Barefoot walking is beneficial for individuals with persistent plantar heel pain: A single-blind randomized controlled trial

Miriam Reinstein, Asaf Weisman, Youssef Masharawi*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

Abstract

Background: A lack of data exist about the effectiveness of active treatments for persistent plantar heel pain (PPHP). Objectives: To compare short-term functional and clinical effects of a 4-week barefoot or shod treadmill walking program for people with PPHP. Methods: A single-blinded clinical trial randomized 52 participants with PPHP into either a barefoot walking group (BWG), or a shod walking group (SWG). All participants received therapeutic ultrasound. Outcomes were measured at baseline (t0), following 4 weeks of treatment (t1), and at 1-month follow-up (t2). The SF-36 functional questionnaire score was the main outcome. Secondary outcomes were self-reported and clinically-assessed pain provocation levels, pressure pain thresholds and pain tolerance. Treadmill walking time and speed were measured at t0 and t1; people also recorded the time spent walking each day in a diary. Results: The BWG exhibited significant improvements in all SF-36 items (except “emotional well-being”) (P < 0.05), whereas the SWG exhibited improvements only in “pain” and “health change” items (P = 0.0001; effect size 0.13–0.94). Greater improvements were observed in the BWG than the SWG for “physical function” (P = 0.019) and “role limitations due to physical health” items (P = 0.035). Both groups demonstrated significant improvements in pain, with greater improvements in the BWG (P = 0.0001; effect size 0.89). Only the BWG showed significant improvements in pain pressure thresholds (P < 0.05; effect size 0.70) and pain tolerance (P < 0.001; effect size 0.67). Both groups significantly increased their speed and time spent walking on the treadmill (BWG Δ=19.7 min and Δ=1.7 km/h; SWG Δ=16.7 min and Δ=1.1 km/h) and time outdoors (SWG ∆=38.2 min/week; BWG mean ∆=48.5 min/week) (P < 0.001). All clinical tests of pain were significantly less positive in the BWG at all time points (P < 0.05). Conclusions: Both walking programs benefited people with PPHP by alleviating pain and improving function and quality of life. Greater improvements were observed in the BWG than the SWG overall.

Original languageEnglish
Article number101786
JournalAnnals of Physical and Rehabilitation Medicine
Volume67
Issue number2
DOIs
StatePublished - Mar 2024

Keywords

  • Exercises
  • Plantar fasciitis
  • Quality of life

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