Ajimsha M S, Binsu D, Chithra S
Department of Physiotherapy, Hamad Medical Corporation, Doha, Qatar; Myofascial Therapy and Research Foundation, India.
Myofascial Therapy and Research Foundation, India.
Foot (Edinb). 2014 Jun;24(2):66-71. doi: 10.1016/j.foot.2014.03.005. Epub 2014 Mar 21.
BACKGROUND: Previous studies have reported that stretching of the calf musculature and the plantar fascia are effective management strategies for plantar heel pain (PHP). However, it is unclear whether myofascial release (MFR) can improve the outcomes in this population. OBJECTIVE: To investigate whether myofascial release (MFR) reduces the pain and functional disability associated with plantar heel pain (PHP) in comparison with a control group receiving sham ultrasound therapy (SUST). DESIGN: Randomized, controlled, double blinded trial. SETTING: Nonprofit research foundation clinic in India. METHOD: Sixty-six patients, 17 men and 49 women with a clinical diagnosis of PHP were randomly assigned into MFR or a control group and given 12 sessions of treatment per client over 4 weeks. The Foot Function Index (FFI) scale was used to assess pain severity and functional disability. The primary outcome measure was the difference in FFI scale scores between week 1 (pretest score), week 4 (posttest score), and follow-up at week 12 after randomization. Additionally, pressure pain thresholds (PPT) were assessed over the affected gastrocnemii and soleus muscles, and over the calcaneus, by an assessor blinded to the treatment allocation. RESULTS: The simple main effects analysis showed that the MFR group performed better than the control group in weeks 4 and 12 (P<0.001). Patients in the MFR and control groups reported a 72.4% and 7.4% reduction, respectively, in their pain and functional disability in week 4 compared with that in week 1, which persisted as 60.6% in the follow-up at week 12 in the MFR group compared to the baseline. The mixed ANOVA also revealed significant group-by-time interactions for changes in PPT over the gastrocnemii and soleus muscles, and the calcaneus (P<0.05). CONCLUSIONS: This study provides evidence that MFR is more effective than a control intervention for PHP.
背景:先前的研究报告称,拉伸小腿肌肉组织和足底筋膜是治疗足跟痛(PHP)的有效管理策略。然而,尚不清楚肌筋膜松解术(MFR)是否能改善该人群的治疗效果。 目的:研究与接受假超声治疗(SUST)的对照组相比,肌筋膜松解术(MFR)是否能减轻与足跟痛(PHP)相关的疼痛和功能障碍。 设计:随机对照双盲试验。 地点:印度的非营利性研究基金会诊所。 方法:66例临床诊断为足跟痛的患者,17例男性和49例女性,被随机分为MFR组或对照组,每位患者在4周内接受12次治疗。使用足部功能指数(FFI)量表评估疼痛严重程度和功能障碍。主要结局指标是随机分组后第1周(预测试评分)、第4周(后测试评分)和第12周随访时FFI量表评分的差异。此外,由对治疗分配不知情的评估者评估患侧腓肠肌和比目鱼肌以及跟骨上的压痛阈值(PPT)。 结果:简单主效应分析显示,MFR组在第4周和第12周的表现优于对照组(P<0.001)。与第1周相比,MFR组和对照组患者在第4周时的疼痛和功能障碍分别降低了72.4%和7.4%,在第12周随访时,MFR组与基线相比仍为60.6%。混合方差分析还显示,腓肠肌和比目鱼肌以及跟骨上PPT变化的组×时间交互作用显著(P<0.05)。 结论:本研究提供的证据表明,对于足跟痛,MFR比对照干预更有效。
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