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Outpatient versus home management protocol results for plantar fasciitis
Cil ET, Sayli U, Subasi F
Foot & Ankle International 2019 Nov;40(11):1295-1303
clinical trial
4/10 [Eligibility criteria: No; Random allocation: Yes; Concealed allocation: No; Baseline comparability: Yes; Blind subjects: No; Blind therapists: No; Blind assessors: No; Adequate follow-up: No; Intention-to-treat analysis: No; Between-group comparisons: Yes; Point estimates and variability: Yes. Note: Eligibility criteria item does not contribute to total score] *This score has been confirmed*

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 < 0.05). 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 versus the home group (p < 0.05). Also, the FFI and VAS scores at the sixth month were superior in the Outpatient group (p < 0.05). CONCLUSION: A combined supervised management protocol had superior clinical results in plantar fasciitis management. LEVEL OF EVIDENCE: Level II, comparative study.

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