Al-Siyabi Zeyana, Karam Mohammad, Al-Hajri Ethar, Alsaif Abdulmalik, Alazemi Mohammad, Aldubaikhi Ahmed A
Podiatry, Starcare Hospital, Muscat, OMN.
Podiatry, University of Huddersfield, Huddersfield, GBR.
Cureus. 2022 Jan 2;14(1):e20871. doi: 10.7759/cureus.20871. eCollection 2022 Jan.
The objective of this study was to compare the outcomes of extracorporeal shockwave therapy (ESWT) versus ultrasound therapy (UST) in plantar fasciitis. A systematic review and meta-analysis were performed. An electronic search identifying studies comparing ESWT and UST for plantar fasciitis was conducted. Primary outcomes were morning and activity pain, functional impairment, and the American Orthopaedic Foot and Ankle Society (AOFAS) scale score. Secondary outcomes included the fascial thickness, primary efficacy success rate, activity limitations, pain intensity, and satisfaction. Seven studies enrolling 369 patients were identified. No significant difference was found between ESWT and UST for functional impairment (mean difference [MD] = -2.90, P = 0.22), AOFAS scale score (MD = 35, P = 0.20), and pain in the first steps in the morning (MD = -4.72, P = 0.39). However, there was a significant improvement in pain during activity for the ESWT group (MD = -1.36, P = 0.005). For secondary outcomes, ESWT had improved results in terms of primary efficacy success rate, activity limitations, and patient satisfaction. The reduction of plantar fascia thickness showed no significant difference. Pain intensity after treatment had varied results amongst included studies. In conclusion, ESWT is superior to UST for plantar fasciitis as it improves pain activity and intensity, primary efficacy success rate, and activity limitations.
本研究的目的是比较体外冲击波疗法（ESWT）与超声疗法（UST）治疗足底筋膜炎的效果。进行了一项系统评价和荟萃分析。通过电子检索确定了比较ESWT和UST治疗足底筋膜炎的研究。主要结局指标为晨起疼痛、活动时疼痛、功能障碍以及美国矫形足踝协会（AOFAS）评分。次要结局指标包括筋膜厚度、主要疗效成功率、活动受限情况、疼痛强度及满意度。共纳入7项研究，涉及369例患者。ESWT和UST在功能障碍（平均差[MD]= -2.90，P = 0.22）、AOFAS评分（MD = 35，P = 0.20）以及晨起第一步时的疼痛（MD = -4.72，P = 0.39）方面未发现显著差异。然而，ESWT组在活动时的疼痛有显著改善（MD = -1.36，P = 0.005）。对于次要结局指标，ESWT在主要疗效成功率、活动受限情况及患者满意度方面有更好的结果。足底筋膜厚度的减少无显著差异。纳入研究中治疗后的疼痛强度结果各异。总之，ESWT治疗足底筋膜炎优于UST，因为它能改善疼痛活动度和强度、主要疗效成功率及活动受限情况。
