[目的]本研究的目的是比较结构诊断和管理(SDM)方法与肌筋膜释放(MFR)方法在改善足底足跟痛中的有效性。踝关节的活动范围,和残疾。[科目]六十四个科目,30-60岁,诊断为足底足跟痛,足底筋膜炎,医生根据ICD-10将跟骨骨刺或跟骨骨刺按医院随机分组和隐蔽分配平均分配到MFR(n=32)和SDM(n=32)组.[方法]在本评估盲法随机临床试验中,对照组对足底表面进行MFR,小腿三头肌,和深的后室小腿肌肉,而实验组在4周内利用SDM概念进行了12个疗程的多模式方法。两组亦接受加强训练,冰压缩,和超声治疗。疼痛,使用通用测角仪对踝关节背屈和足底屈肌进行足功能指数(FFI)和活动范围(ROM)评估,将活动限制和残疾作为主要结局进行评估.次要结果使用足踝残疾指数(FADI)和踝背屈肌和足底屈肌的10点手动肌肉测试过程进行测量。[结果]MFR组和SDM组在所有结果变量中均显示出较基线的显著改善,包括疼痛,活动水平,残疾,运动范围,和功能后12周干预期(p<0.05)。对于FFI疼痛,SDM组显示出比MFR更多的改善(p<0.01),FFI活性(p<0.01),FFI(p<.01)和FADI(p=<.01)。[结论]MFR和SDM均能有效减轻疼痛,改善功能,踝关节的活动范围,减少足底脚跟疼痛的残疾,然而,SDM方法可能是首选的治疗选择。
[Purpose] The purpose of this
study was to compare the effectiveness of the Structural Diagnosis and Management (SDM) approach with Myofascial Release (MFR) in improving plantar heel pain, ankle range of motion, and disability. [Subjects] Sixty-four subjects, aged 30-60 years, with a diagnosis of plantar heel pain, plantar fasciitis, or calcaneal spur by a physician according to ICD-10, were equally allocated to the MFR (n = 32) and SDM (n = 32) groups by hospital randomization and concealed allocation. [Methods] In this assessor-blinded randomized clinical
trial, the control group performed MFR to the plantar surface of the foot, triceps surae, and deep posterior compartment calf muscles, while the experimental group performed a multimodal approach utilizing the SDM concept for 12 sessions over 4 weeks. Both groups also received strengthening exercises, ice compression, and ultrasound therapy. Pain, activity limitations and disability were assessed as primary outcomes using the Foot Function Index (
FFI) and Range of motion (ROM) assessment of the ankle dorsiflexors and plantar flexors using a universal goniometer. Secondary outcomes were measured using the Foot Ankle Disability Index (FADI) and a 10-point manual muscle testing process for the ankle dorsiflexors and plantar flexors. [Results] Both MFR and SDM groups exhibited significant improvements from baseline in all outcome variables, including pain, activity level, disability, range of motion, and function after the 12-week intervention period (p < .05). The SDM group showed more improvements than MFR for
FFI pain (p < .01),
FFI activity (p < .01),
FFI (p < .01) and FADI (p = <.01). [Conclusion] Both MFR and SDM approaches are effective in reducing pain, improving function, ankle range of motion, and reducing disability in plantar heel pain, however, the SDM approach may be a preferred treatment option.