Brachman Anna, Sobota Grzegorz, Marszałek Wojciech, Pawłowski Michał, Juras Grzegorz, Bacik Bogdan
Institute of Sport Sciences, Department of Biomechanics, The Jerzy Kukuczka Academy of Physical Education in Katowice, Poland.
Institute of Sport Sciences, Department of Human Motor Behavior, The Jerzy Kukuczka Academy of Physical Education in Katowice, Poland.
J Biomech. 2020 May 22;105:109773. doi: 10.1016/j.jbiomech.2020.109773. Epub 2020 Apr 3.
Radial shock wave therapy (RSWT) has been recommended as an appropriate, safe and effective method in the treatment of chronic plantar fasciitis (PF). The main purpose of this study was to examine how RSWT affects gait parameters. This study included 23 patients with unilateral, chronic PF. RSWT were administered in 5 interventions, during a consecutive 3-week period. Objective kinetic (force distribution under the forefoot, midfoot, rearfoot) and spatiotemporal parameters (cadence, step length, stance phase duration) during treadmill walking at, preferred" speed were evaluated on. 4 sessions: before therapy, immediately after (primary endpoint), 3 and 6 weeks after therapy. The mean reduction in the reported pain when taking first steps in the morning from baseline to the primary endpoint, 3- and 6-weeks post procedure was 42.7%, 50.1% and 66.9% respectively. Similar reduction was seen in the reported pain during walking. After the therapy during gait at the preferred speed patients had a significantly higher force beneath the rearfoot and forefoot of both limbs. Force beneath the midfoot was not significantly affected by treatment. The step length in both limbs increased by 3.3-3.6 cm after RSWT. After the therapy stance phase duration in symptomatic foot was longer by 7% and it slightly decreased until POST-6wk. Similar changes were seen in an asymptomatic limb. The spatiotemporal and kinetic results indicate that RSWT therapy induces changes in patient's gait structure and alter regional loading in the affected foot.
放射状冲击波疗法(RSWT)已被推荐为治疗慢性足底筋膜炎(PF)的一种合适、安全且有效的方法。本研究的主要目的是探讨RSWT如何影响步态参数。本研究纳入了23例单侧慢性PF患者。在连续3周的时间内进行了5次RSWT干预。在以“偏好”速度进行跑步机行走期间,评估了4个阶段的客观动力学参数(前足、中足、后足下方的力分布)和时空参数(步频、步长、站立相持续时间):治疗前、治疗后即刻(主要终点)、治疗后3周和6周。从基线到主要终点、术后3周和6周,早晨首次行走时报告的疼痛平均减轻分别为42.7%、50.1%和66.9%。行走时报告的疼痛也有类似程度的减轻。治疗后,在以偏好速度行走时,患者双下肢后足和前足下方的力显著更高。中足下方的力未受到治疗的显著影响。RSWT后双下肢的步长增加了3.3 - 3.6厘米。治疗后,患侧足的站立相持续时间延长了7%,直到术后6周略有下降。无症状肢体也出现了类似变化。时空和动力学结果表明,RSWT疗法可引起患者步态结构的改变,并改变患足的局部负荷。