Comparative Effectiveness of Iontophoresis vs. Low Dye Taping in Plantar Fasciitis: A Systematic Review

Vol.:(0123456789)
Indian Jou nal o O hopaedics
h ps://doi.o g/10.1007/s43465-025-01477-4
REVIEW ARTICLE
Compa a i e E ec i eness o Ion opho esis s. Low Dye Taping
inPlan a Fascii is: ASys ema ic Re iew
Au o aCas o‑Méndez1· LucíaRoldán‑Fe nández2· Na aliaTo a uela‑Ca ión3 · ManuelPabón‑Ca asco4·
JuanÁl a ez‑Co de o2· Ma íaVázquez‑Cas o2
Recei ed: 17 Feb ua y 2025 / Accep ed: 25 June 2025
© The Au ho (s) 2025
Abs ac
Backg ound Plan a ascii is (PF) is a equen cause o heel pain, a ec ing app oxima ely 10% o he popula ion. Conse a-
i e ea men s such as ion opho esis and low-dye aping (LDT) a e widely used o alle ia e symp oms, o en p o iding
sho - e m pain elie .
Objec i e This sys ema ic e iew aims o compa e he e icacy o ion opho esis (wi h 5% ace ic acid, 0.4% dexame hasone,
dexame hasone and lidocaine, o placebo) e sus low-dye aping (LDT) in ea ing plan a ascii is. Addi ionally, i e alua es
he combined e ec o ion opho esis and LDT applica ion.
Me hods A sys ema ic sea ch was conduc ed in Scopus, PubMed, Web o Science, CINAHL, and he Coch ane Lib a y
da abases, ollowing PRISMA guidelines and he Coch ane Handbook o Sys ema ic Re iews o In e en ions. Inclusion and
exclusion c i e ia we e p ede ined. Two independen e iewe s sc eened and ex ac ed da a om eligible s udies, assessing
hei quali y. Included s udies comp ised andomized con olled ials, non- andomized clinical ials, case–con ol s udies,
sys ema ic e iews, and me a-analyses. The e iew p o ocol was egis e ed wi h PROSPERO ( egis a ion numbe : [blind
o e iew]).
Resul s Eigh s udies published be ween 1997 and 2018 we e included, p o iding a mode a e le el o e idence. Bo h ion-
opho esis (wi h he speci ied agen s) and low-dye aping, alone o combined, we e associa ed wi h s a is ically signi ican
educ ions in pain sco es compa ed o baseline.
Conclusion Ion opho esis and low-dye aping a e e ec i e conse a i e in e en ions o plan a ascii is, wi h hei com-
bined use also showing bene icial e ec s. These ea men s can be conside ed iable op ions o educe pain in pa ien s wi h
plan a ascii is.
Keywo ds Low-dye aping· Ion opho esis· Plan a ascii is· Foo · The apy
* Na alia To a uela-Ca ión
n o[email p o ec ed]
Au o a Cas o-Méndez
au o acas [email p o ec ed]
Lucía Roldán-Fe nández
oldan e [email p o ec ed]
Manuel Pabón-Ca asco
[email p o ec ed]
1 G upo de In es igación en Lide azgo He mes CTS-601,
Depa amen o de Podología, Facul ad de En e me ía,
Fisio e apia y Podología. Lide azgo DS-30 Bases
biomédicas del pie que a ec an al apoyo y la ma cha,
Ins i u o de Biomedicina de Se illa, IBiS/Uni e sidad de
Se illa, 41009, Se illa, España
2 Independen Resea che s, Luis Mon o o S : 91, 41018,
Se ille, Spain
3 G upo de In es igación He mes CTS-601, Depa amen o de
Podología, Facul ad de En e me ía, Fisio e apia y Podología.
G upo de In es igación DS-30 Bases biomédicas del pie que
a ec an al apoyo y la ma cha, Ins i u o de Biomedicina de
Se illa, IBiS/ Uni e sidad de Se illa, 41009, Se illa, España
4 CTS-1050 “Complex Ca e, Ch onici y andHeal h
Ou comes” Resea ch G oup, Facul y o Nu sing,
Physio he apy andPodia y, Uni e si y o Se ille, 41009,
Se ille, Spain
Indian Jou nal o O hopaedics
Abb e ia ions
PF Plan a Fascii is
LDT Low dye ape echnique
MFA Medial oo a ch
PRP Pla ele - ich plasma
AWB Au ologous whole blood
In oduc ion
Plan a ascii is (PF), also e e ed o as plan a asciosis,
is he mos common cause o heel pain [1, 2], a ec ing
app oxima ely 10% o he popula ion du ing hei li e ime
[3]. The e iology o PF is conside ed mul i ac o ial and no
ye ully unde s ood, wi h isk ac o s including obesi y,
seden a y li es yle, epe i i e s ess, physical ac i i y, and
male sex among o he s [4–9]. Acco ding o Ma dani e al.,
PF is ega ded as a degene a i e condi ion ( asciosis) when
symp oms pe sis beyond 8 weeks, wi h he ch onic s age
de ined a e his ime ame [10, 11].
The diagnosis o PF is p ima ily clinical [12–14], bu
imaging echniques such as ul asound, elas og aphy, o
sonoelas og aphy can con i m cha ac e is ic plan a ascia
hickening [15, 16]. Typical ul asound indings include
hypoechogenici y, inc eased issue igidi y, and dis up ion
o he no mal ib illa pa e n [17, 18].
Conse a i e ea men is he i s -line app oach in man-
aging PF, wi h su gical in e en ions ese ed o cases
e ac o y o conse a i e he apies [19]. Common con-
se a i e modali ies include o ho ics, d y needling, s e ch-
ing, pha macological he apy, manual he apy, shockwa e
he apy, nigh splin s, physical he apy echniques (ul a-
sound, elec o he apy, phonopho esis), in insic oo muscle
s eng hening, and aping [1, 20, 21].
Co icos e oid injec ions a e equen ly used o hei
an i-in lamma o y and analgesic e ec s in PF [22]. C aw o d
e al. epo ed pain elie up o one mon h pos -injec ion,
al hough e ec s ypically diminish by h ee mon hs [23].
Howe e , injec ions can be pain ul and a e no sui able o
all pa ien s, wi h po en ial ad e se e ec s including in ec-
ion, skin a ophy, and plan a ascia up u e [22].
Ion opho esis is a non-in asi e echnique ha uses low-
ol age elec ical cu en s o deli e co icos e oids o ace ic
acid ansde mally in o so issues [24–26]. I is employed
in app oxima ely 13.04% o PF cases [27]. S udies ha e
demons a ed ha ion opho esis wi h 0.4% dexame hasone
can es o e unc ion in musculoskele al condi ions and may
se e as an al e na i e o co icos e oid injec ions [28].
Ace ic acid ( ypically 5%) deli e ed by ion opho esis o ms
calcium ace a e, which binds and acili a es he emo al o
calcium deposi s, making his echnique use ul in PF and
o he calci ic endini is condi ions [29, 30].
Ad an ages o ion opho esis include p ese a ion o he
skin ba ie and a oidance o needle- ela ed issue damage
and pain. This minimizes isks such as plan a ascia up-
u e and in ec ion commonly associa ed wi h co icos e oid
injec ions [22].
Low-Dye aping (LDT) is a widely used aping echnique
designed o p o ide empo a y ex e nal suppo o he medial
oo a ch (MFA), add essing biomechanical ac o s con ib-
u ing o PF [31, 32]. Among a ious aping me hods (e.g.,
X-a ch, High-Dye), LDT is conside ed he gold s anda d and
is equen ly applied in ea ly PF managemen [32]. O ho-
pedic de ices combined wi h aping ha e demons a ed
enhanced e ec i eness compa ed o single modali ies [27].
Despi e ad ances in PF ea men , symp om managemen
emains challenging. Co icos e oid injec ions o e ansien
pain elie bu a e associa ed wi h po en ial complica ions
and lack s anda dized guidelines o use [19, 26]. Thus,
explo ing al e na i e o adjunc i e conse a i e ea men s
is essen ial.
This e iew speci ically compa es ion opho esis and
LDT, gi en hei widesp ead use and po en ial complemen-
a y mechanisms—ion opho esis deli e ing an i-in lamma-
o y agen s di ec ly in o a ec ed issues and LDT p o iding
mechanical suppo o he oo a ch. Addi ionally, he com-
bined applica ion o bo h ea men s is assessed, as his may
o e syne gis ic bene i s.
The e o e, his e iew aims o compa e he e icacy o
ion opho esis (wi h 5% ace ic acid, 0.4% dexame hasone,
dexame hasone and lidocaine, o placebo) e sus LDT in
he ea men o PF. Fu he mo e, i e alua es he combined
e ec o ion opho esis and LDT applica ion. The guiding
esea ch ques ion is: In he symp oma ic ea men (pain
educ ion) o PF, which is mo e e ec i e—ion opho esis,
LDT, o hei combined use?
Me hods
The sea ch s a egy was conduc ed be ween Feb ua y and
Oc obe 2021 on he da abases: Scopus, PubMed, Web o
Science, CINHAL, and he Coch ane Lib a y.
This sys ema ic e iew was conduc ed ollowing he P e-
e ed Repo ing I ems o Sys ema ic Re iews (PRISMA)
guidelines and he Coch ane Guide o Sys ema ic Re iews
o In e en ions. The sys ema ic e iew p o ocol was egis-
e ed in he In e na ional P ospec i e Regis e o Sys ema ic
Re iews PROSPERO (numbe : ‘‘[blinded o e iew]”).
The esea ch ques ion ollowed he PICOS c i e ia (P—
pa ien s: adul popula ion wi h PF; I—in e en ion: symp-
oma ological ea men o PF wi h ion opho esis; C—com-
pa ison wi h LD- ype bandage and wi h combined ea men
wi h LDT- ype bandage wi h ion opho esis; and O—Ou -
comes: pain educ ion).
Indian Jou nal o O hopaedics
To design he sea ch s a egy, index e ms and ee ex
wo ds ela ed o keywo ds o he e iew objec i e we e used
and connec ed wi h Bolean ope a o s (AND, OR and NOT).
The ollowing wo common sea ch s a egies we e used
o all da abases: (‘‘Plan a ascii is’’ OR ‘‘Heel pain’’)
AND ea men AND (‘‘ion opho esis’’ OR 'dexame hasone'
OR ‘‘ace ic acid’’) NOT (‘‘injec ions’’ OR ‘‘su ge y’’) and
(‘‘Plan a ascii is’’ OR ‘‘Heel pain’’) AND ea men AND
'low dye aping'. The desc ip ion o he da abase is shown
in Table1.
A e emo ing duplica es (Check o duplica es o Men-
deley oll), wo independen e iewe s (LRF and ACM)
sc eened he i le and abs ac o all a icles o eligibili y.
In case o disag eemen , a consensus was eached wi h he
opinion o a hi d e iewe (EFG).
The inclusion c i e ia o his e iew we e as ollows:
s udies published in English, Spanish, F ench, o Ge man;
in ol ing adul pa icipan s diagnosed wi h plan a ascii-
is (PF), ei he unila e al o bila e al. Eligible s udies we e
published wi hin he las 25yea s ( om 1996 o 2021) and
included andomised con olled ials (RCTs), non- an-
domised clinical ials, case–con ol s udies, coho s ud-
ies, sys ema ic e iews, and me a-analyses. S udies we e
equi ed o e alua e he e ec o ion opho esis (using dexa-
me hasone and/o ace ic acid) in he ea men o PF. This
included s udies compa ing ion opho esis wi h placebo, no
ea men , Low-Dye aping (LDT), o he combined applica-
ion o ion opho esis and LDT. Addi ionally, s udies had o
epo ou comes using alida ed measu emen ools such as
he Visual Analogue Scale (VAS), he Ma yland Foo Sco e
(MFS), o he Foo Func ion Index (FFI).
The exclusion c i e ia we e: s udies in ol ing animal
models, and hose compa ing ion opho esis wi h su gical
in e en ions, co icos e oid in il a ions, o o he conse a-
i e ea men me hods no unde e iew in his s udy.
Da a Ex ac ion
The e iew was ca ied ou independen ly by wo esea ch-
e s; s udy au ho s (LRC, ACM). The e e ences ound
we e expo ed o he Mendeley bibliog aphic manage , and
duplica e a icles we e dele ed. Subsequen ly, he e iew-
e s ead he abs ac s o he p eselec ed esea ches, and
inally he ull ex s o he a icles ha s ill me he inclu-
sion c i e ia we e analysed. Any disc epancy was esol ed
by a join discussion and a hi d e iew. The ollowing da a
we e ex ac ed: (1) i s au ho ; (2) s udy Ti le; (3) publica-
ion yea ; (4) ype o design; (5) ype o in e en ion; (6)
me hod and du a ion o in e en ion; (7) sample size; (8)
age o s udy pa icipan s; (9) a ing scale(s) used; (10) main
indings and conclusions.
Table 1 Sea ch s a egies used in each da abase
Da abase Sea ch s a egies Resul s
Medline
(Pubmed)
1s sea ch (‘‘Plan a ascii is’’ OR ‘‘Heel pain’’) AND ea men
AND (‘‘ion opho esis’’ OR ‘‘dexame hasone’’ OR ‘‘ace ic acid’’) NOT (‘‘injec ions’’ OR ‘‘su ge y’’)
8
2nd sea ch (‘‘Plan a ascii is’’ OR ‘‘Heel pain’’) AND ea men
AND ‘‘Low-Dye Taping’’
5
CINAHL 1s sea ch (‘‘Plan a ascii is’’ OR ‘‘Heel pain’’) AND ea men AND (‘‘ion opho esis’’ OR ‘‘dexame hasone’’
OR
‘‘ace ic acid’’) NOT (‘‘injec ions’’ OR ‘‘su ge y’’)
18
2nd sea ch (‘‘Plan a ascii is’’ OR ‘‘Heel pain’’) AND ea men
AND ‘‘Low-Dye Taping’’
4
Web o Science 1s sea ch
2nd sea ch
(‘‘Plan a ascii is’’ OR ‘‘Heel pain’’) AND ea men
(‘‘Plan a ascii is’’ OR ‘‘Heel pain’’) AND ea men AND (‘‘ion opho esis’’ OR ‘‘dexame hasone’’
OR ‘‘ace ic acid’’) NOT (‘‘injec ions’’ OR ‘‘su ge y’’)
15
17
2nd sea ch (‘‘Plan a ascii is’’ OR ‘‘Heel pain’’) AND ea men AND (‘‘ion opho esis’’ OR ‘‘dexame hasone’’
OR ‘‘ace ic acid’’) NOT (‘‘injec ions’’ OR ‘‘su ge y’’)
17
Scopus 1s sea ch (‘‘plan a ascii is’’ OR ‘‘heel pain’’) AND ea men
AND (‘‘ion opho esis’’ OR ‘‘dexame hasone’’ OR
‘‘ace ic acid’’) NOT(‘‘injec ions’’OR
‘‘su ge y’’)
5
2nd sea ch (‘‘Plan a ascii is’’ OR ‘‘Heel pain’’) AND ea men
AND ‘‘Low-Dye Taping’’
17
Coch ane 1s sea ch (‘‘Plan a ascii is’’ OR ‘‘Heel pain’’) AND ea men
AND (‘‘ion opho esis’’ OR ‘‘dexame hasone’’ OR
‘‘ace ic acid’’) NOT (‘‘injec ions’’ OR ‘‘su ge y’’)
24
2nd sea ch (‘‘Plan a ascii is’’ OR ‘‘Heel pain’’) AND ea men
AND ‘‘Low-Dye Taping’’
2
Indian Jou nal o O hopaedics
Da a Syn hesis andRisk o Bias
Wi h he ool p o ided by Coch ane 'Re iew Manage ' o
'Re Man', was assessed he isk o bias o he selec ed s ud-
ies ( e sion 5.4.1.was used).
Quali y Assessmen
Two esea che s (EFG, ACM) e iewed me hodological
quali y based on he C i ical Assessmen Skills P og amme
and a PRISMA Decla a ion Checklis (P e e ed Repo ing
I ems o Sys ema ic Re iews and Me a-Analyses). This
p ocess was ca ied ou by he wo di e en esea che s o
dec ease he p obabili y o isk o bias.
Resul s
Acco ding o he guidance o PRISMA guidelines, he i s
sea ch gene a ed 70 a icles, while he second gene a ed 35
a icles, and inally whe e added he 3 a icles by snowball
sampling, so he o al was o 108 a icles.
A e using he ''check o duplica es'' op ion o he biblio-
g aphic manage , we disca d hose documen s ha we ind in
duplica e in se e al da abases. In his way, we a e le wi h
53 a icles om he i s sea ch, 26 om he second sea ch,
and 3 o he a icles ob ained by snowball.
A e disca ding duplica es, we p oceeded o make a mo e
exhaus i e selec ion o he 82 a icles we had. To do his, we
e iewed and ead he i les and abs ac s o all a icles and
p oceeded o emo e hose ha we e no co ec ly classi ied
by he da abases. By his me hod, we limi ed he selec ion o
a icles o 23, o which he ull ex s we e assessed so ha
hey me he equi emen s o ou PICO esea ch ques ion.
A e ha only nine o he 23 a icles ully me he selec-
ion c i e ia, so he emaining 14 we e elimina ed, among
he main easons being language and no o iginal esea ch
a icles.
Howe e , i should be no ed ha , a e conduc ing an
in-dep h eading o he 9 a icles, we could obse e ha
2 o hem had exac ly he same me hodology and a i ed
a exac ly he same esul s, despi e being published in di -
e en scien i ic jou nals. Fo his eason, we included he
o iginal a icle and emo ed he duplica e s udy, wi h eigh
a icles inalising ou sys ema ic e iew. Finally, he eigh
selec ed s udies we e analysed in de ail o co obo a e ha
hei con en was in acco dance wi h he equi emen s p e i-
ously es ablished o he PICO esea ch ques ion (Fig.1).
Risk o bias in included s udies was assessed using he
Re iew Manage so wa e (Re iew Manage ® o Re Man
ool®), de eloped by The Coch ane Collabo a ion. This
ool acili a ed a s uc u ed e alua ion o po en ial biases
ac oss s udies, wi h esul s isually summa ized in Fig.2,
indica ing a gene ally low isk o bias in he majo i y o
included publica ions. Fu he mo e, a de ailed ma ix dia-
g am (Fig.3) depic s he isk o bias le els o each s udy
indi idually, ca ego ized by colo codes: g een o low isk,
yellow o mode a e isk, and ed o high isk o bias.
S a is ical Analysis o S udy Quali y
The CASPe and PRISMA assessmen guidelines we e used
and applied o he eigh a icles included in he sys ema ic
e iew [33]. This p ocess was ca ied ou by wo di e en
esea che s (LRF and ACM) o educe he p obabili y o isk
o bias, and he sco e ob ained is shown in Table2.
Resul s o Syn heses
Table3 p o ides a comp ehensi e syn hesis o he objec-
i es, me hodologies, esul s, and conclusions o all included
s udies. Each s udy is subsequen ly analyzed indi idually,
wi h de ailed desc ip ions o key cha ac e is ics, including
me hodological quali y assessed using he Sacke e idence
classi ica ion sys em [34].
Main Resul s
Gudeman e al. published in 1997 was he i s known s udy
in which he e ec s o ion opho esis wi h 0.4% dexame ha-
sone we e s udied in he symp oma ic ea men o PF we e
s udied. The esul s ob ained we e e y signi ican ; hey con-
cluded ha he applica ion o ion opho esis wi h 0.4% dexa-
me hasone educes pain and inc eases oo unc ionali y in
he sho e m (2–3 weeks) in pa ien s wi h PF, and ecom-
mended i insi ua ions whe e immedia e educ ion in symp-
oms o PF was needed, o example, in eli e a hle es. As a
limi a ion, his s udy only shows s a is ically signi ican di -
e ences in he sho e m (2–3 weeks), wi h no di e ences
in he one-mon h ollow-up [35]. Subsequen ly, Japou e al.,
1999 s udied he e ec i eness o 5% ace ic acid in educ-
ing ch onic heel pain, concluding ha applica ion o ion o-
pho esis wi h 5% ace ic acid educes heel pain in he i s
s ep o he day (a cha ac e is ic sign o PF) and is he e o e
an e ec i e conse a i e ea men o acu e o ecalci an
heel pain, al hough i is necessa y o con inue in es iga ing
in his line o con i m hese esul s. In his s udy, i should
be no ed as a limi a ion ha i lacks a con ol g oup [36]. In
2006 Osbo ne e al. conduc ed a s udy andomly di iding
he sample in o 3 g oups: G oup 1 (G1) ecei ed LDT and
ion opho esis wi h 0.4% dexame hasone as ea men , G oup
2 (G2) applied LDT and ion opho esis wi h placebo (0.9%
NaCl) and G oup 3 (G3) ecei ed LDT as ea men oge he
wi h ion opho esis wi h 5% ace ic acid. Fu he mo e, he
h ee g oups ecei ed guidelines o s e ch he leg muscle
[25]. Pain and mo ning s i ness we e measu ed using he
Indian Jou nal o O hopaedics
Fig. 1 PRISMA lowcha o
s udy selec ion
Fig. 2 Gene al analysis o he isks o bias in he s udies analyzed

Indian Jou nal o O hopaedics
Visual Analogue Scale (VAS), he Visual Analogue S i -
ness Scale, and he Mo ning S i ness Du a ion Ques ion-
nai e. These measu emen s we e aken a he beginning
o ea men , a he end o i , and a e 4 weeks om he
end o ea men . As a esul , all g oups showed signi ican
imp o emen s in mo ning pain and s i ness. Howe e , o
mo ning pain, he ace ic acid and bandage g oup showed a
signi ican ly g ea e imp o emen han he es o he g oups.
The esea che s concluded ha applying LDT oge he wi h
ion opho esis and ace ic acid, dexame hasone, o placebo
educes he pain and s i ness caused by PF. As indica ed
in he i le o he s udy, he esul s shown a e sho - e m, so
he conclusions a e limi ed o he pe iod obse ed, lacking
long- e m esul s [25].
Following his line o esea ch, Goyal e al. compa ed
he e ec i eness o LDT wi h he combina ion o his band-
age and ion opho esis o educe oo pain and inc ease i s
unc ionali y in PF, he au ho s concluded ha bo h LDT
and combined bandage he apy and ion opho esis cause a
signi ican dec ease in pain and disabili y in pa ien s wi h
PF The e ec s o combina ion he apy a e mo e bene icial.
As a limi a ion, since i is a s udy wi h a quasi-expe imen-
al design, he s udy lacks andomiza ion o g oups, which
inc eases he isk o bias and limi s he s eng h o causal
in e ences. Di e ences be ween g oups a baseline could
in luence he esul s [37]. In ela ion o combined ea -
men s, Che i e al. concluded ha he combina ion o ion-
opho esis wi h ace ic acid and conse a i e ea men s can
p omo e he eco e y o oo unc ionali y and he educ ion
o pain mo e e ec i ely compa ed o he use o ea men
app oaches in which only one me hod is used. LDT is e y
bene icial and e ec i e in he symp oma ic ea men o PF,
and ace ic acid ion opho esis has shown p omising esul s
[38]. Howe e , Kal a, 2016 concluded in his s udy ha he
applica ion o ion opho esis wi h 0.4% dexame hasone and
lidocaine hyd ochlo ide shows be e esul s in he symp o-
ma ic ea men o PF compa ed o ion opho esis wi h dis-
illed wa e (placebo) [39].
Rega ding he sys ema ic e iew by Podolsky e al., 2015
i concluded ha al hough se e al bandaging echniques
ha e been shown o educe pain in PF, LDT has he bes
e idence o he ea men o PF in he sho e m, al hough
he long- e m e ec and e ec i eness o his echnique mus
be in es iga ed. This e iew is limi ed by he quali y o he
included s udies, since he indi idual limi a ions p esen ed
by he included RCTs, c osso e s udies, and epea ed meas-
u es clus e s udy a e ans e ed o he conclusions o he
e iew [40]. Ve b uggen e al. In 2018, s udies in which he
du a ion o ea men was longe (6 weeks ins ead o 2 o
3) p oduced he g ea es e ec s, sugges ing ha long- e m
LDT ea men may be mo e bene icial in educing PF pain.
This e iew is limi ed by he quali y o he included s udies
and he sea ch pa ame e s (2005–2016) [41].
Fig. 3 Risks o bias acco ding o each s udy included in he sys em-
a ic e iew
Table 2 Sco e o each s udy analyzed acco ding o he c i ical
app aisal guides
S udy Scales Resea che 1 Resea che 2
Gudeman e al., 1997 CASPe 9/11 9/11
Japou e al., 1999 CASPe 7/11 8/11
Osbo ne e al., 2006 CASPe 9/11 10/11
Goyal e al., 2013 CASPe 9/11 9/11
Che i e al., 2016 CASPe 8/11 8/11
Kal a, 2016 CASPe 9/11 9/11
Podolsky e al., 2015 PRISMA 18/27 21/27
Ve b uggen e al., 2018 PRISMA 17/27 20/27
Indian Jou nal o O hopaedics
Table 3 Main cha ac e is ics o he s udies included in his sys ema ic e iew
Au ho /s, yea s S udy i le Design ype Type o in e en-
ion
Me hod and
du a ion
Sample size and
age
Le el o e i-
dence (Sacke
Assessmen
scale/s
Resul s Conclusions
Gudeman e al.,
1997
T ea men o
Plan a Fascii-
is by Ion opho-
esis o 0.4%
Dexame hason
e. A andomized,
double-blind,
placebo- con-
olled s udy
RCT, double
blind
GC: s e ching,
heel suppo ,
exe cises and
placebo ion o-
pho esis
GExp: s e ching,
heel suppo ,
exe cises and
ion opho esis
wi h 0.4% dexa-
me hason e
2weeks
6ion opho esis
sessions (pla-
cebo o wi h
dexame hason
e), each las ing
20min wi h
a cu en o
40mA
N = 39
pa ien s (40 ee ),
mean age 42.1
yea s
G ade Ib (A) Ma yland Foo
Sco e (meas-
u es he pain
and unc ional-
i y o he oo ,
whe e 100
poin s implies
maximum
independence
and < 45 poin s
g ea depend-
ence
G1 had a much
mo e signi i-
can imp o e-
men (6.8 ±
5.6 inc ease
in he MFS
scale) han he
GC (3.1 ± 4.1
inc ease).
(P = 0.022)
1-mon h ollow-
up: he e was
no signi ican
di e ence.
(P = 0.434)
The applica ion o
dexame hasone
ion opho esis
educes pain and
inc eases oo
unc ionali y in
he sho e m
(2–3weeks) in
pa ien s wi h PF
Japou e al.,
1999
Managemen
o Heel Pain
Synd ome wi h
Ace ic Acid
Ion opho esis
Quasi- expe im
en al s udy (no
con ol g oup)
Exp:ion opho esis
wi h 5% ace ic
acid
3weeks
2–3 sessions o
ion opho esis
wi h ace ic acid
pe week o
20min
N = 35
pa ien s, mean age
58.6
yea s
G ade II-b (B) Pain scale om
0 o 10,
whe e 0 ep-
esen s no
pain and 10
ep esen s
maximum pain
P e- ea men
pain: 7.5/10
Pos - ea men
pain: 1.8/10
The applica ion
o ion opho esis
wi h ace ic acid
educes pain
in PF
Osbo ne e al.,
2006
T ea men o
plan a ascii is
by LowDye
aping and
ion opho esis:
sho e m esul s
o a double
blinded,
andomized,
placebo
con olled clini-
cal ial
RCT,
double blind
G1: Low-Dye
bandage, s e ch-
ing and ion o-
pho esis (0.4%
dexame hason e)
G2: Low-Dye
bandage,
s e ching and
ion opho esis
(placebo)
G3: Low-Dye
bandage,
s e ching and
ion opho esis
(5% ace ic
acid)
2weeks
6 ion opho esis
sessions (wi h
placebo,
dexame hason e
o ace ic acid)
wi h 40
mA cu en and
Low-Dye band-
age
N = 31
pa ien s (42 ee ),
age be ween 18
and 75yea s
G ade Ib (A) Visual Analogue
Scale (VAS),
Visual Ana-
logue Scale o
s i ness and
mo ning s i -
ness
du a ion ques-
ionnai e
All g oups
showed signi i-
can imp o e-
men s in
mo ning pain,
mean pain, and
mo ning s i -
ness. Howe e ,
o mo ning
pain, he ace ic
acid + bandage
g oup showed
g ea e
imp o emen
Low-dye ap-
ing applica-
ion + ion opho-
esis wi h ace ic
acid, dexame ha-
sone, o placebo
educes pain
and s i ness
caused by PF.
Fo bes esul s
a 4weeks, he
bandage combined
wi h ace ic acid
is p e e ed
Indian Jou nal o O hopaedics
Table 3 (con inued)
Au ho /s, yea s S udy i le Design ype Type o in e en-
ion
Me hod and
du a ion
Sample size and
age
Le el o e i-
dence (Sacke
Assessmen
scale/s
Resul s Conclusions
Goyal e ., al.,
2013
T ea men o
Plan a Fascii is
by Taping s.
Ion opho esis:
A Randomized
Clinical T ial
Quasi- expe im
en al s udy (no
andomi za ion
o g oups)
GExp: LDT and
ion opho esis
wi h 0.9% NaCl
G2: LOD
1week
1 session pe day
o aping
+
ion opho esis
wi h NaCl wi h
a cu en o
40mA, o only
bandage
N = 30
pa ien s, age
be ween 24 and
58yea s
G ade II-b (B) Visual analogue
scale (VAS)
and Foo
Func ion Index
(FFI)
A e one week,
he e was a
signi ican di -
e ence in VAS
and FFI in bo h
g oups, bu
he imp o e-
men was mo e
signi ican in
G1 han in G2
(p < 0.05)
The combined
he apy o aping
and ion opho-
esis causes
a signi ican
dec ease in pain
and disabili y in
pa ien s wi h PF
Podolsky e al.,
2015
Taping o plan-
a ascii is
Sys ema ic
e iew
The e ec s o
a ious ypes o
bandage in he
ea men o PF
we e analyzed
in 5
RCTs, 2
c osso e s udies
and 1 epea ed
measu es clus e
s udy
We sea ched
PubMed,
CINAHL,
PED o, ISIWeb
o Science, and
Google Schola
in 2012. S ud-
ies published
be ween 2004
and 2012 we e
included
N = 8
s udies analyzed
G ade Ia (A) The me hodolog-
ica l quali y o
he s udies was
assessed using
he PED o a -
ing scale
All 8 s udies
a o ed he use
o di e en
bandaging
echniques. The
mos common
echnique was
he LDT
The LDT has he
bes e idence o
he ea men o
PF in he sho
e m. The long-
e m e ec and
e ec i eness o
his echnique
needs o be
in es iga ed
Che i e al.,
2016
A compa a-
i e s udy on
e ec i eness
o apping wi h
ion opho esis
and aping
alone in
ch onic plan a
ascii is
RCT GExp: bandage,
s e ching and
ion opho esis
wi h 5% ace ic
acid
GC: bandage and
s e ching
2weeks
6 ea men
sessions wi h
ion opho esis
+ bandage, o
only bandage
N = 50
pa ien s, age
be ween 30 and
60yea s
G ade Ib (A) Visual analogue
scale (VAS)
and Foo
Func ion Index
(FFI)
The VAS and
FFI sco es
showed a
signi ican
imp o emen
(p < 0.05) in
bo h g oups,
bu g ea e in
G1
Ion opho esis
oge he wi h
aping and
s e ching ga e
addi ional ben-
e i compa ed
o aping and
s e ching alone
in educing pain
in PF
Indian Jou nal o O hopaedics
Table 3 (con inued)
Au ho /s, yea s S udy i le Design ype Type o in e en-
ion
Me hod and
du a ion
Sample size and
age
Le el o e i-
dence (Sacke
Assessmen
scale/s
Resul s Conclusions
Kal a, 2016 T ea men
o plan a
ascii is wi h
dexame hason e
wi h lidocaine
hyd ochlo ide
RCT G1: ul asound,
s e ching and
ion opho esis
wi h 0.4% dexa-
me hason e + 4%
lidocaine hyd o-
chlo ide
GC: ul asound,
s e ching and
ion opho esis
wi h placebo
2weeks
3
ion opho esis
sessions (pla-
cebo o wi h
dexame hason
e + lidocaine
hyd ochlo ide)
pe week wi h
a cu en o
40mA
N = 40
pa ien s, age:
be ween 30 and
40yea s
G ade Ib (A) Visual analogue
scale (VAS)
and Foo
Func ion Index
(FFI)
G1 had a g ea e
imp o emen
( om 7 poin s
o 3′17 on he
EVA scale and
om 44′17 o
30′17 on he
FFI) han he
GC ( om 5.8
poin s o 4′40
on he EVA
scale and om
43 ′40 o 37 in
he FFI)
The applica ion
o ion opho esis
is e ec i e in
he ea men
o PF, bu i
i is admin-
is e ed wi h
dexame hasone
and lidocaine
hyd ochlo ide, i
is signi ican ly
mo e e ec i e
Ve b uggen
e al., 2018
The E ec i e-
ness o LDT in
Reducing Pain
Associa ed
Wi h Plan a
Fascii is
Re i e sys ema
ic ision
The e ec s o
a ious ypes o
bandaging (alone
o combined
wi h o he ea -
men s) in he
ea men o PF
we e analyzed
in 5
s udies: 4 le el
2 RCTs and 1
le el 2 con olled
clinical ial
Sea ches
we e made
inPubMed,
EBSCOhos ,
Spo Discus,
Medline, and
Google Schola
A icles pub-
lished be ween
2005
and 2016 we e
selec ed
N = 5
s udies analyzed
G ade Ia (A) The me hodolog-
ica l quali y o
he s udies was
assessed using
he PED o a -
ing scale
Compa ed wi h
o he aping
echniques
o PF, LDT
aping (alone
o combined
wi h o he
ea men s) was
ound o be he
mos e ec i e
in educ-
ing pain and
inc easing oo
unc ion in PF
S udies whe e
he du a ion o
ea men was
longe p oduced
he la ges e ec
sizes: long- e m
LDT ea men
may be mo e
bene icial in
educing PF pain
Cu en e idence
suppo s i s use
as pa o a
mul imodal in e -
en ion scheme