Faculty of Medical and Social Sciences, Warsaw Medical Academy of Applied Sciences, 8 Rydygiera St., 01-793 Warszawa, Poland.
Collegium Medicum im dr Władysława Biegańskiego, Jan Długosz University in Częstochowa, 13/15 Armii Krajowej St., 42-200 Częstochowa, Poland.
Medicina (Kaunas). 2024 May 6;60(5):766. doi: 10.3390/medicina60050766.
Treatment of chronic plantar fasciitis is challenging given that there are various of available treatment options with no clear gold standard. The aim of the study was to examine the dose-escalation effect of rESWT on the biomechanical parameters of the plantar fascia and pain ailments. In the experimental group ( = 30), the intensity of the shock wave was increased every two subsequent treatment sessions. In the control group ( = 32), the treatment parameters were not changed. In both groups, six treatments were performed, with two treatment sessions a week. In order to assess the biomechanical parameters of the plantar fascia, myotonometric measurements were performed. The pain intensity was assessed using the Visual Analog Scale (VAS). The tension of the plantar fascia attachment in the experimental group decreased from 27.69 ± 2.06 [Hz] before treatment to 26.29 ± 1.69 [Hz] after treatment ( = 0.009) and to 26.03 ± 2.15 [Hz] 1 month after the beginning of treatment ( = 0.003). In the control group, the frequency results did not change significantly ( > 0.05). Flexibility increased in both groups. The test results before treatment and 1 month after the beginning of the treatment showed statistical significance in the experimental group ( = 0.001) vs. ( = 0.002) in the control group. The differences were not statistically significant between groups ( > 0.05). The assessment of pain intensity carried out 1 month after the end of treatment in the experimental group amounted to 3.14 ± 2.28 points, which was statistically significantly lower compared to that in the control group, where it amounted to 5.14 ± 1.92 points. ( < 0.001). The use of rESWT performed with an increasing intensity of impact during subsequent treatment procedures demonstrated greater effectiveness in improving the biomechanical parameters of the plantar fascia and was also more effective in reducing the pain ailments. Our results are encouraging. The dose escalation in the treatment cycle is worth considering. To prove that this method of treatment is more effective, a randomized controlled trial should be carried out on a representative sample.
治疗慢性足底筋膜炎具有挑战性，因为有多种治疗方法可供选择，没有明确的金标准。本研究旨在探讨 rESWT 对足底筋膜生物力学参数和疼痛疾病的递增剂量效应。实验组（n=30）的冲击波强度在随后的两次治疗中逐渐增加。对照组（n=32）的治疗参数没有改变。两组均进行 6 次治疗，每周 2 次治疗。为了评估足底筋膜的生物力学参数，进行了肌电测量。使用视觉模拟评分（VAS）评估疼痛强度。实验组足底筋膜附着处的张力从治疗前的 27.69±2.06[Hz]下降到治疗后的 26.29±1.69[Hz]（=0.009）和治疗开始后 1 个月的 26.03±2.15[Hz]（=0.003）。对照组的频率结果没有明显变化（>0.05）。两组的柔韧性均增加。实验组治疗前和治疗开始后 1 个月的测试结果具有统计学意义（=0.001）与对照组（=0.002）相比。组间差异无统计学意义（>0.05）。实验组治疗结束后 1 个月评估的疼痛强度为 3.14±2.28 分，明显低于对照组的 5.14±1.92 分（<0.001）。rESWT 治疗过程中随着冲击强度的增加，改善了足底筋膜的生物力学参数，也更有效地减轻了疼痛症状。我们的结果令人鼓舞。在治疗周期中增加剂量值得考虑。为了证明这种治疗方法更有效，应该在有代表性的样本中进行随机对照试验。
