Roca Bernardino, Mendoza María A, Roca Manuel
a General and Provincial Hospitals , Castellon , Spain.
Disabil Rehabil. 2016 Oct;38(21):2114-21. doi: 10.3109/09638288.2015.1114036. Epub 2016 Mar 1.
To compare the efficacy of extracorporeal shock wave therapy (ESWT) with botulinum toxin type A (BoNT-A) in the treatment of plantar fasciitis (PF).
Open label, prospective, randomized study.
A total of 72 patients were included. In all participants the median (and interquartile range) of the visual analog scale (VAS) of pain result, when taking the first steps, was 8 (6-9) points before treatment and 6 (4-8) points after treatment (p < 0.001). In the group of patients that received ESWT, the median (and interquartile range) of improvement in the VAS of pain result, when taking the first steps, was 2 (1-4) points, and in the group of patients that received BoNT-A the same result was 1 (0-2) points (p = 0.009). In the group of patients that received ESWT, the median (and interquartile range) of improvement in the Roles and Maudsley scale of pain result was 1 (0-1) points, and in the group of patients that received BoNT-A the same result was 0 (0-1) points (p = 0.006). In a multivariate analysis use of ESWT and lower weight were associated with improvement of pain with treatment in at least one of the three VAS of pain scales used in the study.
ESWT was superior to BoNT-A in the control of pain in patients with PF. Implications for Rehabilitation Plantar fasciitis is characterized by pain at the calcaneal origin of the plantar fascia, exacerbated by weight bearing after prolonged periods of rest. Although studies comparing extracorporeal shock wave therapy or botulinum toxin type A to placebo suggest a superiority of the first one, no reliable data exist about it. Extracorporeal shock wave therapy was superior to botulinum toxin type A in the control of pain in patients with PF.
比较体外冲击波疗法（ESWT）与A型肉毒杆菌毒素（BoNT-A）治疗足底筋膜炎（PF）的疗效。
开放标签、前瞻性、随机研究。
共纳入72例患者。所有参与者在迈出第一步时疼痛视觉模拟量表（VAS）的中位数（及四分位间距）在治疗前为8（6-9）分，治疗后为6（4-8）分（p<0.001）。在接受ESWT治疗的患者组中，迈出第一步时疼痛VAS改善的中位数（及四分位间距）为2（1-4）分，在接受BoNT-A治疗的患者组中，该结果为1（0-2）分（p=0.009）。在接受ESWT治疗的患者组中，疼痛结果的罗尔斯和莫兹利量表改善的中位数（及四分位间距）为1（0-1）分，在接受BoNT-A治疗的患者组中，该结果为0（0-1）分（p=0.006）。在多变量分析中，ESWT的使用和较低体重与研究中使用的三个疼痛VAS量表中至少一个的疼痛治疗改善相关。
在控制PF患者疼痛方面，ESWT优于BoNT-A。康复意义足底筋膜炎的特征是足底筋膜跟骨起点处疼痛，长时间休息后负重会加重。尽管比较体外冲击波疗法或A型肉毒杆菌毒素与安慰剂的研究表明前者更具优势，但尚无可靠数据支持。在控制PF患者疼痛方面，体外冲击波疗法优于A型肉毒杆菌毒素。
