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™) 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™ (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™ 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™ 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™ 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™ group at 12 and 24 weeks. In this study, both interventions improved symptoms of heel pain syndrome. Although the ETP™ 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).