Rompe, J Bone Joint Surg Am 2010 - Plantar Fascia-Specific Stretching versus Radial Shock-Wave Therapy as Initial Treatment of Plantar Fasciopathy

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Plantar Fascia-Specific Stretching versus Radial Shock-Wave Therapy as Initial Treatment of Plantar Fasciopathy

Rompe, Maffulli, et al.·J Bone Joint Surg Am·2010·121 citations·RCT

Background

Whether plantar fascia-specific stretching or shock-wave therapy is effective as an initial treatment for proximal plantar fasciopathy remains unclear. The aim of this study was to test the null hypothesis of no difference in the effectiveness of these two forms of treatment for patients who had unilateral plantar fasciopathy for a maximum duration of six weeks and which had not been treated previously.

Methods

102 patients with acute plantar fasciopathy were randomly assigned to perform an 8-week plantar fascia-specific stretching program (Group I, n = 54) or to receive repetitive low-energy radial shock-wave therapy without local anesthesia, administered weekly for 3 weeks (Group II, n = 48).
All patients completed the 7-item pain subscale of the validated Foot Function Index and a patient-relevant outcome questionnaire.
Patients were evaluated at baseline and at 2, 4, and 15 months after baseline.
The primary outcome measures were a mean change in the Foot Function Index sum score at 2 months after baseline, a mean change in item 2 (pain during the first few steps of walking in the morning) on this index, and satisfaction with treatment.

Results

No difference in mean age, sex, weight, or duration of symptoms was found between the groups at baseline.
At 2 months after baseline, the Foot Function Index sum score showed significantly greater changes for the patients managed with plantar fascia-specific stretching than for those managed with shock-wave therapy (p < 0.001), as well as individually for item 2 (p = 0.002).
35 patients (65%) in Group I versus 14 patients (29%) in Group II were satisfied with the treatment (p < 0.001).
These findings persisted at 4 months.
At 15 months after baseline, no significant between-group difference was measured.

Conclusions

A program of manual stretching exercises specific to the plantar fascia is superior to repetitive low-energy radial shock-wave therapy for the treatment of acute symptoms of proximal plantar fasciopathy.

Copyright remains with the authors and publisher.

Plantar Fascia-Specific Stretching versus Radial Shock-Wave Therapy as Initial Treatment of Plantar Fasciopathy

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Plantar Fascia-Specific Stretching versus Radial Shock-Wave Therapy as Initial Treatment of Plantar Fasciopathy

Rompe, Maffulli, et al.·J Bone Joint Surg Am·2010·121 citations·RCT

Background

Whether plantar fascia-specific stretching or shock-wave therapy is effective as an initial treatment for proximal plantar fasciopathy remains unclear. The aim of this study was to test the null hypothesis of no difference in the effectiveness of these two forms of treatment for patients who had unilateral plantar fasciopathy for a maximum duration of six weeks and which had not been treated previously.

Methods

102 patients with acute plantar fasciopathy were randomly assigned to perform an 8-week plantar fascia-specific stretching program (Group I, n = 54) or to receive repetitive low-energy radial shock-wave therapy without local anesthesia, administered weekly for 3 weeks (Group II, n = 48).
All patients completed the 7-item pain subscale of the validated Foot Function Index and a patient-relevant outcome questionnaire.
Patients were evaluated at baseline and at 2, 4, and 15 months after baseline.
The primary outcome measures were a mean change in the Foot Function Index sum score at 2 months after baseline, a mean change in item 2 (pain during the first few steps of walking in the morning) on this index, and satisfaction with treatment.

Results

No difference in mean age, sex, weight, or duration of symptoms was found between the groups at baseline.
At 2 months after baseline, the Foot Function Index sum score showed significantly greater changes for the patients managed with plantar fascia-specific stretching than for those managed with shock-wave therapy (p < 0.001), as well as individually for item 2 (p = 0.002).
35 patients (65%) in Group I versus 14 patients (29%) in Group II were satisfied with the treatment (p < 0.001).
These findings persisted at 4 months.
At 15 months after baseline, no significant between-group difference was measured.

Conclusions

A program of manual stretching exercises specific to the plantar fascia is superior to repetitive low-energy radial shock-wave therapy for the treatment of acute symptoms of proximal plantar fasciopathy.

Copyright remains with the authors and publisher.

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