title: Comparison of a physiotherapy program versus dexamethasone injections for plantar fasciopathy in prolonged standing workers: a randomized clinical trial.
abstract: OBJECTIVE
  To investigate the effectiveness of a physiotherapy-based exercise program versus dexamethasone injection for chronic plantar fasciopathy in workers standing for prolonged periods of time.
  
  
  METHODS
  A parallel group nonblinded randomized controlled trial with 12-week follow-up.
  
  
  METHODS
  An outpatient sports medicine clinic in Vancouver, British Columbia, Canada.
  
  
  METHODS
  Fifty-six workers required to stand for greater than 5 h/d with chronic plantar fasciopathy took part. Diagnosis from a physiotherapist must include signs of structural changes to the plantar fascia seen on ultrasound.
  
  
  METHODS
  The PHYSIO group included 7 physiotherapy-led exercises performed daily over a 12-week period. The INJECTION group received 1 palpation-guided dexamethasone injection followed by a daily routine of calf stretching.
  
  
  METHODS
  The Foot and Ankle Disability Index (FADI) scores 12-weeks postintervention and ultrasound-based measures of ligament appearance.
  
  
  RESULTS
  At follow-up, both groups reported significant improvements in FADI and visual analog scales for pain at work and with activities of daily living at 6 and 12 weeks compared with baseline scores (P < 0.001). There were no significant between-group differences. There were no significant changes to plantar fascia thickness reported at the 6- and 12-week follow-up point. Both the number of cases with focal anechoic areas and the size of these anechoic areas improved significantly in the PHYSIO (P = 0.003) and INJECTION (P < 0.001) groups at 12-week follow-up.
  
  
  CONCLUSIONS
  Workers standing for prolonged periods experienced the same short-term therapeutic effectiveness with a physiotherapy-led exercise program compared with an injection of corticosteroid with stretching.
authors.affiliation: *Allan McGavin Sports Medicine Centre, University of British Columbia, Vancouver, British Columbia, Canada; and †Griffith Health Institute, Griffith University, Southport, Australia.
authors.forename: Michael
authors.initials: M
authors.lastname: Ryan
authors.forename: Jamie
authors.initials: J
authors.lastname: Hartwell
authors.forename: Scott
authors.initials: S
authors.lastname: Fraser
authors.forename: Richard
authors.initials: R
authors.lastname: Newsham-West
authors.forename: Jack
authors.initials: J
authors.lastname: Taunton
mesh_terms: D000328:Adult; D000893:Anti-Inflammatory Agents / Q000008:administration & dosage*; D003907:Dexamethasone / Q000008:administration & dosage*; D005081:Exercise Therapy; D036981:Fasciitis, Plantar / Q000000981:diagnostic imaging / Q000628:therapy*; D005260:Female; D006801:Humans; D015552:Injections, Intralesional; D008297:Male; D008875:Middle Aged; D009784:Occupational Diseases / Q000000981:diagnostic imaging / Q000628:therapy*; D010147:Pain Measurement; D011187:Posture; D014463:Ultrasonography
chemical_list: D000893:Anti-Inflammatory Agents; D003907:Dexamethasone