The effectiveness of combined prescription of ankle–foot orthosis and stretching program for the treatment of recalcitrant plantar fasciitis

Abstract

Plantar fasciitis frequently responds to a wide range of conservative treatments with various degrees of success. Therefore, a continued search for an effective conservative treatment for plantar fasciitis exists. The aim of this study was to evaluate the effects of individually prescribed night ankle–foot orthosis, stretching exercises, and a combined prescription of them on chronic plantar fasciitis. This study is a prospective randomized case–control study. Seventy-five patients with unilateral recalcitrant plantar fasciitis were randomized to one of three treatment groups. Group I was treated with stretching exercises to the plantar flexors and plantar fascia. Group II was treated using a night-stretch ankle–foot orthosis. Group III received the same stretching exercises as in group I in combination with night-stretch ankle–foot orthosis as in group II. Patients receiving the combination of stretching exercises and night ankle–foot orthosis showed a statistically significant reduction in morning and activity pain, improvement in assessment scores, and improvement of ankle dorsiflexion range of motion as compared with those receiving night ankle–foot orthosis only. Patients receiving stretching exercises provide no statistically significant improvement of pain, assessment scores, and ankle dorsi flexion range of motion. No significant differences were observed in the ankle plantar flexion after treatment in the three groups. Combined prescription of night-stretch ankle–foot orthosis and stretching exercises for plantar flexors and fascia had greater therapeutic effects compared with each treatment alone. Stretching exercises alone are not beneficial in the treatment of recalcitrant plantar fasciitis.