Authors’ response to the Comments on: Effect of aquatic exercises on pain and functional performance in plantar fasciitis

Dear Editor,

We would like to express our sincere gratitude to the author(s) of the letter titled “Comments on: Effect of Aquatic Exercises on Pain and Functional Performance in Plantar Fasciitis”^[1] for their valuable observations and for recognizing the contribution of our study to the expanding body of evidence on aquatic rehabilitation for plantar fasciitis.^[2] We sincerely appreciate the opportunity to address the thoughtful points raised.

Regarding the follow-up duration, the authors rightly emphasized that an extended follow-up could provide deeper insights into the sustainability of the observed therapeutic benefits. The present study^[1] adopted a shorter follow-up period due to participant scheduling constraints and the intervention’s defined timeline. Nevertheless, we fully concur that future investigations incorporating long-term follow-up would enhance the understanding of the durability of pain relief and functional improvement following aquatic exercise programs.

Furthermore, the focus on short-term outcomes was intended to establish the immediate efficacy of aquatic exercises in plantar fasciitis. We acknowledge that future studies with longer follow-up periods and broader participant profiles, including those with common comorbidities such as diabetes, would further enhance the clinical relevance and generalizability of the findings.

Regarding assessor blinding, it is acknowledged that such methodological rigor strengthens internal validity. In this study, blinding was not feasible owing to the nature of the intervention and logistical limitations. However, the outcome evaluations were conducted by trained physiotherapists using standardized procedures to minimize observer bias and ensure consistency in data collection.

The suggestion to incorporate objective functional assessment tools, such as gait analysis and plantar pressure measurement, is well-received. These advanced evaluation methods would undoubtedly provide complementary biomechanical insights and enrich the evidence base for aquatic therapy in musculoskeletal rehabilitation. We will surely incorporate these valuable suggestions in future studies.

The point raised regarding the feasibility and clinical applicability of aquatic therapy in routine physiotherapy practice is particularly appreciated. While specialized aquatic facilities may not be universally available, the encouraging outcomes demonstrated in our study highlight the significant therapeutic potential of water-based interventions. With growing awareness and interdisciplinary collaboration, aquatic therapy can increasingly be integrated into mainstream physiotherapy practice, offering patients a safe and effective medium to initiate early movement, reduce pain, and regain function with greater confidence.

Once again, we thank the author(s) for their insightful suggestions, which we will surely incorporate into our future studies.