Phys Ther. 2026 May 23:pzag056. doi: 10.1093/ptj/pzag056. Online ahead of print.

ABSTRACT

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 (RoB2), and the certainty of evidence was evaluated with the Confidence in Network Meta-Analysis (CINeMA) framework.

MAIN OUTCOMES AND MEASURES: Pain and functional outcomes were evaluated using standardized mean differences (SMDs) with 95% confidence intervals (CIs).

RESULTS: Twenty-four RCTs (1240 participants) were included. For pain outcomes, dry needling (SMD = -1.26, 95% CI = -2.25 to -0.28), low-level laser therapy (-1.54, -2.82 to -0.27), and manual therapy (-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 dry needling delivered with HEP were sustained in the medium term (-1.14, -1.62 to -0.66; high-quality evidence). For functional outcomes, dry needling (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, dry needling 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, dry needling, low-level laser therapy, and manual therapy provided clinically significant short-term improvements in pain compared to HEP alone, with dry needling and taping improving short-term functional outcomes. Dry needling further sustained its benefits in both pain and function into the medium term.

PMID:42176209 | DOI:10.1093/ptj/pzag056