EFFECT OF LOW ENERGY VERSUS MEDIUM ENERGY RADIAL SHOCK WAVE THERAPY IN THE TREATMENT OF CHRONIC PLANTER FASCIITIS

Authors

  • Khaled Z. Fouda Lecturer of Physical Therapy, Basic Science for Physical Therapy Department, Faculty of Physical Therapy, Cairo University, Egypt.
  • Mona H. El Laithy Lecturer of Physical Therapy, Physical Therapy for Musculoskeletal Disorders and its Surgery Department, Faculty of Physical Therapy, Cairo University, Egypt.

DOI:

https://doi.org/10.15621/ijphy/2016/v3i1/88900

Keywords:

ow energy, Medium energy, Radial shock wave, Treatment, Planter fasciitis

Abstract

Background: Plantar fasciitis (PF) is the most common cause of heel pain and it can often be a challenge for clinicians to treat successfully. Radial shock wave therapy (RSWT) has been introduced recently for treatment of musculoskeletal disorders. Different energy levels of shock wave therapy have been used in the literatures for treatment of PF with no clear settled parameters. Therefore, the purpose of this study was intended to investigate and compare the efficacy of two different energy levels of RSWT on PF patients.
Methods: Forty patients having unilateral chronic PF were recruited for the study from orthopedic outpatient clinics of Cairo University hospitals and National Institute of Neuromotor System Cairo Egypt, with a mean age of (47.15±4.57) years. Patients were randomly assigned into two equal groups. Group (A) treated with low intensity level of 1.6 bars (0.16 mJ/mm2) RSWT and group (B) treated with medium intensity level of 4 bars (0.38 mJ/mm2) RSWT. Functional assessment of the foot based on Foot Function Index (FFI) and Present pain intensity was measured during rest by Visual Analogue Scale (VAS).
Results: There was as significant decreased in the total FFI scores from (118.42 ±6.51) to (81.37 ±3.46) for group (A) and from (118.93 ±6.85) to (58.50 ±3.22) for group (B). Also regarding VAS Scores there was as significant decreased in the pain intensity from (5.11 ±0.41) to (2.85 ±0.31) for group (A) and from (4.95 ±0.39) to (2.05 ±0.22) for group (B).
Conclusion: Radial shock wave therapy is an effective modality that should be considered in the treatment of chronic PF, while the medium energy level RSWT is better than the low energy level RSWT in regarding to the measured treatment outcomes.

References

[1] Rompe JD. Plantar fasciopathy. Sports Med Arthrosc.2009; 17(2):100-104. [2] Buchbinder R. Plantar fasciitis. N Engl J Med. 2004; 350: 2159-2166. [3] Thomas JL, Christensen JC, Kravitz SR, et al. American College of Foot and Ankle Surgeons heel pain committee: The diagnosis and treatment of heel pain. A clinical practice guideline-revision 2010. J Foot Ankle Surg. 2010, 49:S1–S19. [4] Tong KB, Furia J. Economic burden of plantar fasciitis treatment in the United States. Am J Orthop. 2010; 39(5):227–231. [5] Marx, RC, Mizel, MS. What’s new in foot and ankle surgery. J Bone Joint Surg. 2014; 96(10): 872-878. [6] Cheung J, Zhang M, An K. Effects of Plantar Fascia Stiffness on the Biomechanical Responses of the Ankle-Foot Complex. Clinical Biomechanics. 2004; 19(8):839-46. [7] Digiovanni BF, Nawoczenski DA, Lintal ME, et al. Tissue specific planter fascia stretching exercise enhances outcomes in patients with chronic heel pain. A prospective randomized study. J Bone Joint Surg Am. 2003; 85-A (7):1270-1277. [8] Roxas, M. Plantar fasciitis: diagnosis and therapeutic considerations. Alt Med Rev. 2005; 10(2): 83-93. [9] Zhao Z, Jing R, Shi Z, Zhao B, Ai Q, Xing G. Efficacy of extracorporeal shockwave therapy for knee osteoarthritis: a randomized controlled trial. J Surg Res. 2013; 185(2):661-666. [10] Csaszar NBM, Schmitz C. Extracorporeal shock wave therapy in musculoskeletal disorders. J Orthop Surg Res. 2013; 8(1):22. [11] Saxena A, Fournier M, Gerdesmeyer L, Gollwitzer H. Comparison between extracorporeal shockwave therapy, placebo ESWT and endoscopic plantar fasciotomy for the treatment of chronic plantar heel pain in the athlete. Muscles, Ligaments and Tendons Journal. 2012; 2 (4): 312-316. [12] Radwan YA, Mansour AM, Badawy WS. Resistant plantar fasciopathy: shock wave versus endoscopic plantar fascial release. International Orthopaedics (SICOT). 2012; 36:2147–2156. [13] Lohrer H, Nauck T, Dorn-Lange NV, Vester JC. Comparison of radial versus focused extracorporeal shock waves in plantar fasciitis using functional measures. Foot & Ankle International.2010; 31(1):1-9. [14] Ibrahim MI, Donatelli RA, Schmitz C, Hellman MA, Buxbaum F. Chronic plantar fasciitis treated with two sessions of radial extracorporeal shock wave therapy. Foot Ankle Int. 2010; 31(5):391–397. [15] Greve JM, Grecco MV, Santos-Silva PR. Comparison of radial shockwaves and conventional physiotherapy for treating plantar fasciitis. Clinics 2009; 64(2):97– 103. [16] Malay DS, Pressman MM, Assili A et al. Extracorporeal shockwave therapy versus placebo for the treatment of chronic proximal plantar fasciitis: results of a randomized, placebo-controlled, double-blinded, multicenter intervention trial. J Foot Ankle Surg. 2006; 45(4):196–210. [17] Theodore GH, Buch M, Amendola A, Bachmann C, Fleming LL, Zingas C. Extracorporeal shock wave therapy for the treatment of plantar fasciitis. Foot Ankle Int. 2004; 25(5):290–297. [18] Worp H, Akker-Scheek I, Schie H, Zwerver J. ESWT for tendinopathy: technology and clinical implications. Knee Surg Sports Traumatol Arthrosc. 2013; 21(6):1451–1458. [19] Schmitz1 C, Császár1 N, Rompe J, Chaves H, Furia J. Treatment of chronic plantar fasciopathy with extracorporeal shock waves (review). J Orthop Surg Res. 2013; 8:31-42. [20] Gerdesmeyer L, Weil LS. Extracorporeal Shock Wave Therapy. Technologies, Basics, Clinical Results. 1st Int J Physiother 2016; 3(1) Page | 10 edition; 2007. [21] Gerdesmeyer L, Frey C, Vester J et al. Radial extracorporeal shock wave therapy is safe and effective in the treatment of chronic recalcitrant plantar fasciitis: results of a confirmatory randomized placebo-controlled multicenter study. Am J Sports Med. 2008; 36(11):2100–2109. [22] Aqil A, Siddiqui M, Solan M, Redfern D, Gulati V, Cobb J. Extracorporeal Shock Wave Therapy Is Effective In Treating Chronic Plantar Fasciitis: A Meta-analysis of RCTs. Clin Orthop Relat Res. 2013; 471(11):3645–3652. [23] Irving DB, Cook JL, Young MA, Menz HB. Obesity and pronated foot type may increase the risk of chronic plantar heel pain: a matched case-control study. BMC Musculoskeletal Disorders. 2007; 8: 41-49. [24] Martinelli N, Scotto GM, Sartorelli E, Bonifacini C, Bianchi A, Malerba F. Reliability, validity and responsiveness of the Italian version of the Foot Function Index in patients with foot and ankle diseases. Qual Life Res. 2014; 23(1): 277–284. [25] Venditto T, Tognol L, Rizzo RS, et al. 17-Italian Foot Function Index with numerical rating scale: Development, reliability, and validity of a modified version of the original Foot Function Index. The Foot. 2015; 25(1):12–18. [26] Li D, Puntillo K, Miaskowski C. A review of objective pain measures for use with critical care adult patients unable to self-report. Journal of Pain. 2008; 9 (1): 2-10. [27] Breivik H, Borchgrevink PC, Allen SM, et al. Assessment of pain. British Journal of Anesthesia 2008; 101 (1):17–24. [28] Krishnan CA, Sharma CY, Singh MS. Evaluation of therapeutic effects of extracorporeal shock wave therapy in resistant plantar fasciitis patients in a tertiary care setting. Medical Journal Armed Forces India. 2012; 68(3): 236-239. [29] Rompe JD, Kirkpatrick CJ, Kullmer K, Schwitalle M, Krischek O. Dose-related effects of shock waves on rabbit tendoAchillis—A sonographic and histological study. J Bone JtSurg Br.1998; 80(3):546–552. [30] Hausdorf J, Lemmens MM, Kaplan S, Marangoz C, Milz S, Odaci E, Korr H, Schmitz C, Maier M. Extracorporeal shockwave application to the distal femur of rabbits diminishes the number of neurons immunoreactive for substance P in dorsal root ganglia L5. Brain Res. 2008; 1207:96–101. [31] Maier M, Averbeck B, Milz S, Refior HJ, Schmitz C. Substance P and prostaglandin E-2 release after shock wave application to the rabbit femur. Clin Orthop. 2003; 406(1):237–245. [32] Takahashi N, Wada Y, Ohtori S, Saisu T, Moriya H. Application of shock waves to rat skin decreases calcitonin gene-related peptide immunoreactivity in dorsal root ganglion neurons. Auton Neurosci. 2003; 107(2):81–84. [33] Hausdorf J, Lemmens MM, Heck KW, et al. Selective loss of unmyelinated nerve fibers after extracorporeal shockwave application to the musculoskeletal system. Neuroscience. 2008; 155(1): 138–144. [34] Orhan Z, Cam K, Alper M, Ozturan K. The effects of extracorporeal shock waves on the rat Achilles tendon: is there a critical dose for tissue injury? Arch Orthop Trauma Surg. 2004; 124(9): 631-635. [35] Khan KM, Scott A. Mechanotherapy: how physical therapists’ prescription of exercise promotes tissue repair. Br J Sports Med. 2009; 43(4):247–252. [36] Vetrano M, d’Alessandro F, Torrisi MR, Ferretti A, Vulpiani MC, Visco V. Extracorporeal shock wave therapy promotes cell proliferation and collagen synthesis of primary cultured human tenocytes. Knee Surg Sports Traumatol Arthrosc. 2011; 19(12):2159– 2168. [37] Caminoto EH, Alves AL, Amorim RL, Thomassian A, HussniCA, Nicoletti JL. Ultrastructural and immunocytochemical evaluation of the effects of extracorporeal shock wave treatment in the hind limbs of horses with experimentally induced suspensory ligament desmitis. Am J Vet Res. 2005; 66(5):892-896. [38] Wang CJ, Wang FS, Yang KD, Weng LH, Hsu CC, Huang CS, Yang LC. Shock wave therapy induces neovascularization at the tendon-bone junction-a study in rabbits. J Orthop Res. 2003; 21(6):984–989. [39] Han SH, Lee JW, Guyton GP, Parks BG, Courneya J, Schon LC. Effect of extracorporeal shock wave therapy on cultured tenocytes. Foot Ankle Int. 2009; 30(2):93–98.

Published

07-02-2016
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How to Cite

Fouda, K. Z. ., & Laithy, M. H. E. . (2016). EFFECT OF LOW ENERGY VERSUS MEDIUM ENERGY RADIAL SHOCK WAVE THERAPY IN THE TREATMENT OF CHRONIC PLANTER FASCIITIS. International Journal of Physiotherapy, 3(1), 5–10. https://doi.org/10.15621/ijphy/2016/v3i1/88900

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