Liang Huey-Wen, Wang Tyng-Guey, Chen Wen-Shiang, Hou Sheng-Mou
Department of Physical Medicine and Rehabilitation, National Taiwan University Hospital and College of Medicine, National Taiwan University, Taipei, Taiwan.
Clin Orthop Relat Res. 2007 Jul;460:219-25. doi: 10.1097/BLO.0b013e31804ffd19.
Increased plantar fascia thickness is common with chronic plantar fasciitis, and reduction of the thickness after extracorporeal shock wave therapy or steroid injection has been reported. We hypothesized a decrease of plantar fascia thickness was associated with pain reduction after extracorporeal shock wave therapy. Fifty-three eligible patients with 78 symptomatic feet were randomly treated with piezoelectric-type extracorporeal shock wave therapy of two intensity levels (0.12 and 0.56 mJ/mm2). Two thousand shock waves for three consecutive sessions were applied at weekly intervals. A visual analog scale for pain, the Foot Function Index, the Short Form-36 Health Survey, and ultrasonographic measurement of plantar fascia thickness were evaluated at baseline and 3 and 6 months after treatment. We analyzed the association between pain level and plantar fascia thickness with generalized estimating equation analysis and adjusted for demographic and treatment-related variables. Patients with thinner plantar fascia experienced less pain after treatment; high-intensity treatment and regular exercise were associated with lower pain level. The overall success rates were 63% and 60% at the 3- and 6-month followups. High- and low-intensity treatments were associated with similar improvements in pain and function. Receiving high-intensity treatment, although associated with less pain at followup, did not provide a higher success rate.
足底筋膜增厚在慢性足底筋膜炎中很常见，据报道，体外冲击波治疗或类固醇注射后足底筋膜厚度会减小。我们推测体外冲击波治疗后足底筋膜厚度的减小与疼痛减轻有关。53例符合条件的患者共78只患足，被随机分为两组，接受两种强度水平（0.12和0.56 mJ/mm2）的压电式体外冲击波治疗。每周进行一次，连续三个疗程，每次施加2000次冲击波。在基线以及治疗后3个月和6个月时，评估疼痛视觉模拟量表、足部功能指数、简短健康调查问卷36项以及足底筋膜厚度的超声测量结果。我们采用广义估计方程分析疼痛水平与足底筋膜厚度之间的关联，并对人口统计学和治疗相关变量进行了校正。足底筋膜较薄的患者治疗后疼痛较轻；高强度治疗和规律运动与较低的疼痛水平相关。在3个月和6个月的随访中，总体成功率分别为63%和60%。高强度和低强度治疗在疼痛和功能改善方面相似。接受高强度治疗虽然在随访时疼痛较轻，但并未带来更高的成功率。
