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Meta-analysis of shockwave therapy for plantar fasciitis

Discussion in 'Biomechanics, Sports and Foot orthoses' started by NewsBot, Jul 4, 2013.

  1. NewsBot

    NewsBot The Admin that posts the news.

    Articles:
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    Extracorporeal Shock Wave Therapy Is Effective In Treating Chronic Plantar Fasciitis: A Meta-analysis of RCTs.
    Aqil A, Siddiqui MR, Solan M, Redfern DJ, Gulati V, Cobb JP.
    Clin Orthop Relat Res. 2013 Jun 2013
     
  2. Admin2

    Admin2 Administrator Staff Member

  3. NewsBot

    NewsBot The Admin that posts the news.

    Articles:
    1
    Meta-analysis of high-energy extracorporeal shockwave therapy in recalcitrant plantar fasciitis
    Zhiyun Li, Tao Jin, Zengwu Shao
    Swiss Med Wkly. 2013;143:w13825
     
  4. NewsBot

    NewsBot The Admin that posts the news.

    Articles:
    1
    Effectiveness of Extracorporeal Shock Wave Therapy Without Local Anesthesia in Patients With Recalcitrant Plantar Fasciitis: A Meta-Analysis of Randomized Controlled Trials.
    Lou, Jing MD; Wang, Shuai MD; Liu, Shuitao PhD, MD; Xing, Gengyan PhD, MD
    American Journal of Physical Medicine & Rehabilitation: December 9, 2016
     
  5. NewsBot

    NewsBot The Admin that posts the news.

    Articles:
    1
    Extracorporeal shock wave therapy is effective in treating chronic plantar fasciitis: A meta-analysis of RCTs.
    Sun J, Gao F, Wang Y, Sun W, Jiang B, Li Z.
    Medicine (Baltimore). 2017 Apr;96(15):e6621. doi: 10.1097/MD.0000000000006621.
     
  6. eddavisdpm

    eddavisdpm Active Member

    The author makes a good point about variations in study design.
    One variable that need be addressed is inclusion criteria for studies. Criteria such as "recalcitrant" plantar fasciitis based on treatment failures are weak in that treatment failures occur for numerous reasons such as lack of biomechanical control and so on. ESWT is, more precisely, not a treatment for plantar fasciitis but a treatment for plantar fasciosis. Sonographic imaging readily determines plantar fascial thickness and fascial "texture" (hypoechogenicity, loss of fibrillar pattern of fascia) and should be the primary inclusion criterion.

    ESWT demonstrates a fairly consistent effect on fascial thickness and texture, that is, thinning of the fascia and restoration of the normal fibrillar pattern in my experience. Early studies had shown thickness reduction in the 25 to 30 percent range at the end of 20 weeks post treatment which appears consistent with my clinical experience. While use of VAS scales has value, I would prefer studies to include before and after sonographic imaging/measurements as a more objective criterion.

    Sonography allows the practitioner to distinguish between three stages of plantar "fasciitis," acute, chronic and fasciosis. Acute plantar fasciitis is essentially a sprain of the fascia demonstrating only mild to moderate increases in fascial thickness but acute changes such as a zone of hypoechogenicity often superficial to the fascial origin. Chronic plantar fasciitis demonstrates thickening of the fascia but without interruption of the normal fibrillar pattern. Fasciosis demonstrates the changes mentioned above. The authors use of the term chronic plantar fasciitis is problematic in that, again, ESWT is not really a treatment for that entity.
     
  7. NewsBot

    NewsBot The Admin that posts the news.

    Articles:
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    Treatment of Plantar Fasciitis With Radial Soundwave “Early” Is Better Than After 6 Months: A Pilot Study
    Amol Saxena et al
    JFAS; September–October, 2017Volume 56, Issue 5, Pages 950–953
     
  8. NewsBot

    NewsBot The Admin that posts the news.

    Articles:
    1
    Effectiveness of Extracorporeal Shock Wave Therapy Without Local Anesthesia in Patients With Recalcitrant Plantar Fasciitis: A Meta-Analysis of Randomized Controlled Trials.
    Lou J et al
    Am J Phys Med Rehabil. 2017 Aug;96(8):529-534. doi: 10.1097/PHM.0000000000000666.
     
  9. NewsBot

    NewsBot The Admin that posts the news.

    Articles:
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    Long-term results of radial extracorporeal shock wave treatment for chronic plantar fasciopathy: A prospective, randomized, placebo-controlled trial with two years follow-up.
    Ibrahim MI et al
    J Orthop Res. 2017 Jul;35(7):1532-1538. doi: 10.1002/jor.23403. Epub 2016 Sep 16.
     
  10. NewsBot

    NewsBot The Admin that posts the news.

    Articles:
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    The effectiveness of extracorporeal shockwave therapy in common lower limb conditions: a systematic review including quantification of patient-rated pain reduction
    Vasileios Korakakis et al
    BMJ
     
  11. NewsBot

    NewsBot The Admin that posts the news.

    Articles:
    1
    Extracorporeal Shockwave Therapy Plus Rehabilitation for Patients With Chronic Plantar Fasciitis Might Reduce Pain and Improve Function but Still Not Lead to Increased Activity: A Case-Series Study With Multiple Outcome Measures
    Patrick C. Wheeler et al
    JFAS; Article in Press
    Plantar fasciitis is a common cause of plantar-aspect heel pain. Although many patients will improve, a proportion will have ongoing and sometimes debilitating symptoms. Evidence from randomized controlled trials has shown that extracorporeal shockwave therapy (ESWT) results in benefits in treating pain. However, uncertainties remain whether these benefits translate to improvements in overall function. The present prospective case series examined the results from 35 patients with chronic plantar fasciitis who had undergone a course of ESWT in addition to a graded rehabilitation program. Of the 35 subjects, 34% were male, and the median age was 50.9 years. The duration of symptoms before ESWT was 24 months. The results of the present case series demonstrated statistically significant improvements in measures of self-reported “average pain” from a median of 7.0 of 10 at baseline to 5.0 of 10 at 3 months (p < .001) and of “worst pain” from 9.0 of 10 at baseline to 7.0 of 10 at 3 months (p < .001). In addition, significant improvements were found in several validated patient-rated outcome measures of local foot/ankle function but not in overall markers of health, anxiety/depression scores, or activity levels, despite the improvements in pain. No statistically significant correlations were found between gender, age, or chronicity of symptoms and the improvements seen. No significant side effects occurred in the present study. The results of our series support the use of ESWT for patients with chronic plantar fasciitis for local pain symptoms; however, uncertainties remain regarding global benefits to health.
     
  12. NewsBot

    NewsBot The Admin that posts the news.

    Articles:
    1
    Analgesic Effect of Low Energy Extracorporeal Shockwave Therapy on Chronic Plantar Fasciitis: A Randomized, Placebo-Controlled, Clinical Trial
    Amirreza Aftabi et al
    Journal of Clinical Physiotherapy Research
     
  13. NewsBot

    NewsBot The Admin that posts the news.

    Articles:
    1
    Effect of Extracorporeal Shockwave Therapy on Passive Ankle Stiffness in Patients With Plantar Fasciopathy
    Wei-Hsiu Hsu et al
    JFAS; Article in Press
     
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