PDF(Pubmed)
Abstract：
BACKGROUND: Plantar fasciitis (PF) is the most common cause of heel pain. Among conservative treatments, extracorporeal shock wave therapy (ESWT) is considered effective for refractory PF. Studies have shown that applying ESWT to the trigger points (TrPs) in the triceps surae may play an important role in pain treatment in patients with PF. Therefore, the purpose of this study was to combine the concept of trigger points and ESWT to explore the effect of this combination on plantar temperature and pressure in patients with PF.
METHODS: After applying inclusion and exclusion criteria, 86 patients with PF were recruited from the pain clinic of Huadong Hospital, Fudan University and randomly divided into experimental (n = 43) and control groups (n = 43). The experimental group was treated with extracorporeal shock waves to treat the medial heel pain point and the gastrocnemius and soleus TrPs. The control group was only treated with extracorporeal shock waves at the medial heel pain point. The two groups were treated twice with an interval of 1 week. Primary measurements included a numerical rating scale (NRS) score (overall, first step, heel pain during daily activities), and secondary measurements included heel temperature, Roles-Maudsley score (RMS), and plantar pressure. All assessments were performed before treatment (i.e., baseline) and 6 and 12 weeks after treatment.
RESULTS: During the trial, 3 patients in the experimental group withdrew from the study, 2 due to interruption of the course of treatment by the COVID-19 epidemic and 1 due to personal reasons. In the control group, 3 patients fell and were removed due to swelling of the heel. Therefore, only 80 patients with PF were finally included. After treatment, the two groups showed good results in NRS score (overall, first step, heel pain during daily activities), RMS, and plantar temperature, especially in the experimental group, who showed a significantly better effect than the control group.
CONCLUSIONS: ESWT of the heel combined with the triceps trigger point of the calf can more effectively improve the pain, function and quality of life of refractory PF than ESWT of the heel alone. In addition, ESWT of the heel combined with the triceps trigger point of the calf can effectively reduce the skin temperature of the heel on the symptomatic side, indicating that the heel temperature as measured by infrared thermal imaging may be used as an independent tool to evaluate the therapeutic effect for patients with chronic PF. Although extracorporeal shock waves combined with TrPs treatment can cause changes in the patients\' gait structure, plantar pressure is still difficult to use as an independent tool to evaluate the therapeutic effect for PF.
BACKGROUND: Registered in the Chinese Clinical Trial Registry ( www.chictr.org.cn ) on 12/17/2021 with the following code: ChiCTR-INR-2,100,054,439.
METHODS: After applying inclusion and exclusion criteria, 86 patients with PF were recruited from the pain clinic of Huadong Hospital, Fudan University and randomly divided into experimental (n = 43) and control groups (n = 43). The experimental group was treated with extracorporeal shock waves to treat the medial heel pain point and the gastrocnemius and soleus TrPs. The control group was only treated with extracorporeal shock waves at the medial heel pain point. The two groups were treated twice with an interval of 1 week. Primary measurements included a numerical rating scale (NRS) score (overall, first step, heel pain during daily activities), and secondary measurements included heel temperature, Roles-Maudsley score (RMS), and plantar pressure. All assessments were performed before treatment (i.e., baseline) and 6 and 12 weeks after treatment.
RESULTS: During the trial, 3 patients in the experimental group withdrew from the study, 2 due to interruption of the course of treatment by the COVID-19 epidemic and 1 due to personal reasons. In the control group, 3 patients fell and were removed due to swelling of the heel. Therefore, only 80 patients with PF were finally included. After treatment, the two groups showed good results in NRS score (overall, first step, heel pain during daily activities), RMS, and plantar temperature, especially in the experimental group, who showed a significantly better effect than the control group.
CONCLUSIONS: ESWT of the heel combined with the triceps trigger point of the calf can more effectively improve the pain, function and quality of life of refractory PF than ESWT of the heel alone. In addition, ESWT of the heel combined with the triceps trigger point of the calf can effectively reduce the skin temperature of the heel on the symptomatic side, indicating that the heel temperature as measured by infrared thermal imaging may be used as an independent tool to evaluate the therapeutic effect for patients with chronic PF. Although extracorporeal shock waves combined with TrPs treatment can cause changes in the patients\' gait structure, plantar pressure is still difficult to use as an independent tool to evaluate the therapeutic effect for PF.
BACKGROUND: Registered in the Chinese Clinical Trial Registry ( www.chictr.org.cn ) on 12/17/2021 with the following code: ChiCTR-INR-2,100,054,439.
摘要：
背景：足底筋膜炎（PF）是足跟痛的最常见原因。在保守治疗中，体外冲击波治疗（ESWT）被认为对难治性PF有效。研究表明，将ESWT应用于小腿三头肌的触发点（TrP）可能在PF患者的疼痛治疗中起重要作用。因此,这项研究的目的是结合触发点和ESWT的概念，以探讨该组合对PF患者足底温度和压力的影响。
方法：应用纳入和排除标准后，从华东医院疼痛门诊招募了86例PF患者，复旦大学随机分为实验组(n=43)和对照组(n=43)。实验组采用体外冲击波治疗足跟内侧痛点及腓肠肌和比目鱼肌TrPs。对照组仅在足跟内侧疼痛点给予体外冲击波治疗。两组均治疗两次,间隔1周。主要测量包括数字评定量表(NRS)评分(总体，第一步,日常活动中的足跟疼痛)，二次测量包括脚跟温度，Roles-Maudsley评分(RMS),和足底压力。所有评估均在治疗前进行(即，基线）以及治疗后6周和12周。
结果：在试验期间，实验组有3名患者退出研究，2是由于COVID-19疫情导致治疗过程中断，1是由于个人原因。在对照组中，3名患者跌倒并由于脚跟肿胀而被移除。因此,最终仅纳入80例PF患者。治疗后,两组在NRS评分方面均表现良好(总体而言，第一步,日常活动中的足跟疼痛)，RMS,和足底温度，尤其是在实验组，显着优于对照组。
结论：脚跟的ESWT结合小腿三头肌触发点可以更有效地改善疼痛，难治性PF的功能和生活质量比ESWT单独的足跟。此外,脚跟的ESWT结合小腿三头肌触发点可以有效降低症状侧脚跟的皮肤温度，表明通过红外热成像测量的足跟温度可以用作评估慢性PF患者治疗效果的独立工具。尽管体外冲击波结合TrP治疗可引起患者步态结构的改变，足底压力仍然难以作为评估PF治疗效果的独立工具。
背景：在中国临床试验注册中心注册（www。chictr.org.cn)于2021年12月17日，代码如下：ChiCTR-INR-2,100,054,439。
方法：应用纳入和排除标准后，从华东医院疼痛门诊招募了86例PF患者，复旦大学随机分为实验组(n=43)和对照组(n=43)。实验组采用体外冲击波治疗足跟内侧痛点及腓肠肌和比目鱼肌TrPs。对照组仅在足跟内侧疼痛点给予体外冲击波治疗。两组均治疗两次,间隔1周。主要测量包括数字评定量表(NRS)评分(总体，第一步,日常活动中的足跟疼痛)，二次测量包括脚跟温度，Roles-Maudsley评分(RMS),和足底压力。所有评估均在治疗前进行(即，基线）以及治疗后6周和12周。
结果：在试验期间，实验组有3名患者退出研究，2是由于COVID-19疫情导致治疗过程中断，1是由于个人原因。在对照组中，3名患者跌倒并由于脚跟肿胀而被移除。因此,最终仅纳入80例PF患者。治疗后,两组在NRS评分方面均表现良好(总体而言，第一步,日常活动中的足跟疼痛)，RMS,和足底温度，尤其是在实验组，显着优于对照组。
结论：脚跟的ESWT结合小腿三头肌触发点可以更有效地改善疼痛，难治性PF的功能和生活质量比ESWT单独的足跟。此外,脚跟的ESWT结合小腿三头肌触发点可以有效降低症状侧脚跟的皮肤温度，表明通过红外热成像测量的足跟温度可以用作评估慢性PF患者治疗效果的独立工具。尽管体外冲击波结合TrP治疗可引起患者步态结构的改变，足底压力仍然难以作为评估PF治疗效果的独立工具。
背景：在中国临床试验注册中心注册（www。chictr.org.cn)于2021年12月17日，代码如下：ChiCTR-INR-2,100,054,439。
