Cil ET, Sayli U, Subasi F Outpatient vs Home Management Protocol Results for Plantar Fasciitis. Foot Ankle Int. 2019 Aug 6:1071100719865302. doi: 10.1177/1071100719865302. (Original study)

BACKGROUND: We compared the effectiveness of stretching and strengthening exercises combined with myofascial releasing and mobilization techniques to a stretching and strengthening only home program in plantar fasciitis (PF) management.

METHOD: The study included 53 feet of 47 patients with plantar fasciitis (35 women / 12 men; mean age 48.9±11.2 years). Pain, disability, and activity restrictions were assessed by Foot Function Index (FFI), and first step pain was graded by visual analog scale (VAS). Ankle range of motion (ROM), gastrocnemius-soleus flexibility, proprioception, dynamic balance, and foot sensation were also considered. The patients were randomly divided into outpatient clinic treatment (Outpatient, n = 27 feet) and home rehabilitation groups (Home, n = 26 feet). Patient education was routine for all at the beginning of the management programs. In the Outpatient group, the foot-ankle-hip exercise program, myofascial releasing, and joint and soft tissue mobilization techniques were "hands on" at a clinic (twice a week for 8 weeks), whereas the Home group completed their home rehabilitation program on their own (8 weeks' duration with follow-ups every week).

RESULTS: VAS, FFI, ROM, balance, proprioception, foot sense, and flexibility improved at the eighth week in both groups according to intragroup comparison (P < .05). When the 2 groups were compared, the results of plantar flexion range, balance, proprioception, foot sensation, flexibility, FFI, and VAS showed significant improvements in the Outpatient vs the Home group (P < .05). Also, the FFI and VAS scores at the sixth month were superior in the Outpatient group (P < .05).

CONCLUSION: A combined supervised management protocol had superior clinical results in plantar fasciitis management.

LEVEL OF EVIDENCE: Level II, comparative study.

Discipline Area Score
Rehab Clinician (OT/PT) 6 / 7
Physician 5 / 7
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Comments from MORE raters

Physician rater

I see many patients with plantar fasciitis. I use shockwave therapy in a lot of them in addition to other non-surgical interventions. The combined treatment is important in this disease. Good methodology in the article.

Rehab Clinician (OT/PT) rater

This is an interesting article that would be clinically applicable for most musc physios.
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