Effect of stretching with and without muscle strengthening exercises for the foot and hip in patients with plantar fasciitis: A randomized controlled single-blind clinical trial

• Daily stretching exercises are effective at improving pain and function.
• Stretching with strengthening did not achieve better results than stretching alone.
• The three treatment groups had high drop-out rate.
• Natural progression cannot be inferred because of the lack of non-treatment group.

ObjectiveTo compare the effect of stretching with and without muscle strengthening of the foot alone or foot and hip on pain and function in patients with plantar fasciitis.DesignSingle blind randomized controlled trial.MethodEighty-three patients with plantar fasciitis were allocated to one of three treatment options for an eight-week period: Foot Exercise Group (FEG – extrinsic and intrinsic foot muscles), Foot and Hip Exercise Group (FHEG – abductor and lateral rotator muscles) and Stretching Alone Exercise Group (SAEG). Main measures: A visual analog scale for pain, the Foot and Ankle Outcome Score and the Star Excursion Balance Test. All evaluations were performed before treatment and after the last treatment session.ResultsImprovements were found in all groups regarding the visual analog scale, the pain, activities of daily living, sports and recreation, quality of life (p < 0.001) and other symptoms (p < 0.01) subscales of the Foot and Ankle Outcome Score as well as posterolateral movement, posteromedial movement and composite score (p < 0.001) on the Star Excursion Balance Test. No time-group interactions were found for any of the variables (p > 0.05).ConclusionsAll three exercise protocols analyzed led to improvements at eight-week follow-up in pain, function and dynamic lower limb stability in patients with plantar fasciitis.