---
title: "Home-based digital exercise versus hospital physiotherapy for plantar fasciitis: clinical and cost"
id: "pubmed-42683610"
canonical_url: "https://medichelpline.com/clinical-feed/pubmed-42683610"
content_type: "clinical_feed_article"
specialty: "Pharmacology"
source_name: "PubMed / NCBI"
source_url: "https://pubmed.ncbi.nlm.nih.gov/42683610/"
doi: "10.2340/jrm.v58.45974"
published_at: "2026-09-02T00:00:00.000Z"
evidence_level: "Journal Article"
license: "CC-BY-NC-4.0 / Informational Use"
---
# Home-based digital exercise versus hospital physiotherapy for plantar fasciitis: clinical and cost
## Provenance & Clinical Metadata
- **Canonical URL:** https://medichelpline.com/clinical-feed/pubmed-42683610
- **Specialty:** [Pharmacology](https://medichelpline.com/clinical-feed/pharmacology.md)
- **Primary Source:** PubMed / NCBI
- **Source URL:** [Original Journal Publication](https://pubmed.ncbi.nlm.nih.gov/42683610/)
- **DOI:** [10.2340/jrm.v58.45974](https://doi.org/10.2340%2Fjrm.v58.45974)
- **Published At:** 2026-09-02T00:00:00.000Z
- **Evidence Rating:** Journal Article
## Executive GIST (TL;DR)
- Objective: Compare a 12-week **home-based digital exercise** programme with 12-week hospital-supervised physiotherapy for adults with **plantar fasciitis** in routine Chinese tertiary-hospital care, assessing clinical effectiveness and **cost-utility**. - Design: Single-centre retrospective cohort study with 1:2 propensity-score matching on 13 baseline covariates; study period included treatments delivered in 2022–2024. - Population: 587 adults with clinician-confirmed plantar fasciitis were matched; only 6.3% of screened patients met matching eligibility criteria. - Primary outcome: First-step morning pain at 3 months measured on a 0–10 numeric rating scale; predefined non-inferiority margin 1.3 points with sensitivity margins 0.9 and 1.9. - Clinical result: Adjusted mean difference in first-step pain at 3 months was −0.63 points (95% CI −0.92 to −0.35; p < 0.001), meeting non-inferiority against all three margins; reported E-value 2.84. - Economic result: 12-month cost-utility analysis from payer and societal perspectives showed incremental payer cost −¥4,920 (−US$684) and incremental societal cost −¥7,008 (−US$974), with incremental quality-adjusted life-years (QALYs) +0.011; home-based digital exercise dominated in 96.7% of bootstrap replications. - Limitations: Matching failed to balance 12 of 13 covariates, raising likely residual confounding; selection bias due to small eligible fraction; observational, single-centre and retrospective design. - Conclusion: **Home-based digital exercise** was **non-inferior** to hospital physiotherapy for 3-month first-step pain and less costly from both payer and societal perspectives, but results are provisional and require confirmation in a pragmatic multicentre randomized controlled trial before informing reimbursement decisions. - Key metrics and caveats: non-inferiority margins, adjusted mean difference, confidence intervals, E-value, cost savings (¥ and US$), QALY gain, dominance probability, and explicit call for randomized confirmation.
## Clinical Analysis & Structured Key Points
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Shengdi.Lu@pbrc.edu."), [Lei Huang](https://pubmed.ncbi.nlm.nih.gov/?term=Huang+L&cauthor_id=42683610)[ 4 ](https://pubmed.ncbi.nlm.nih.gov/42683610/#full-view-affiliation-4 "Department of Foot and Ankle , Ningbo No.6 Hospital, Ningbo, Zhejiang, China; Ningbo Clinical Research Center for Orthopedics, Sports Medicine & Rehabilitation, Ningbo, Zhejiang, China. wyklwyjk@163.com.") Affiliations Expand ### Affiliations * 1 Department of Foot and Ankle , Ningbo No.6 Hospital, Ningbo, Zhejiang, China; Ningbo Clinical Research Center for Orthopedics, Sports Medicine & Rehabilitation, Ningbo, Zhejiang, China. * 2 Ningbo Clinical Research Center for Orthopedics, Sports Medicine & Rehabilitation, Ningbo, Zhejiang, China; Department of Rehabilitation Medicine, Ningbo No. 6 Hospital, Ningbo, Zhejiang, China. * 3 Pennington Biomedical Research Center, Baton Rouge, LA, United States. Shengdi.Lu@pbrc.edu. * 4 Department of Foot and Ankle , Ningbo No.6 Hospital, Ningbo, Zhejiang, China; Ningbo Clinical Research Center for Orthopedics, Sports Medicine & Rehabilitation, Ningbo, Zhejiang, China. wyklwyjk@163.com. * PMID: **42683610** * DOI: [ 10.2340/jrm.v58.45974 ](https://doi.org/10.2340/jrm.v58.45974) Item in Clipboard Comparative Study # Home-based digital exercise versus hospital physiotherapy for plantar fasciitis: a propensity-score-matched retrospective cohort study with dual-perspective cost-utility evaluation Wenbo Xu et al. J Rehabil Med. 2026. Show details Display options Display options Format Abstract PubMed PMID J Rehabil Med Actions * [ Search in PubMed ](https://pubmed.ncbi.nlm.nih.gov/?term=%22J+Rehabil+Med%22%5Bjour%5D&sort=date&sort_order=desc) * [ Search in NLM Catalog ](https://www.ncbi.nlm.nih.gov/nlmcatalog?term=%22J+Rehabil+Med%22%5BTitle+Abbreviation%5D) * [ Add to Search ](https://pubmed.ncbi.nlm.nih.gov/42683610/) . 2026 Sep 2:58:jrm45974. doi: 10.2340/jrm.v58.45974. ### Authors [Wenbo Xu](https://pubmed.ncbi.nlm.nih.gov/?term=Xu+W&cauthor_id=42683610)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42683610/#short-view-affiliation-1 "Department of Foot and Ankle , Ningbo No.6 Hospital, Ningbo, Zhejiang, China; Ningbo Clinical Research Center for Orthopedics, Sports Medicine & Rehabilitation, Ningbo, Zhejiang, China."), [Lufeng Yao](https://pubmed.ncbi.nlm.nih.gov/?term=Yao+L&cauthor_id=42683610)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42683610/#short-view-affiliation-1 "Department of Foot and Ankle , Ningbo No.6 Hospital, Ningbo, Zhejiang, China; Ningbo Clinical Research Center for Orthopedics, Sports Medicine & Rehabilitation, Ningbo, Zhejiang, China."), [Haigang Wang](https://pubmed.ncbi.nlm.nih.gov/?term=Wang+H&cauthor_id=42683610)[ 2 ](https://pubmed.ncbi.nlm.nih.gov/42683610/#short-view-affiliation-2 "Ningbo Clinical Research Center for Orthopedics, Sports Medicine & Rehabilitation, Ningbo, Zhejiang, China; Department of Rehabilitation Medicine, Ningbo No. 6 Hospital, Ningbo, Zhejiang, China."), [Chenqin Xu](https://pubmed.ncbi.nlm.nih.gov/?term=Xu+C&cauthor_id=42683610)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42683610/#short-view-affiliation-1 "Department of Foot and Ankle , Ningbo No.6 Hospital, Ningbo, Zhejiang, China; Ningbo Clinical Research Center for Orthopedics, Sports Medicine & Rehabilitation, Ningbo, Zhejiang, China."), [Pinpin He](https://pubmed.ncbi.nlm.nih.gov/?term=He+P&cauthor_id=42683610)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42683610/#short-view-affiliation-1 "Department of Foot and Ankle , Ningbo No.6 Hospital, Ningbo, Zhejiang, China; Ningbo Clinical Research Center for Orthopedics, Sports Medicine & Rehabilitation, Ningbo, Zhejiang, China."), [Yi Zhang](https://pubmed.ncbi.nlm.nih.gov/?term=Zhang+Y&cauthor_id=42683610)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42683610/#short-view-affiliation-1 "Department of Foot and Ankle , Ningbo No.6 Hospital, Ningbo, Zhejiang, China; Ningbo Clinical Research Center for Orthopedics, Sports Medicine & Rehabilitation, Ningbo, Zhejiang, China."), [Jiasong Pan](https://pubmed.ncbi.nlm.nih.gov/?term=Pan+J&cauthor_id=42683610)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42683610/#short-view-affiliation-1 "Department of Foot and Ankle , Ningbo No.6 Hospital, Ningbo, Zhejiang, China; Ningbo Clinical Research Center for Orthopedics, Sports Medicine & Rehabilitation, Ningbo, Zhejiang, China."), [Shengdi Lu](https://pubmed.ncbi.nlm.nih.gov/?term=Lu+S&cauthor_id=42683610)[ 3 ](https://pubmed.ncbi.nlm.nih.gov/42683610/#short-view-affiliation-3 "Pennington Biomedical Research Center, Baton Rouge, LA, United States. Shengdi.Lu@pbrc.edu."), [Lei Huang](https://pubmed.ncbi.nlm.nih.gov/?term=Huang+L&cauthor_id=42683610)[ 4 ](https://pubmed.ncbi.nlm.nih.gov/42683610/#short-view-affiliation-4 "Department of Foot and Ankle , Ningbo No.6 Hospital, Ningbo, Zhejiang, China; Ningbo Clinical Research Center for Orthopedics, Sports Medicine & Rehabilitation, Ningbo, Zhejiang, China. wyklwyjk@163.com.") ### Affiliations * 1 Department of Foot and Ankle , Ningbo No.6 Hospital, Ningbo, Zhejiang, China; Ningbo Clinical Research Center for Orthopedics, Sports Medicine & Rehabilitation, Ningbo, Zhejiang, China. * 2 Ningbo Clinical Research Center for Orthopedics, Sports Medicine & Rehabilitation, Ningbo, Zhejiang, China; Department of Rehabilitation Medicine, Ningbo No. 6 Hospital, Ningbo, Zhejiang, China. * 3 Pennington Biomedical Research Center, Baton Rouge, LA, United States. Shengdi.Lu@pbrc.edu. * 4 Department of Foot and Ankle , Ningbo No.6 Hospital, Ningbo, Zhejiang, China; Ningbo Clinical Research Center for Orthopedics, Sports Medicine & Rehabilitation, Ningbo, Zhejiang, China. wyklwyjk@163.com. * PMID: **42683610** * DOI: [ 10.2340/jrm.v58.45974 ](https://doi.org/10.2340/jrm.v58.45974) Item in Clipboard Cite Display options Display options Format Abstract PubMed PMID ## Abstract **Objective:** To compare the clinical effectiveness and cost-effectiveness of a 12-week home-based digital exercise programme with 12-week hospital-supervised physiotherapy for plantar fasciitis in routine Chinese tertiary-hospital care. **Design:** Single-centre retrospective cohort study with 1:2 propensity-score matching on 13 baseline covariates. **Subjects/patients:** 587 adults with a clinician-confirmed diagnosis of plantar fasciitis treated in 2022-2024 were matched. **Methods:** The primary outcome was first-step morning pain at 3 months on a 0-10 numeric rating scale (non-inferiority margin 1.3 points; sensitivity margins 0.9 and 1.9). A 12-month cost-utility analysis took payer and societal perspectives. **Results:** The adjusted mean difference was -0.63 points (95% confidence interval -0.92 to -0.35; p < 0.001), non-inferior against all 3 margins (E-value 2.84). Incremental payer cost was -¥4,920 (-US$684), incremental societal cost -¥7,008 (-US$974), and incremental quality-adjusted life-years +0.011, with dominance in 96.7% of bootstrap replications. **Conclusion:** Home-based digital exercise was non-inferior for 3-month first-step pain and less costly from both perspectives. Matching left 12 of 13 covariates imbalanced and only 6.3% of screened patients were eligible, so residual confounding and selection bias are likely. These observational findings are provisional and require confirmation in a pragmatic multicentre randomized controlled trial before informing reimbursement. 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