Video-Based Versus Physician-Led Exercise Training for Plantar Fasciitis

Clinical Effectiveness of Video-Based Exercise Training Compared With Physician-Led Face-to-Face Exercise Instruction in Patients With Plantar Fasciitis: A Randomized Non-Inferiority Trial

This prospective, single-center, two-arm, parallel-group randomized non-inferiority trial will compare physician-led face-to-face exercise instruction with standardized video-based exercise instruction in adults with plantar fasciitis. Participants will be randomized in a 1:1 ratio to receive either face-to-face exercise training by an orthopedic physician or access to a standardized exercise video via QR code/web link. The exercise content will be identical in both groups; only the method of instruction will differ. The primary outcome will be the change in the Foot Function Index total/index score from baseline to 3 months. Secondary outcomes will include pain score, Foot Function Index subscales, exercise knowledge, exercise adherence, education time, video viewing status, additional treatment requirement, and patient satisfaction.

Study Overview

• Status: Recruiting
• Conditions: Plantar Fascitis; Plantar Fasciitis of Both Feet
• Intervention / Treatment: Behavioral: Physician-Led Face-to-Face Exercise Instruction; Behavioral: Video-Based Exercise Instruction

Detailed Description

Plantar fasciitis is a common cause of chronic plantar heel pain and may lead to functional limitation and reduced quality of life. Exercise education is an important component of conservative treatment; however, in busy outpatient settings, the time available for detailed face-to-face instruction may be limited. Standardized video-based education may provide a practical alternative by delivering the same exercise content in a reproducible format.

This study will evaluate whether video-based exercise instruction is non-inferior to physician-led face-to-face instruction in patients with plantar fasciitis. All participants will receive standard information about plantar fasciitis, load management, footwear recommendations, weight control, short-term analgesic or anti-inflammatory use when needed, and heel pad or insole support. The home exercise program will be identical in both groups and will include plantar fascia-specific stretching, gastrocnemius/soleus stretching, plantar fascia self-massage, gradual toe raises, and towel pull exercises.

Assessments will be performed at baseline, 1 month, and 3 months after randomization. Functional status will be assessed using the Foot Function Index, and pain will be measured using a 0-10 numerical rating scale. Exercise knowledge, adherence, education duration, video viewing behavior, additional treatment use, and satisfaction will also be recorded.

• Study Type: Interventional
• Enrollment (Estimated): 300
• Phase: Not Applicable

Contacts and Locations

• Study Contact: Name: gunes SARIKAYA; Phone Number: 05436733113; Email: gunessarikaya05@hotmail.com

Study Locations

• Turkey (Türkiye)
  • Balıkesir, Turkey (Türkiye), +90(543)673-3113
    • Recruiting
    • Balikesir Ataturk City Hospital
    • Contact: gunes SARIKAYA; Phone Number: 05436733113; Email: gunessarikaya05@hotmail.com

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Adult; Older Adult
• Accepts Healthy Volunteers: No

Description

Inclusion Criteria:

• Adults aged 18 to 70 years
• Clinical diagnosis of plantar fasciitis
• Plantar heel pain lasting for at least 3 months
• Heel pain that is most prominent with the first steps in the morning or after rest
• Tenderness on palpation of the medial calcaneal tubercle
• Baseline heel pain score of 4 or higher on a 0-10 numerical rating scale
• Functional capacity to perform the prescribed exercises
• Access to a smartphone, tablet, or computer to view the exercise video
• Ability to provide written informed consent

Exclusion Criteria:

• Previous foot or ankle surgery on the affected side
• History of foot fracture, foot tumor, advanced neuropathy, Charcot arthropathy, or tarsal tunnel syndrome
• Corticosteroid injection, extracorporeal shock wave therapy, platelet-rich plasma injection, or other interventional treatment for plantar fasciitis within the last 6 months
• Inflammatory arthritis or systemic rheumatologic disease affecting the foot
• Severe knee or hip osteoarthritis limiting exercise performance
• Severe cognitive impairment preventing participation or completion of questionnaires
• Pregnancy
• Inability or unwillingness to comply with the study protocol

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Treatment
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: None (Open Label)

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Active Comparator: Physician-Led Face-to-Face Exercise Instruction; Participants in this arm will receive standard plantar fasciitis education and physician-led face-to-face instruction of the home exercise program. The orthopedic physician will explain and demonstrate the exercises during the baseline visit. The exercise program will include plantar fascia-specific stretching, gastrocnemius/soleus stretching, plantar fascia self-massage, gradual toe raises, and towel pull exercises.	Behavioral: Physician-Led Face-to-Face Exercise Instruction; Face-to-face instruction and demonstration of a standardized home exercise program by an orthopedic physician. The program includes plantar fascia-specific stretching, gastrocnemius/soleus stretching, plantar fascia self-massage, gradual toe raises, and towel pull exercises.
Experimental: Video-Based Exercise Instruction; Participants in this arm will receive standard plantar fasciitis education and a QR code or web link providing access to a standardized exercise video prepared by the study team. The video will not be watched in the outpatient clinic; participants will be instructed to perform the exercises at home by watching the video. The exercise content, order, repetitions, and frequency will be identical to the physician-led group.	Behavioral: Video-Based Exercise Instruction; Access to a standardized home exercise video prepared by the study team via QR code or web link. Participants will be instructed to watch the video at home and perform the same exercise program used in the physician-led group.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Change in Foot Function Index Total/Index Score From Baseline to 3 Months	The Foot Function Index total/index score is a patient-reported measure of foot pain, disability, and activity limitation, converted to a 0-100 score. Higher scores indicate worse foot-related function. The primary endpoint will be the change from baseline to 3 months, calculated as baseline FFI score minus 3-month FFI score; higher positive values indicate greater clinical improvement.	Baseline and 3 months after randomization

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Change in Numeric Rating Scale Pain Score From Baseline to 1 and 3 Months	Heel pain while walking during the previous week will be assessed using an 11-point numerical rating scale ranging from 0 to 10, where 0 indicates no pain and 10 indicates unbearable pain. Change scores will be calculated from baseline to each follow-up visit.	Baseline, 1 month, and 3 months after randomization
Change in Foot Function Index Pain Subscale Score From Baseline to 1 and 3 Months	The pain subscale of the Foot Function Index will be used to assess foot-related pain. Scores will be converted according to the standard Foot Function Index scoring method; higher scores indicate worse pain.	Baseline, 1 month, and 3 months after randomization
Change in Foot Function Index Disability Subscale Score From Baseline to 1 and 3 Months	The disability subscale of the Foot Function Index will be used to assess foot-related functional disability. Higher scores indicate greater disability.	Baseline, 1 month, and 3 months after randomization

Collaborators and Investigators

• Sponsor: Balikesir Ataturk City Hospital
• Investigators: Principal Investigator: gunes SARIKAYA, Balikesir Ataturk City Hospital

Study record dates

Study Major Dates

• Study Start (Actual): February 12, 2026
• Primary Completion (Estimated): August 12, 2026
• Study Completion (Estimated): August 12, 2026

Study Registration Dates

• First Submitted: May 29, 2026
• First Submitted That Met QC Criteria: June 3, 2026
• First Posted (Actual): June 4, 2026

Study Record Updates

• Last Update Posted (Actual): June 4, 2026
• Last Update Submitted That Met QC Criteria: June 3, 2026
• Last Verified: June 1, 2026

More Information

Terms related to this study

• Keywords: Exercise Therapy; Patient Education; Non-Inferiority Trial
• Other Study ID Numbers: PF-RCT-NI-2026-001; 2025/12/147 (Other Identifier: Balıkesir Atatürk City Hospital Clinical Research Ethics Committee)

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO
• IPD Plan Description: Individual participant data will not be publicly shared because the ethics approval and informed consent do not include public sharing of participant-level data. De-identified aggregate study results will be reported in scientific presentations and publications.

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No