Physical therapy · 2026
Efficacy of physical therapy interventions delivered with home exercise programs for pain and function in plantar fasciitis: a systematic review and network meta-analysis of randomized controlled trials.
СтатьяNetwork Meta-AnalysisСистематический обзорНазвание и аннотация: Перевод в очереди
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Li Zelin, He Siyi, Wu Jiaqi, Zhu Zhaoying, Chen Ling, Lu Wei
Аннотация
OBJECTIVE: This study aimed to compare the effects of 7 physical therapy interventions delivered with Home Exercise Program (HEP) versus HEP alone on pain and function in plantar fasciitis (PF).
DATA SOURCES: Studies were identified through PubMed, Embase, the Cochrane Library, Web of Science, and Scopus from database inception to January 2026.
STUDY SELECTION: Randomized controlled trials (RCTs) comparing physical therapy interventions delivered with HEP versus HEP alone in individuals with PF were included.
DATA EXTRACTION AND SYNTHESIS: A frequentist random-effects network meta-analysis was conducted.Outcomes were assessed at short-term (≤6 weeks), medium-term (6-12 weeks), and long-term (≥12 weeks) follow-up periods. Eight treatment nodes were analyzed: extracorporeal shock wave therapy, ultrasound therapy, manual therapy, taping, low-level laser therapy, orthoses, and dry needling, all delivered with HEP, and HEP alone as the control. Risk of bias was assessed using the Cochrane Risk-of-Bias tool, and the certainty of evidence was evaluated with the Confidence in Network Meta-Analysis framework.
MAIN OUTCOMES AND MEASURES: Pain and functional outcomes were evaluated using standardized mean differences (SMDs) with 95% CIs.
RESULTS: Twenty-four RCTs (1240 participants) were included. For pain outcomes, dry needling (DN) (SMD = -1.26, 95% CI = -2.25 to -0.28), low-level laser therapy (-1.54, -2.82 to -0.27), and manual therapy (MT) (-1.02, -1.82 to -0.21), delivered with HEP, resulted in clinically significant improvements in short-term pain (moderate-quality evidence). The pain-relieving effects of DN delivered with HEP were sustained in the medium term (-1.14, -1.62 to -0.66; high-quality evidence). For functional outcomes, DN (0.66, 0.13 to 1.19) and taping (0.84, 0.27 to 1.40), delivered with HEP, resulted in clinically significant improvements in short-term function (moderate-quality evidence). Additionally, DN with HEP sustained significant clinical improvements in medium-term function (1.06, 0.24 to 1.87; moderate-quality evidence).
CONCLUSIONS AND RELEVANCE: When delivered with HEP, DN, low-level laser therapy, and MT provided clinically significant short-term improvements in pain compared to HEP alone, with DN and taping improving short-term functional outcomes. Dry needling further sustained its benefits in both pain and function into the medium term.
DATA SOURCES: Studies were identified through PubMed, Embase, the Cochrane Library, Web of Science, and Scopus from database inception to January 2026.
STUDY SELECTION: Randomized controlled trials (RCTs) comparing physical therapy interventions delivered with HEP versus HEP alone in individuals with PF were included.
DATA EXTRACTION AND SYNTHESIS: A frequentist random-effects network meta-analysis was conducted.Outcomes were assessed at short-term (≤6 weeks), medium-term (6-12 weeks), and long-term (≥12 weeks) follow-up periods. Eight treatment nodes were analyzed: extracorporeal shock wave therapy, ultrasound therapy, manual therapy, taping, low-level laser therapy, orthoses, and dry needling, all delivered with HEP, and HEP alone as the control. Risk of bias was assessed using the Cochrane Risk-of-Bias tool, and the certainty of evidence was evaluated with the Confidence in Network Meta-Analysis framework.
MAIN OUTCOMES AND MEASURES: Pain and functional outcomes were evaluated using standardized mean differences (SMDs) with 95% CIs.
RESULTS: Twenty-four RCTs (1240 participants) were included. For pain outcomes, dry needling (DN) (SMD = -1.26, 95% CI = -2.25 to -0.28), low-level laser therapy (-1.54, -2.82 to -0.27), and manual therapy (MT) (-1.02, -1.82 to -0.21), delivered with HEP, resulted in clinically significant improvements in short-term pain (moderate-quality evidence). The pain-relieving effects of DN delivered with HEP were sustained in the medium term (-1.14, -1.62 to -0.66; high-quality evidence). For functional outcomes, DN (0.66, 0.13 to 1.19) and taping (0.84, 0.27 to 1.40), delivered with HEP, resulted in clinically significant improvements in short-term function (moderate-quality evidence). Additionally, DN with HEP sustained significant clinical improvements in medium-term function (1.06, 0.24 to 1.87; moderate-quality evidence).
CONCLUSIONS AND RELEVANCE: When delivered with HEP, DN, low-level laser therapy, and MT provided clinically significant short-term improvements in pain compared to HEP alone, with DN and taping improving short-term functional outcomes. Dry needling further sustained its benefits in both pain and function into the medium term.