Information and communications technology-based versus handout-based home exercise programs for heel pain syndrome: a prospective randomized study

Abstract

To compare the clinical outcomes of information and communications technology (ICT)-based home exercise programs using the exercise therapy platform (ETP (TM)) with traditional handout-based programs for treating heel pain syndrome. Eighty-seven patients with heel pain syndrome (plantar fasciitis or Achilles tendinitis) were randomly assigned to either an ICT-based ETP (TM) (n = 44) or a traditional handout-based (n = 43) home exercise program. Both groups performed the same exercises for 12 weeks. Outcomes were assessed at baseline and at 4, 12, and 24 weeks using a visual analog scale (VAS) for first-step pain (primary outcome), pain at rest and during activity, foot function index (FFI), Short Form-36 (SF-36) score, and self-reported recovery. In the ETP (TM) group, mean improvement in VAS score for first-step pain exceeded the minimal clinically important difference (MCID) of 1.9 at all follow-up points, whereas the handout group did not achieve MCID at 4 weeks (1.4 +/- 1.9). However, the mixed-effects model did not demonstrate a statistically significant between-group difference for first-step pain. For FFI, the ETP (TM) group showed greater improvement than the handout group at 4 weeks (between-group difference in change - 16.66, 95% confidence interval [CI] - 32.34 to - 0.99; p = 0.037; Hedges g = - 0.47) and 24 weeks (- 16.37, 95% CI - 32.04 to - 0.69; p = 0.041; g = - 0.39). For SF-36 PCS, improvement was significantly greater in the ETP (TM) group at 24 weeks than in the handout group (8.90, 95% CI 2.41 to 15.40; p = 0.007; g = 0.47). Self-reported recovery rates were higher in the ETP (TM) group at 12 and 24 weeks. In this study, both interventions improved symptoms of heel pain syndrome. Although the ETP (TM) group demonstrated clinically meaningful reductions in first-step pain and greater improvements in some secondary outcomes, no statistically significant between-group difference was observed for the primary outcome. These findings suggest potential benefits of ICT-based exercise therapy platforms, and further studies are needed to confirm their comparative effectiveness. Trial registration Retrospectively registered with the Clinical Research Information Services (identifier KCT0010211, registration date: 19/02/2025).