Therapeutic Exercise in Plantar Fasciitis: A Systematic Review with Meta-Analysis

Abstract

Purpose. Plantar fasciitis (PF) is a degeneration of the plantar fascia. There are different forms of treatment for PF. Conservative treatment stands out as the main method of choice. The aim was to review in the literature the effectiveness of therapeutic exercise (TE) on pain and functionality in PF. Methods. The search was carried out in the databases: PubMed, Web of Science, Embase and Lilacs, and in the gray literature: Google Scholar, Open Grey, LIVIVO and Brazilian Library of Theses and Dissertations. A Cochrane tool was used to assess the quality of the studies. The primary outcome was pain, and the secondary outcomes were range of motion (ROM) and functionality. The assessments were performed by two reviewers and a third reviewer resolved conflicts. Randomized controlled trials using therapeutic exercise compared with placebo, no treatment, phototherapy, thermotherapy, and electrotherapy. There was no restriction on time or language. Results. The references of 2,984 studies were identified, 2,832 from major databases and 152 from gray literature. A total of 10 articles were included in this review. Nine studies assessed pain, and all had positive results in decreasing pain levels. All 10 studies used to stretch exercises, but only one used strengthening exercises. Conclusions. It is concluded that TE, mainly through plantar fascia and triceps sural stretching, is effective in reducing pain and functionality when associated with other therapies in PF. Study registration. The study is registered with the International Prospective Register of Systematic Review (PROSPERO) under protocol CRD42021296710.