Ong Samuel Sing Li, Mao David Weijia, Socklingam Raj Kumar, Moo Ing How, Kon Kam King Charles
Department of Orthopaedic Surgery, Changi General Hospital, 2 Simei St 3, 529889, Singapore.
J Orthop. 2025 Mar 15;70:25-28. doi: 10.1016/j.jor.2025.03.015. eCollection 2025 Dec.
We aimed to evaluate whether the addition of early extracorporeal shockwave therapy (ESWT) to physiotherapy improved outcomes in patients with acute plantar fasciitis.
We conducted a randomized controlled trial in a tertiary hospital in Singapore. Eligibility criteria were patients ≥21 years old presenting from April 2017 to November 2019 with untreated plantar fasciitis for <1 month with no prior physiotherapy. Exclusion criteria included history of plantar fasciitis, calcaneal fractures, chronic steroid use, pregnancy, chronic limb injuries and risks for venous thromboembolism. Patients were randomized using a random number generator into either Group A (ESWT + physiotherapy) or Group B (physiotherapy only). Visual Analogue Scale (VAS), 36-Item Short Form Survey (SF-36) and American Orthopaedic Foot and Ankle Society (AOFAS) ankle-hindfoot score were measured at baseline and 3 months. T-tests were performed for statistical significance.
46 patients were eligible for the trial. 10 were lost to follow up. 15 in Group A and 21 in Group B were treated and assessed. Mean age was 51.6. Baseline VAS scores were Group A (5.5 ± 2.3) and Group B (6.1 ± 2.1) (p = 0.451). There was no significant difference in 3-month VAS scores between Group A (4.7 ± 2.2) and Group B (5.2 ± 2.6) (p = 0.543). Baseline AOFAS scores were Group A (72.7 ± 12.8) and Group B (73.9 ± 14.2) (p = 0.801). There was also no significant difference in 3-month AOFAS scores between Group A (76.7 ± 5.1) and Group B (77.2 ± 13.4) (p = 0.876). No significant difference in SF-36 scores was seen at 3 months between the two groups.
The addition of early ESWT to physiotherapy did not result in better outcomes compared to physiotherapy alone for acute plantar fasciitis.
我们旨在评估在物理治疗基础上增加早期体外冲击波疗法（ESWT）是否能改善急性足底筋膜炎患者的治疗效果。
我们在新加坡一家三级医院进行了一项随机对照试验。纳入标准为2017年4月至2019年11月期间年龄≥21岁、未经治疗且病程<1个月、未接受过物理治疗的足底筋膜炎患者。排除标准包括足底筋膜炎病史、跟骨骨折、长期使用类固醇、妊娠、慢性肢体损伤以及静脉血栓栓塞风险。使用随机数字生成器将患者随机分为A组（ESWT + 物理治疗）或B组（仅物理治疗）。在基线和3个月时测量视觉模拟量表（VAS）、36项简短健康调查问卷（SF - 36）以及美国矫形足踝协会（AOFAS）踝 - 后足评分。采用t检验进行统计学显著性分析。
46例患者符合试验条件。10例失访。A组15例、B组21例接受治疗并进行评估。平均年龄为51.6岁。基线VAS评分A组为（5.5 ± 2.3），B组为（6.1 ± 2.1）（p = 0.451）。A组3个月时VAS评分为（4.7 ± 2.2），B组为（5.2 ± 2.6），两组间无显著差异（p = 0.543）。基线AOFAS评分A组为（72.7 ± 12.8），B组为（73.9 ± 14.2）（p = 0.801）。A组3个月时AOFAS评分为（76.7 ± 5.1），B组为（77.2 ± 13.4），两组间也无显著差异（p = 0.876）。两组在3个月时SF - 36评分无显著差异。
对于急性足底筋膜炎，在物理治疗基础上增加早期ESWT与单纯物理治疗相比，并未产生更好的治疗效果。
