Mishra Bibhuti Nath, Poudel Rishi Ram, Banskota Bibek, Shrestha Babu Kaji, Banskota Ashok Kumar
Department of Orthopaedics, Nobel Medical College Teaching Hospital, Kanchanbari, Biratnagar, Nepal.
Department of Orthopaedics & Trauma, B&B Hospital, Kathmandu, Nepal.
J Clin Orthop Trauma. 2019 Mar-Apr;10(2):401-405. doi: 10.1016/j.jcot.2018.02.011. Epub 2018 Feb 23.
In Plantar Fasciitis, the main concern of the patients is the pain that disturbs their day to day activities. Different modalities of treatments are being used for its pain management. This study seeks to investigate and compare decrease in level of pain following treatment with Methylprednisolone injections (DMP) Vs Extra-Corporeal Shock Wave Therapy (ESWT) in plantar fasciitis.
This prospective comparative non randomized study was conducted in 60 patients of any age presenting with Plantar Fasciitis at B&B Hospital, Kathmandu. Patients were divided into 2 groups (30 each) based on patients preference. Methylprednisolone injection was given to one group and another group received ESWT. Follow up of both groups were carried out at 6 weeks, 3 months and 6 months and the outcome was measured with Visual Analogue Pain Scale (VAS). Statistical analysis wasdone using SPSS software, version 13. Chi-square and Independent -test were applied to look for significant variations in outcome.
Follow-up at 6 weeks revealed 26 (86.7%) patients attaining VAS < 5 in ESWT group in comparison to 16 (53.3%) patients of DMP group (p = 0.005). At the end of 6 months, 5 patients in DPM group still had significant pain (VAS ≥ 5) compared to 2 patients in ESWT group (p = 0.02). However 11 patients of DMP group and 23 of ESWT group received single episode of treatment only and had persistent symptomatic pain relief (VAS < 5) during all follow ups at 6 weeks, 3 months and 6 months (p = 0.004).
Plantar fasciitis was more prevalent in overweight population and females. Significant improvement in pain was observed with both ESWT and DMP Injections. However, ESWT was found to be more effective than DMP Injections for treatment of Plantar Fasciitis.
在足底筋膜炎中，患者主要关心的是困扰其日常活动的疼痛。目前采用了不同的治疗方式来管理这种疼痛。本研究旨在调查和比较在足底筋膜炎患者中，使用甲泼尼龙注射（DMP）与体外冲击波疗法（ESWT）治疗后疼痛程度的降低情况。
这项前瞻性比较非随机研究在加德满都B&B医院对60例患有足底筋膜炎的任何年龄患者进行。根据患者的偏好将患者分为两组（每组30例）。一组接受甲泼尼龙注射，另一组接受ESWT治疗。两组均在6周、3个月和6个月时进行随访，并使用视觉模拟疼痛量表（VAS）测量结果。使用SPSS软件13版进行统计分析。应用卡方检验和独立样本t检验来寻找结果中的显著差异。
6周随访时，ESWT组有26例（86.7%）患者VAS＜5，而DMP组有16例（53.3%）患者VAS＜5（p = 0.005）。在6个月末，DPM组有5例患者仍有明显疼痛（VAS≥5），而ESWT组有2例患者（p = 0.02）。然而，DMP组有11例患者和ESWT组有23例患者仅接受了单次治疗，并且在6周、3个月和6个月的所有随访期间均有持续的症状性疼痛缓解（VAS＜5）（p = 0.004）。
足底筋膜炎在超重人群和女性中更为普遍。ESWT和DMP注射治疗后疼痛均有显著改善。然而，发现ESWT在治疗足底筋膜炎方面比DMP注射更有效。
