Magnetic Resonance Imaging and Clinical Outcomes of Laser Therapy, Ultrasound Therapy, and Extracorporeal Shock Wave Therapy for Treatment of Plantar Fasciitis: A Randomized Controlled Trial (original) (raw)
Related papers
International Journal of Rheumatology, 2020
Objective. Low-level laser therapy (LLLT) and extracorporeal shock wave therapy (ESWT) is applied in the conservative treatment of inflammatory plantar fasciitis, which is also a characteristic feature of spondyloarthritis (SpA) (Gill, 1997 and Roxas, 2005). We determined and compared the effectiveness of LLLT and ESWT using magnetic resonance imaging (MRI). Methods. This study is a prospective, randomized, comparative, single-blind clinical study. Voluntarily followed 40 patients with the diagnosis of SpA and having pain at the heels at least for 6 months. Patients were divided randomly into two treatment groups. One group undertook 14 sessions of infrared Ga-Al-As LLLT, and the other group undertook 3 sessions ESWT. Feet functions of the patients were evaluated by American Orthopaedic Foot and Ankle Society (AOFAS) and Roles and Maudsley Scoring; VAS was evaluated for foot pain and function. In clinical assessment, disease activity was carried out by applying the BASDAI, the functional assessment was evaluated through the BASFI, and the patient quality of life was evaluated through the ASQoL; enthesitis was scored according to MASES assessment, performed before and at 1 month after treatment. The thickness of the plantar fascia was measured with MRI before and 1 month after treatment. Results. Compared with the pretherapy, progress in the feet function by AOFAS and Roles-Maudsley scoring and decrease in VAS levels were statistically significant in both groups (p < 0:001). Only the VAS exercise score was superior to LLLT (p < 0:05). The thickness of the plantar fascia had decreased significantly on MRI in all two groups. Conclusion. The treatment of plantar fasciitis with LLLT and ESWT was more successful in pain improvement and functional outcomes with the dose, frequency, and duration used in our study.
Journal of the American Podiatric Medical Association, 2018
Background: Extracorporeal shockwave therapy (ESWT) has recently been used as a new treatment modality for plantar fasciitis. We aimed to determine the efficacy of ESWT by magnetic resonance imaging (MRI) findings. Methods: Thirty patients with plantar fasciitis who had received no treatment for 6 months were included. Extracorporeal shockwave therapy was applied once a week for a total of three sessions (frequency of 12-15 Hz, 2-3 bars, and 2,500 pulses). All of the patients were assessed with the visual analog scale, a 6-point evaluation scale, the Foot and Ankle Outcome Score (FAOS), and MRI findings before and 3 months after ESWT. Visual analog scale scores were used in determining the pain level of patients in the morning, during activity, and at rest. Foot and ankle-related problems were evaluated with the FAOS. Results: The duration of painless walking according to the 6-point rating scale, the FAOS, and pain showed significant improvements after ESWT (P , .05). Significant decreases in MRI findings, including thickening of the plantar fascia, soft-tissue edema, and bone marrow edema, were observed after treatment (P , .05). Conclusions: Extracorporeal shockwave therapy is a safe and effective treatment that yields favorable results in improvement of pain and function for plantar fasciitis. An MRI is useful for determining response to ESWT for these patients.
Suez Canal University Medical Journal, 2018
Objectives: to compare and evaluate the effectiveness of extracorporeal shock wave therapy (ESWT) and low-level laser therapy (LLLT) using diagnostic ultrasound (US) in the management of chronic plantar fasciitis (PF). Patients and Methods: The study was done as a prospective, randomized, comparative clinical study. Patients with PF were randomly allocated into 2 groups: ESWT (n= 23), LLLT (n= 23), group 1 underwent 2 sessions of ESWT (2050 shocks, 2.5 bars) and group 2 underwent 6 sessions of LLLT (27 J/cm2; 830 nm). All patients were assessed using the visual analog scale (VAS), foot function index (FFI) and diagnostic US to measure plantar fascia thickness and to assess echogenicity before and 1 month after treatment. Results: There were significant improvement after one month of treatment in the mean VAS, FFI, thickness of the plantar fascia and echogenicity in both groups. LLLT proved significantly superior to ESWT in pain relief (p = 0.029), but no significant difference between both groups in FFI improvement (p= 0 .264). No statistically significant difference between both groups regarding improvement in US findings including plantar fascia thickness (p= 0.885) and echogenicity (p= 0.34). Conclusion: LLLT proved to be more effective than ESWT in pain relief in patients with PF after one month of treatment.
Foot (Edinburgh, Scotland), 2017
The objective of this study is to examine the relationships between treatment outcome and changes in magnetic resonance (MR) imaging findings after extracorporeal shock wave therapy (ESWT) for chronic plantar fasciitis. The subjects were 23 feet of 23 patients of refractory plantar fasciitis. The mean age was 53.7 years. The thickness of the plantar fascia (PF) and findings of a high-signal intensity area (HSIA) inside the PF, edema around the PF, and bone marrow edema (BME) of the calcaneus were investigated on MR images. The Japanese Society for Surgery of the Foot (JSSF) ankle-hindfoot scale and a visual analogue scale (VAS) were used. Correlations between an improvement in symptoms and one in the MRI findings were analyzed. The mean thickness of the PF was 4.4±1.6mm before ESWT and 4.6±1.8mm six months after ESWT. After ESWT, there was a decrease in the numbers of feet showing HSIA inside the PF from 15 to 6, in edema around the PF from 16 to 2, and in BME of the calcaneus from ...
Effects of Conventional Ultrasound V/S Low Level Laser Treatment in Chronic Plantar Fasciitis
https://ijshr.com/IJSHR\_Vol.4\_Issue.3\_July2019/IJSHR\_Abstract.0010.html, 2019
Background: Plantar fasciitis is one of the common soft-tissue disorders of the foot, yet little is known about its aetiology. The purpose of the present study was to see the effects of the conventional ultrasound and low level laser treatment on plantar fasciitis. Aim and objective: To study the effects of conventional ultrasound versus low level laser treatment on pain disability in chronic plantar fasciitis. Methods: 52 participants were selected according to the inclusion and exclusion criteria and consent was taken. Participants were divided into Group A, Group B. Group A were given therapeutic conventional ultrasound along with stretching exercises and Group B were given LLLT along with stretching exercises. Participants were assessed for plantar fasciitis using Foot Function Index and Maryland foot score. Assessment was done on pre and post intervention on Day 1, 7, 14, 21, 28 i.e. study duration was four weeks. Results: The P value of Group A is <0.0001 and Group B is <0.0001.The comparative p value of two group is <0.05. Conclusion: In this study we conclude that, LLLT is more effective on pain disability in chronic plantar fasciitis than Conventional ultrasound. Keywords: Therapeutic conventional ultrasound, LLLT, Plantar fasciitis, Foot Function Index, Maryland Foot Score, Stretching Exercises
Acta Informatica Medica, 2019
Introduction: Patients with plantar fasciitis usually suffer from reduced mobility due to the pain caused by the movement of the tendons involved. Aim: This study was aimed to compare both shockwave and ultrasound therapies in patients with plantar fasciitis by assessing the pain intensity, and both the functionality of the lower limbs and the quality of life impairments. Methods: Total amount of 88 patients with plantar fasciitis constituted the shockwave group, 56 the ultrasound group and 15 the control group. The self-administered questionnaire "University of Peloponnese Pain, Functionality and Quality of Life Questionnaire" was used. The intensity of pain, functionality impairment and quality of life impairment were evaluated on a five-point Likert scale, before treatment, immediately after and at 4-week follow-up. Results: The pain reduction and the improvement of functionality and quality of life after shockwave treatment and ultrasound treatment significantly increased both post-treatment (p<0,001) and at the 4-week follow-up (p<0,001) compared to post-treatment. However, the improvements in the ultrasound group were not as pronounced as in shockwave group (p<0,001). Conclusions: Although both radial shockwave and ultrasound therapies were found to be effective in patients with plantar fasciitis, the statistical analysis showed that radial shockwave is significantly more effective than ultrasound therapy.
International Journal of Clinical Skills, 2017
Objective: To compare the effects of low-level laser therapy and ultrasound therapy in subjects with chronic plantar fasciitis in reducing pain and improving function. Methods: Experimental study design, Comparative study type. 30 subjects were selected and divided into 2 groups & each group consisted of 15 members assessed with Foot function index and Visual analogue scale. Results: Statistical analysis was done by using paired 't' test which showed significant improvement in both groups. Therefore, there is a significant difference between Group-A and Group-B, showing that low-level laser therapy (LLLT) is more effective than the ultrasound(US) therapy with exercises on chronic plantar fasciitis (p <0.05). Conclusion: Low-level laser therapy has shown significant result in reduction of pain and improving function in subjects with chronic plantar fasciitis.
Journal of exercise rehabilitation, 2018
This study was conducted to compare the acute effects of radial extracorporeal shockwave therapy (r-ESWT), ultrasound (US) therapy and home exercise therapy on pain, fatigue, performance and walking distance in women with plantar fasciitis (PF). Fifty-four female patients diagnosed with PF participated in the study. The patients were randomly divided into 3 groups as r-ESWT and home exercise groups, US and home exercise groups, and only home exercise groups. Patients' pain and fatigue levels were assessed by using a visual analog scale. Also walking distances, walking speed and plantar flexor muscles performance were assessed. Patients' pain at night before bedtime and leg fatigue after the 6-min walking test decreased in the US therapy group in comparison to the other two groups (<0.05). The 20-m walking speed improved in the US and r-ESWT therapy groups following the treatments (<0.05) and there was no difference between the groups. After treatment, while the 20-m wa...
IOSR Journals , 2019
Plantar fasciitis is the most common cause of heel pain. Approximately 10% of the United States population experiences bouts of heel pain, which results in 1 million visits per year to medical professionals for the treatment.Extracorporeal shock wave therapy(ESWT) is a new therapeutic modality and has become increasingly used worldwide in the treatment of plantar fasciitis. Despite increasing use of ESWT, its effectiveness is still controversial. A randomized controlled trial was conducted in the Department of Physical Medicine and Rehabilitation (PMR),Regional Institute of Medical Sciences(RIMS), Imphalamong patients suffering from planter fasciitis from September 2016 to August 2018.Patients were randomizedinto theintervention (ESWT)and control (Ultrasound therapy) groups (n=36 in each group).The outcome of interest were VAS and MRM scores which were assessed at the end of 1 st , 3 rd and 6 th months. Independent Sample t-test was used for analysis between the groups and paired t-test was used in analysis within the groups. Out of the 72 patients recruited, majority were females(68%). The mean age of the study participants was 44.91±10.2 years in the intervention group and 41.88 ±11.6 years in the control group.Both groups showed significant improvement over the course of the study (p<0.001), though VAS scores and MRM scores were significantly more reduced in the ESWT group than ultrasound therapy group. The study thus shows that ESWT is more effective than Ultrasound therapy in the management of plantar fasciitis.