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'Electric shoes' for plantar fasciitis

Discussion in 'Biomechanics, Sports and Foot orthoses' started by Simon Spooner, Jan 10, 2010.

  1. Griff

    Griff Moderator

    Re: electric shoes for plantar fasciitis

    Wot, no control group?
     
  2. Re: electric shoes for plantar fasciitis

    Obviously! The other obvious thing is that the pre treatment was measured in the patients own shoes, then they were measured in different shoes! It would make a lovely placebo controlled trial for someone. Same shoes, one group with the piezoelectric generator connected, the other group without.
     
  3. Re: electric shoes for plantar fasciitis

    I wonder if these little babies with the microcurrent produce a little heat which could keep the Plantar Fascia warm and more elastic etc.
     
  4. Griff

    Griff Moderator

    Re: electric shoes for plantar fasciitis

    Simon,

    According to the power calculator I use, a sample size of n=10 with the significance level set at p<0.05 - even with a large effect size (Cohen) - this would give this a power of only 35% or so. A small effect size and we are looking at more like 5% statistical power.

    If I could borrow your research methods expertise for a mo - firstly, are my figures about right on this? If so I reckon to achieve acceptable statistical power then n=40 ish?

    Ian
     
  5. Re: electric shoes for plantar fasciitis

    I tend to use Cohen's expertise when it comes to statistical power too. As you said it depends on the effect size. Without looking it up (i.e. off the top of my head), effect size (mu) comes down to the detectable difference in measures, so it depends on what you calculate the effect size as.

    EDIT, OK you made me look it up- CPD in action!
    "Cohen (1977) provides tables of power (1-beta) as a function of the significance criteria (alpha) and the probability of detecting a clinically relevant difference (delta). Alpha is commonly set at 0.05. The probability of detecting a clinically relevant difference (delta) is given by:
    delta = gamma root(n/2)

    where gamma = population effect size, n =sample size

    Gamma = mu /SD

    Where mu= minimal detectable difference in measurements, SD= pooled standard deviation"

    Spooner SK: Predictors of Hallux Valgus, PhD Thesis, University of Leicester 1998
     
  6. Years ago I worked as the equipment tech at a large chronic pain clinic that was staffed by anesthesiologists, physical medicine & rehab specialists, and physical and occupational therapists. The clinicians there used a protocol that included physical therapy, nerve blocks, pain medication, and electrostimulation.

    The basic form of electrotherapy (TENS) is shown only to block the brain's perception of pain. A different waveform (galvanic or high volt pulsed current) has objective studies showing that this modality can reduce edema and muscle spasms. It has been also used effectively in chronic wound healing to speed up the healing process and has been reported to increase tensile strength of healed tissue. NMES or neuromuscular electrical stimulators have a wave form that is more comfortable than a TENS waveform and can cause the targeted muscle group to contract and to relax. So NMES are used for reducing atrophy or for pumping more blood through a muscle group by passively exercising those muscles. Interferrential estim is a mix of TENS and NMES waveforms so patients experience pain relief and increased blood flow to the treatment area. Microcurrent is a somewhat puzzling form of estim (at least for me) with less clinical documentation so I did not have much experience with it. Most physicians in the United States that refer patients to physical therapy with an "evaluate and treat" Rx are having estim done as one of the modalities used on their patients with soft tissue injuries if the therapist is not one who thinks that only manual therapy (stretching, resistance training, etc.) is the sole (no pun intended) solution to all problems. The advantage of some of the estim modalities is that small home units can be rented and used by patients on a daily basis and speed up the recovery process versus having therapy 2-3 times a week at a clinic. I have had a few local podiatrists order after foot surgery home estim (HVPC or interferrential) to increase blood flow to speed the recovery process and to reduce pain. There are relatively few adverse effects and if skin irritation from electrodes occurs, stopping therapy is a matter of not doing the next treatment, unlike a medication that might take time to metabolize out of one's system. There is one company that makes a conductive garment (silver fibers woven into material to conduct current) that fits the lower limb. Their estim unit (HVPC) has a night time setting that turns unit on and off during sleep so that therapy can be done while sleeping. We found this unit to have positive results in diabetic neuropathy with improvements in sensation and/or reduction in hypersensitivity symptoms. When one considers how much our body depends on the flow of electrical charges, adding electrostimulation to one's practice could offer new options to treat routine or difficult cases involving rehab, recovery from surgery, wound healing, chronic inflammation, and other soft tissue conditions.
     
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