Graduate Institute of Clinical Medical Sciences, Chang-Gung University, and Division of Sports Medicine, Department of Orthopaedic Surgery, Chang Gung Memorial Hospital at Chia Yi, 6 West, Chia-Pu Road, Puzih City, Chiayi 613, Taiwan.
Bone Joint J. 2013 Aug;95-B(8):1088-93. doi: 10.1302/0301-620X.95B8.31497.
It has been suggested that extracorporeal shockwave therapy is a safe and effective treatment for pain relief from recalcitrant plantar fasciopathy (PF). However, the changes in gait and associated biomechanical parameters have not been well characterised. We recruited 12 female patients with recalcitrant PF who had a mean age of 59 years (50 to 70) and mean body mass index of 25 kg/m(2) (22 to 30). The patients reported a mean duration of symptoms of 9.3 months (6 to 15). Shockwave therapy consisting of 1500 impulses (energy flux density 0.26 mJ/mm(2)) was applied for three sessions, each three weeks apart. A pain visual analogue scale (VAS) rating, plantar pressure assessment and motion analysis were carried out before and nine weeks after first shock wave therapy. It was demonstrated that patients increased their walking velocity and cadence as well indicating a decrease in pain after shockwave therapy. In the symptomatic foot, the peak contact pressure over the forefoot increased and the contact area over the digits decreased. The total foot impulse also decreased as did stance duration. The duration the centre of pressure remained in the hindfoot increased in the symptomatic foot after shockwave therapy. The differences in centre of pressure trajectory at baseline decreased at final follow-up. In conclusion, shockwave therapy not only decreased the pain VAS rating but also improved the gait parameters of the symptomatic foot in PF patients.
有人提出，体外冲击波疗法是治疗顽固性足底筋膜炎（PF）疼痛的一种安全有效的治疗方法。然而，其对步态和相关生物力学参数的影响尚未得到很好的描述。我们招募了 12 名患有顽固性 PF 的女性患者，平均年龄为 59 岁（50 至 70 岁），平均体重指数为 25 kg/m²（22 至 30）。患者报告的平均症状持续时间为 9.3 个月（6 至 15）。冲击波治疗包括 1500 次冲击（能量通量密度 0.26 mJ/mm²），每个疗程相隔 3 周，共进行 3 个疗程。在第一次冲击波治疗前和 9 周后，进行疼痛视觉模拟量表（VAS）评分、足底压力评估和运动分析。结果表明，患者在接受冲击波治疗后，步行速度和步频增加，疼痛减轻。在症状脚中，前脚的最大接触压力增加，趾部的接触面积减少。总的足部冲击力也减少了，支撑期的持续时间也减少了。冲击波治疗后，症状脚的跟骨中心压力的停留时间增加。在最终随访时，中心压力轨迹的差异减少。总之，冲击波疗法不仅降低了疼痛 VAS 评分，还改善了 PF 患者症状脚的步态参数。
