Gait retraining with real-time visual biofeedback reduces pain, plantar loading and increase function in runners with plantar fasciitis: randomized clinical trial

Background Plantar fasciitis (PF) affects approximately 2 million individuals per year, affecting approximately 10–25% of runners around the world. It is considered to have a great impact on health, especially due to the pain and functional limitations of the feet and lower limbs. Thus, the objective of this randomized clinical trial was to verify the effect of gait retraining with real-time visual feedback on pain, function, and biomechanical parameters of plantar loading in runners with and without PF. Methods Controlled, randomized clinical trial with blinded evaluators. Participants: 24 runners were evaluated and divided into two groups: 12 runners with plantar fasciitis and 12 control runners. The assessments were performed pre-intervention and post-intervention. The intervention protocol consisted of gait retraining during treadmill running, for 5 consecutive weeks, over two months (2 sessions/week, 40 min/session, total of 10 sessions). Primary outcomes were: feet pain by visual analogue scale and plantar pressure during gait on the pressure platform. Secondary outcomes were: functionality of the feet and lower limbs, evaluated through the questionnaires: Foot Function Index, Foot and Ankle Ability Measure and Lower Extremity Functional Scale, and the Foot Posture Index. Data were analyzed according to intention-to-treat. Results Runners with PF presented improvement in pain and physical-functional performance, as well as a reduction in plantar overload on the rearfoot after the intervention protocol when compared to the initial assessment and control, with a moderate to high effect size. In relation to the control group, there were no significant differences after intervention in physical-functional performance, but there was a reduction in the loading rate on the rearfoot. Conclusion A ten-week treadmill gait retraining program using real-time visual biofeedback was effective in reducing pain and plantar pressure on the rearfoot, favoring an increase in the functionality of the feet and lower limbs of runners with plantar fasciitis. Trial registration number : RBR-5m6msq7