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Shock wave therapy for plantar fasciopathy doesn't achieve anything in trial!

Discussion in 'Biomechanics, Sports and Foot orthoses' started by scotfoot, Jun 23, 2024.

  1. scotfoot

    scotfoot Well-Known Member


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    200 participants, double blind, randomized and sham controlled. ESWT added nothing over advice and customized foot orthotics.

    "Is radial extracorporeal shock wave therapy (rESWT), sham-rESWT or a standardised exercise programme in combination with advice plus customised foot orthoses more effective than advice plus customised foot orthoses alone in the treatment of plantar fasciopathy? A double-blind, randomised, shamcontrolled trial "

    Marte Heide ,1,2 Cecilie Røe,1,2 Marianne Mørk,1,2 Kjersti Myhre,2 Cathrine Brunborg,3 Jens Ivar Brox,1,2 Aasne Fenne Hoksru


    From paper-

    "WHAT IS ALREADY KNOWN ON THIS TOPIC
    ⇒ Plantar fasciopathy is a common condition. Previous reviews and meta-analyses have not concluded that one treatment is superior to another. ⇒ A recent best practice guide proposed a stepped management strategy with a core approach including education, taping and stretching of the plantar fascia. In cases of suboptimal improvement, additional radial extracorporeal shock wave therapy (rESWT) and custom orthoses were suggested.

    WHAT THIS STUDY ADDS
    ⇒ In patients with plantar fasciopathy who received advice and customised foot orthoses, this randomised controlled trial (RCT) showed no additive effects of rESWT, sham-rESWT or a standardised exercise programme over advice plus customised foot orthoses alone in alleviating heel pain.

    HOW THIS STUDY MIGHT AFFECT RESEARCH, PRACTICE OR POLICY ⇒
    The results indicate that adding rESWT, shamrESWT or exercises in addition to advice plus customised foot orthoses does not improve heel pain for patients with plantar fasciopathy. Research focusing on evaluating and optimising the content and delivery of advice, the use of foot orthoses and RCT’s including ‘a wait and see’ control arm to gain more evidence on the natural course of the condition are warranted"
     
  2. scotfoot

    scotfoot Well-Known Member

    Worth highlighting is that fact that the exercise regime used in the trial mentioned above used exercises that would be unlikely to increase toe flexor strength much, if at all.

    " High-load exercise programme

    The exercise programme administered to the patients allocated to the exercise group included two exercises: unilateral heel raises and unilateral leg squats. Patients in this group were instructed to perform the exercises three times a week for 12 weeks. The heel raise exercise was performed as in the study by Rathleff et al using a rolled-up towel or similar underneath the toes standing on a stairway or similar location21 and the leg squad was performed the same way but standing on the floor. The programme was similarly as reported by Kongsgaard et al30 slowly progressing throughout the period, starting with 12 repetition maximum (RM) in week 1–3, progressing to 6 RM in week 9–12. We used three sets per exercise. "
     
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