Background

Investigating outcomes following radial-extra-corporeal-shockwave-therapy (rESWT) in patients with chronic plantar fasciopathy

Methods

This double-blinded RCT in a single NHS Sports medicine clinic recruited 117 patients with chronic plantar fasciopathy randomised equally to either 3 sessions of rESWT or “minimal-dose” respectively. Mean age 51.7 ± 9.6 years, 66 % female, symptom duration: 32.6 ± 30.8 months.

Results

“Average pain” improved by 50 % at 6-months, (>1/3 at interim time-points). Statistically significant within-group improvements were identified in pain, local function, and “ability” PROMs in both groups. Fewer benefits in activity levels or mood. No between-group differences were seen at the interim or final time-points.

Conclusion

3 sessions of “recommended-dose” rESWT is non-superior to “minimal-dose” rESWT in patients with chronic plantar fasciopathy. rESWT may be ineffective in the treatment of patients with chronic plantar fasciopathy, “minimal-dose” rESWT may be sufficient for a therapeutic effect, or a greater number of treatment sessions may be required for benefit.

Level of evidence

Level I – Randomised controlled trial

中文翻译：

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对于慢性足底筋膜病患者，径向体外冲击波疗法 (rESWT) 并不优于“最小剂量”rESWT；双盲随机对照试验

背景

研究慢性足底筋膜病患者接受径向体外冲击波治疗 (rESWT) 后的结果

方法

这项在单一 NHS 运动医学诊所进行的双盲 RCT 招募了 117 名慢性足底筋膜病患者，分别平均分配至 3 次 rESWT 或“最小剂量”。平均年龄 51.7 ± 9.6 岁，66% 为女性，症状持续时间：32.6 ± 30.8 个月。

结果

“平均疼痛”在 6 个月时改善了 50%（在中间时间点>1/3）。两组在疼痛、局部功能和“能力”PROM 方面都发现了具有统计学意义的组内改善。活动水平或情绪方面的好处较少。在中期或最终时间点未见组间差异。

结论

在慢性足底筋膜病患者中，3 次“推荐剂量”rESWT 并不优于“最小剂量”rESWT。rESWT 可能对慢性足底筋膜病患者的治疗无效，“最小剂量”rESWT 可能足以产生治疗效果，或者可能需要更多的治疗次数才能获益。

证据等级

I 级 – 随机对照试验