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定制足矫形器与鞋垫联合应用体外冲击波治疗足底筋膜炎的比较:一项随机对照试验,中期随访结果。

Comparison between customised foot orthoses and insole combined with the use of extracorporeal shock wave therapy in plantar fasciitis, medium-term follow-up results: A randomised controlled trial.

机构信息

Universidad de Sevilla, Sevilla, Spain.

出版信息

Clin Rehabil. 2021 May;35(5):740-749. doi: 10.1177/0269215520976619. Epub 2020 Nov 24.

Abstract

OBJECTIVE

To determine the clinical results of custom-made foot orthoses versus placebo flat cushioning insoles combined with an extracorporeal shock wave therapy on pain and foot functionality in patients with plantar fasciitis.

DESIGN AND SETTING

A randomised controlled clinical trial with follow-up at six months. Faculty of Podiatry and Centre Clinical private of Physiotherapy, Seville, Spain.

SUBJECTS AND INTERVENTIONS

Patients with plantar fasciitis were randomly assigned to either group A ( = 42), which received custom-made foot orthoses, or group B ( = 41), which received placebo insoles. All the participants received active extracorporeal shock wave therapy including stretching exercises. Recruitment period was from Mach 2019 to July 2020.

MAIN MEASUREMENTS

The main outcome was foot pain, measured by visual analogue scale and the secondary outcome measures were recorded by Roles and Maudsley scores respectively, at the beginning and at one week, one month and six months.

RESULTS

Eighty-eight patients were assessed for eligibility. Eighty-three patients were recruited and randomised. This study showed significant differences between both groups according to the visual analogue scale. In control group, the difference was at baseline ( 0.01) and, in the experimental group was at the one- and six-month follow-up ( 0.001). The mean (SD) visual analogue scale at baseline were Control group 6.31 (1.69) and Experimental group 5.27 (1.64); and at six months were 7.52 (3.40) and 3.29 (4.26), respectively. The custom-made foot orthosis was perceived as 'good' (85%) and 'excellent' (97.5%) at medium-long term.

CONCLUSION

Wearing a custom-made foot orthosis leads to a improvement in patients with plantar fasciitis; it reduced foot pain and improved foot functionality.

摘要

目的

比较定制足垫与安慰剂平底缓冲鞋垫联合体外冲击波疗法对足底筋膜炎患者疼痛和足部功能的临床疗效。

设计和设置

一项随访时间为 6 个月的随机对照临床试验。西班牙塞维利亚足病学和临床私人物理治疗中心。

受试者和干预措施

将足底筋膜炎患者随机分为 A 组( = 42),接受定制足垫,或 B 组( = 41),接受安慰剂鞋垫。所有参与者均接受包括伸展运动在内的主动体外冲击波治疗。招募期为 2019 年 3 月至 2020 年 7 月。

主要测量

主要结局为足部疼痛,采用视觉模拟评分法(VAS)测量;次要结局为 Roles 和 Maudsley 评分,分别在基线、1 周、1 个月和 6 个月时记录。

结果

共评估了 88 例患者的纳入标准。有 83 例患者符合条件并被随机分组。本研究显示,根据 VAS,两组之间存在显著差异。在对照组,差异出现在基线时(0.01),而在实验组出现在 1 个月和 6 个月随访时(0.001)。基线时,对照组的平均(标准差)VAS 为 6.31(1.69),实验组为 5.27(1.64);6 个月时分别为 7.52(3.40)和 3.29(4.26)。在中-长期,定制足垫被认为“好”(85%)和“优秀”(97.5%)。

结论

佩戴定制足垫可改善足底筋膜炎患者的病情,减轻足部疼痛,改善足部功能。

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