Department of Physical Medicine and Rehabilitation, National Taiwan University Hospital, College of Medicine, National Taiwan University, Taipei, Taiwan.
Institute of Health Policy & Management, College of Public Health, National Taiwan University, Taipei, Taiwan.
Sci Rep. 2020 Feb 13;10(1):2571. doi: 10.1038/s41598-020-59464-8.
Extracorporeal shockwave therapy (ESWT) is proposed to be effective in reducing pain and improving functional outcome in chronic plantar fasciitis. However, no long-term reports exist on the changes in plantar fascia (PF) elasticity after ESWT. We aimed to evaluate the changes in PF stiffness in patients with plantar fasciitis undergoing ESWT. The visual analogue scale (VAS, 0-100) was used for evaluating heel pain severity. B-mode sonography and strain sonoelastography were used for evaluating the PF thickness and stiffness. The sonoelastogram was analyzed using hue histogram analysis (value: 0-255, from stiffer to softer). All evaluations were recorded before ESWT, and 1 week, 1 month, 3 months, 6 months, and 12 months after ESWT. Repeated measures ANOVA was used to compare pain VAS, PF thickness, and PF hue value at different follow-up time-points. Twenty-two participants (8 men, 14 women) completed all measurements for 12 months. The VAS of heel pain, PF thickness, and PF hue values at pre-ESWT, and 1-week, 1-month, 3-month, 6-month, and 12-month evaluations after ESWT were 62.4 ± 4.2, 49.3 ± 5.8, 38.3 ± 5.7, 27.9 ± 5.3, 18.9 ± 4.7, and 13.2 ± 3.0 (p < 0.01 in all measurements post ESWT versus pre-ESWT); 5.57 ± 0.22 mm, 5.64 ± 0.18 mm, 5.45 ± 0.24 mm, 5.37 ± 0.20 mm, 5.08 ± 0.20 mm, and 4.62 ± 0.15 mm (p < 0.01 at 6-month; otherwise p > 0.05); and 24.5 ± 2.4, 35.2 ± 3.1, 31.0 ± 4.1, 30.5 ± 3.9, 21.4 ± 2.1, and 15.9 ± 1.6 (p < 0.01 at 1-week and 6-month; otherwise p > 0.05), respectively. In conclusion, the heel pain intensity and PF thickness reduced gradually over 12 months after ESWT. The PF stiffness decreased during the first week and increased thereafter; at the 12-month follow-up, stiffness was more than at pre-ESWT.
体外冲击波疗法（ESWT）被提议可有效减轻慢性足底筋膜炎的疼痛并改善其功能结局。然而，目前尚无关于 ESWT 后足底筋膜（PF）弹性变化的长期报告。我们旨在评估接受 ESWT 的足底筋膜炎患者的 PF 硬度变化。使用视觉模拟量表（VAS，0-100）评估足跟疼痛的严重程度。B 型超声和应变成像弹性超声用于评估 PF 厚度和硬度。使用色调直方图分析（值：0-255，从硬到软）分析弹性声图。所有评估均在 ESWT 之前以及 ESWT 后 1 周、1 个月、3 个月、6 个月和 12 个月进行。使用重复测量方差分析比较不同随访时间点的疼痛 VAS、PF 厚度和 PF 色调值。22 名参与者（8 名男性，14 名女性）完成了所有 12 个月的测量。ESWT 前、ESWT 后 1 周、1 个月、3 个月、6 个月和 12 个月的足跟疼痛 VAS、PF 厚度和 PF 色调值分别为 62.4±4.2、49.3±5.8、38.3±5.7、27.9±5.3、18.9±4.7 和 13.2±3.0（ESWT 后所有测量均低于 ESWT 前，p<0.01）；5.57±0.22mm、5.64±0.18mm、5.45±0.24mm、5.37±0.20mm、5.08±0.20mm 和 4.62±0.15mm（6 个月时低于 ESWT 前，p<0.01；否则 p>0.05）；24.5±2.4、35.2±3.1、31.0±4.1、30.5±3.9、21.4±2.1 和 15.9±1.6（ESWT 后 1 周和 6 个月时低于 ESWT 前，p<0.01；否则 p>0.05）。总之，ESWT 后 12 个月内足跟疼痛强度和 PF 厚度逐渐降低。PF 硬度在第 1 周内降低，此后增加；在 12 个月的随访中，硬度高于 ESWT 前。
