# Comparative Evaluation of Ultrasound Measurement of the Plantar Fascia Between Expert and Novice Technicians

## TL;DR

This study compares how expert and novice technicians measure plantar fascia thickness using ultrasound, finding consistent results but differences in speed and learning progress.

## Contribution

Demonstrates that ultrasound measurements of plantar fascia are reliable regardless of technician experience, but highlights efficiency and learning effects.

## Key findings

- Measurements of plantar fascia thickness were consistent between expert and novice technicians.
- The novice technician improved significantly in speed and consistency over time, showing a learning effect.
- Expert technicians performed measurements faster and with less variability.

## Abstract

Background and Objectives: Plantar fasciitis is one of the most common foot pathologies, and its diagnosis and clinical follow-up increasingly rely on the use of ultrasound. The aim of this study is to compare the reliability of ultrasound measurements of plantar fascia thickness between an expert technician, with more than 5 years of ultrasound experience, and a novice technician, with no prior ultrasound experience—both of whom are podiatrists. This allows us to assess whether operator experience significantly influences the results. Methods: An observational, descriptive, and cross-sectional study was designed with a sample of 60 healthy patients aged between 20 and 32 years. The thickness of the plantar fascia in both feet was measured using ultrasound. Each patient was evaluated by two observers (one expert and one novice) using a Vinno E35 ultrasound machine. Results: The results of the analysis indicated that there were no statistically significant differences in the measurements obtained either between the two technicians or between the left and right feet of the same individual, as the calculated p-value in both cases was greater than the conventional threshold of 0.05. This suggests that the measurements were consistent regardless of the operator or the side being evaluated. Nevertheless, when examining the differences in the time required to measure the plantar fascia between the two technicians, the situation was different. In this case, the data distribution did not meet the assumption of normality, as evidenced (p-value of less than 0.001). Furthermore, it was observed that the experienced technician not only completed the measurements in a shorter amount of time but also demonstrated less variability in those times, indicating a more efficient and standardized approach to the procedure. In contrast, the novice technician initially took longer and exhibited greater inconsistency; however, as the study progressed, a noticeable and progressive learning effect became apparent. Specifically, from approximately the midpoint of the study onward, the novice technician showed a significant improvement, achieving faster and more consistent measurement times compared to the earlier stages of the research. Conclusions: The study demonstrates that ultrasound measurements of the plantar fascia are consistent between technicians. However, the expert technician performs the measurements with greater speed and precision, and a learning effect is evident in the novice technician.