. CTRI/2023/12/060929 [Registered on: December 29, 2023].

BACKGROUND:Chronic Plantar Fasciitis (CPF) is commonly associated with elevated levels of anxiety and pain catastrophizing. Pain Neuroscience Education (PNE) has shown promise in addressing these psychological components, but high-quality evidence assessing its combined impact with physiotherapy for CPF is limited. PURPOSE:This study evaluates the potential benefits of incorporating Pain Neuroscience Education alongside Physiotherapy for managing Chronic Plantar Fasciitis. METHODS:A randomized controlled trial will recruit 160 participants between the ages of 18 and 44, all diagnosed with Chronic Plantar Fasciitis (CPF). Participants will be randomly and equally divided into two groups: a conventional physiotherapy group undergoing 45-min sessions of standard physiotherapy, and an experimental group receiving the same physiotherapy regimen supplemented with a weekly 15-min Pain Neuroscience Education (PNE) session. The outcome measures will include the Numeric Rating Scale (NRS) for assessing morning first-step pain, the Foot Function Index (FFI) for evaluating foot and ankle function, the Pain Catastrophizing Scale (PCS) for measuring catastrophic thinking, the Tampa Scale for Kinesiophobia (TSK) for fear of movement, and the Y-Balance Test for dynamic balance assessment. Data will be collected at baseline, after 3 weeks, and at 6 weeks. RESULTS:Data normality will be checked using the Kolmogorov-Smirnov test. Depending on the data distribution, between-group differences will be analyzed using either the independent t-test or Mann-Whitney U test, and within-group changes will be assessed using the paired t-test or Wilcoxon signed-rank test. DISCUSSION:The findings of this trial are expected to shed light on the additional benefits of integrating Pain Neuroscience Education with conventional physiotherapy in the management of Chronic Plantar Fasciitis. TRIAL REGISTRATION:This study was registered with the CTRI registry. The trial number is CTRI/2024/03/064616.

Chronic Plantar Fasciitis (CPF) is an inflammation of the plantar fascia that lasts for more than 3 months and is caused by repetitive stress on the plantar fascia. Chronic pain patients develop central sensitivity, which means that treatment given on the periphery is insufficient to manage their symptoms.Pain Neuroscience Education (PNE) may help to reduce anxiety and catastrophic thinking related to pain. Currently, there are insufficient data on the effects of PNE as an adjunct to physiotherapy in CPF patients. This case study involves a 26-year-old woman who was diagnosed with CPF and who experienced heel discomfort with her first few steps in the morning and during prolonged standing for the past five years.To measure pain, Numeric Rating Scale (NRS) and to measure ankle dysfunction, Foot and Ankle Disability Index (FADI) was taken,to measure pain Catastrophisation, Pain Catastrophising Scale (PCS) and to measure Kinesiophobia, Tampa Scale for Kinesiophobia (TSK) was taken at baseline, 3rd and on 6th week.Physiotherapy treatment included Plantar fascia release, Plantar fascia stretching, and strengthening of intrinsic muscle of foot and PNE includes metaphors and storytelling. The patient demonstrated significant improvement in pain and activity limitations along with significant improvement in Pain Catastrophization and Kinesiophobia. This case study illustrates that integrating PNE along with physiotherapy treatment is an effective strategy for treating individuals with CPF.