Video-Based Versus Physician-Led Exercise Training for Plantar Fasciitis

This prospective, single-center, two-arm, parallel-group randomized non-inferiority trial will compare physician-led face-to-face exercise instruction with standardized video-based exercise instruction in adults with plantar fasciitis. Participants will be randomized in a 1:1 ratio to receive either face-to-face exercise training by an orthopedic physician or access to a standardized exercise video via QR code/web link. The exercise content will be identical in both groups; only the method of instruction will differ. The primary outcome will be the change in the Foot Function Index total/index score from baseline to 3 months. Secondary outcomes will include pain score, Foot Function Index subscales, exercise knowledge, exercise adherence, education time, video viewing status, additional treatment requirement, and patient satisfaction.

Inclusion Criteria: * Adults aged 18 to 70 years * Clinical diagnosis of plantar fasciitis * Plantar heel pain lasting for at least 3 months * Heel pain that is most prominent with the first steps in the morning or after rest * Tenderness on palpation of the medial calcaneal tubercle * Baseline heel pain score of 4 or higher on a 0-10 numerical rating scale * Functional capacity to perform the prescribed exercises * Access to a smartphone, tablet, or computer to view the exercise video * Ability to provide written informed consent Exclusion Criteria: * Previous foot or ankle surgery on the affected side * History of foot fracture, foot tumor, advanced neuropathy, Charcot arthropathy, or tarsal tunnel syndrome * Corticosteroid injection, extracorporeal shock wave therapy, platelet-rich plasma injection, or other interventional treatment for plantar fasciitis within the last 6 months * Inflammatory arthritis or systemic rheumatologic disease affecting the foot * Severe knee or hip osteoarthritis limiting exercise performance * Severe cognitive impairment preventing participation or completion of questionnaires * Pregnancy * Inability or unwillingness to comply with the study protocol