M.P. Cotchett, BPod, Department of Allied Health, La Trobe Rural Health School, La Trobe University, PO 199 Bendigo, Victoria, Australia 3552, and Department of Podiatry and Lower Extremity and Gait Studies Program, La Trobe University, Bundoora, Melbourne, Victoria, Australia.
S.E. Munteanu, PhD, Department of Podiatry and Lower Extremity and Gait Studies Program, La Trobe University.
Phys Ther. 2014 Aug;94(8):1083-94. doi: 10.2522/ptj.20130255. Epub 2014 Apr 3.
Plantar heel pain can be managed with dry needling of myofascial trigger points; however, there is only poor-quality evidence supporting its use.
The purpose of this study was to evaluate the effectiveness of dry needling for plantar heel pain.
The study was a parallel-group, participant-blinded, randomized controlled trial.
The study was conducted in a university health sciences clinic.
Study participants were 84 patients with plantar heel pain of at least 1 month's duration.
Participants were randomly assigned to receive real or sham trigger point dry needling. The intervention consisted of 1 treatment per week for 6 weeks. Participants were followed for 12 weeks.
Primary outcome measures included first-step pain, as measured with a visual analog scale (VAS), and foot pain, as measured with the pain subscale of the Foot Health Status Questionnaire (FHSQ). The primary end point for predicting the effectiveness of dry needling for plantar heel pain was 6 weeks.
At the primary end point, significant effects favored real dry needling over sham dry needling for pain (adjusted mean difference: VAS first-step pain=-14.4 mm, 95% confidence interval [95% CI]=-23.5 to -5.2; FHSQ foot pain=10.0 points, 95% CI=1.0 to 19.1), although the between-group difference was lower than the minimal important difference. The number needed to treat at 6 weeks was 4 (95% CI=2 to 12). The frequency of minor transitory adverse events was significantly greater in the real dry needling group (70 real dry needling appointments [32%] compared with only 1 sham dry needling appointment [<1%]).
It was not possible to blind the therapist.
Dry needling provided statistically significant reductions in plantar heel pain, but the magnitude of this effect should be considered against the frequency of minor transitory adverse events.
足底跟痛可以通过肌筋膜触发点的干针治疗来进行管理；然而，支持其使用的证据质量较差。
本研究旨在评估干针治疗足底跟痛的效果。
本研究为平行组、参与者盲法、随机对照试验。
本研究在一所大学健康科学诊所进行。
研究参与者为 84 名患有至少 1 个月足底跟痛的患者。
参与者被随机分配接受真实或假触发点干针治疗。干预措施包括每周 1 次，共 6 周。参与者在 12 周内进行随访。
主要结局指标包括视觉模拟量表（VAS）测量的第一步疼痛和足部健康状况调查问卷（FHSQ）疼痛分量表测量的足部疼痛。预测干针治疗足底跟痛效果的主要终点为 6 周。
在主要终点，真实干针治疗在疼痛方面明显优于假干针治疗（调整后的平均差异：VAS 第一步疼痛=-14.4mm，95%置信区间[95%CI]=-23.5 至-5.2；FHSQ 足部疼痛=10.0 分，95%CI=1.0 至 19.1），尽管组间差异低于最小重要差异。6 周时的治疗人数需要 4 人（95%CI=2 至 12）。真实干针治疗组的轻微短暂不良反应发生率显著更高（70 次真实干针治疗预约[32%]，而只有 1 次假干针治疗预约[<1%]）。
治疗师无法被蒙蔽。
干针治疗可显著减轻足底跟痛，但应考虑到轻微短暂不良反应的频率，来评估这种效果的幅度。
