20511

Plantar fasiit tedavisinde ekstrakorporeal şok dalga tedavisinin etkinliğinin değerlendirilmesi

Amaç: Plantar fasiit tedavisinde egzersiz tedavisine eklenen ekstrakorporeal şok dalga tedavisi (ESWT) müdahalesinin ağrı ve işlevsellik üzerindeki etkinliğinin araştırılması amaçlanmıştır. Yöntemler: Çalışmaya klinik olarak plantar fasiit tanısı almış, şikayetleri 6 aydan uzun süredir olan 18-65 yaş arası 57 katılımcı dahil edildi. Hastalar ESWT (n=29) ve kontrol (n=28) olmak üzere iki gruba ayrıldı. Her iki grupta yer alan katılımcılar plantar fasiite yönelik egzersizleri verilmiş ve ESWT+egzersiz grubuna haftada 1 kere toplam 3 seans olarak ESWT uygulanmıştı. Hastaların ağrı durumları Vizüel Analog Skala (VAS) ile fonksiyonel durumları ise Ayak Fonksiyon İndeksi (AFİ) ile değerlendirilmişti. Bulgular: Yapılan değerlendirmelerde ESWT+egzersiz grubu ve sadece egzersiz tedavisi alan hastalarda 4. hafta ve 8. hafta takiplerinde VAS istirahat ve aktivite değerleri, AFİ değerlerinde anlamlı iyileşme saptandı (p<0,05). İki grup arası karşılaştırmalarda hem 4. hafta hem de 8. hafta değerlendirmelerinde ESWT+egzersiz grubundaki iyileşme egzersiz grubuna göre hem VAS hem de AFİ tüm alt gruplarında istatistiksel olarak anlamlı olarak tespit edildi (p<0,05). Sonuç: Sonuç olarak, plantar fasiit tedavisine egzersiz müdahalesine eklenen ESWT etkin ve güvenli bir tedavi yöntemidir ve ağrıda azalma, fonksiyonellikte iyileşme görülebilmektedir.

Anahtar Kelimeler:

Egzersiz, ekstrakorporeal şok dalga terapisi, plantar fasiit

Evaluation of the efficacy of extracorporeal shockwave therapy in the treatment of plantar fasciitis

Aim: It was aimed to investigate the effectiveness of extracorporeal shockwave therapy (ESWT) intervention in addition to exercise therapy on pain and functionality in the treatment of plantar fasciitis. Methods: A total of 57 participants aged 18-65 years, who were clinically diagnosed with plantar fasciitis and had complaints for more than 6 months, were included in the study. The patients were divided into two groups as ESWT (n=29) and control (n=28). The participants in both groups were given exercises for plantar fasciitis and ESWT was applied to the ESWT+exercise group once a week for a total of 3 sessions. Pain status of the patients was evaluated with Visual Analog Scale (VAS) and functional status was evaluated with Foot Function Index (FFI). Results: In the evaluations, a significant improvement was found in VAS resting and activity values, AFI pain, disability and activity limitation values in the 4th and 8th week follow-ups in the ESWT+exercise group and the patients who received only exercise therapy (p<0.05). When the two groups were compared, the improvement in the ESWT+exercise group was statistically significant in all subgroups of both VAS and AFI compared to the exercise group in both the 4th and 8th week evaluations (p<0.05). Conclusion: In conclusion, ESWT added to exercise intervention in the treatment of plantar fasciitis is an effective and safe treatment method. ESWT treatment in addition to exercise therapy can reduce pain and improve functionality in patients with plantar fasciitis.

Keywords:

ESWT, exercise, plantar fasciitis,

PDF

___

Dunn JE, Link CL, Felson DT, Crincoli MG, Keysor JJ, McKinlay JB. Prevalence of foot and ankle conditions in a multiethnic community sample of older adults. Am J Epidemiol. 2004;159(5):491-8.
Cutts S, Obi N, Pasapula C, Chan W. Plantar fasciitis. Ann R Coll Surg Engl. 2012;94(8):539-42.
Riddle DL, Pulisic M, Pidcoe P, Johnson RE. Risk factors for plantar fasciitis: a matched case-control study. J Bone Joint Surg Am. 2003;85(5):872-7.
Trojian T, Tucker AK. Plantar fasciitis. Am Fam Physician. 2019;99(12):744-50.
Goff JD, Crawford R. Diagnosis and treatment of plantar fasciitis. Am Fam Physician. 2011;84(6):676-82.
Buchanan BK, Kushner D. (2022) Plantar Fasciitis. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing
Roerdink RL, Dietvorst M, van der Zwaard B, van der Worp H, Zwerver J. Complications of extracorporeal shockwave therapy in plantar fasciitis: Systematic review. Int J Surg. 2017;46:133-45.
Thong-On S, Bovonsunthonchai S, Vachalathiti R, Intiravoranont W, Suwannarat S, Smith R. Effects of strengthening and stretching exercises on the temporospatial gait parameters in patients with plantar fasciitis: a randomized controlled trial. Ann Rehabil Med. 2019;43(6):662-76.
Huskisson EC. Measurement of pain. Lancet. 1974;2(7889):1127-31.
Budiman-Mak E, Conrad KJ, Roach KE. The Foot Function Index: a measure of foot pain and disability. J Clin Epidemiol. 1991;44(6):561-70.
Yalıman, A. Sen EI, Eskiyurt N, Budiman-Mak E. Turkish translation and adaptation of foot function ındex in patients with plantar fasciitis. Turk J Phys Med Rehabil. 2014;60(3):212-22.
Auersperg V, Trieb K. Extracorporeal shock wave therapy: an update. EFORT Open Rev. 2020;5(10):584-92.
Caner ÖC, Güneş S, Gökmen D, Ataman Ş, Kutlay Ş. The efficacy and safety of extracorporeal shock wave therapy on plantar fasciitis in patients with axial spondyloarthritis: a double-blind, randomized controlled trial. Rheumatol Int. 2022;42(4):581-9.
Zdravkovic A, Mickel M, Crevenna R. Successful application of focused extracorporeal shockwave therapy for plantar fasciitis in patients suffering from metastatic breast cancer. Support Care Cancer. 2021;29(8):4187-90.
Wang FS, Wang CJ, Chen YJ, et al. Ras induction of superoxide activates ERK-dependent angiogenic transcription factor HIF-1alpha and VEGF-A expression in shock wave-stimulated osteoblasts. J Biol Chem. 2004;279(11):10331-7.
Cheng JH, Wang CJ. Biological mechanism of shockwave in bone. Int J Surg. 2015;24(Pt B):143-6.
Sun K, Zhou H, Jiang W. Extracorporeal shock wave therapy versus other therapeutic methods for chronic plantar fasciitis. Foot Ankle Surg. 2020;26(1):33-8.
Lai TW, Ma HL, Lee MS, Chen PM, Ku MC. Ultrasonography and clinical outcome comparison of extracorporeal shock wave therapy and corticosteroid injections for chronic plantar fasciitis: A randomized controlled trial. J Musculoskelet Neuronal Interact. 2018;18(1):47-54.
Sun J, Gao F, Wang Y, Sun W, Jiang B, Li Z. Extracorporeal shock wave therapy is effective in treating chronic plantar fasciitis: A meta-analysis of RCTs. Medicine (Baltimore). 2017;96(15):e6621.
Hammer DS, Adam F, Kreutz A, Kohn D, Seil R. Extracorporeal shock wave therapy (ESWT) in patients with chronic proximal plantar fasciitis: a 2-year follow-up. Foot Ankle Int. 2003;24(11):823-8.
Wang YC, Chen SJ, Huang PJ, Huang HT, Cheng YM, Shih CL. Efficacy of Different Energy Levels Used in Focused and Radial Extracorporeal Shockwave Therapy in the Treatment of Plantar Fasciitis: A Meta-Analysis of Randomized Placebo-Controlled Trials. J Clin Med. 2019;8(9):1497.
Lim AT, How CH, Tan B. Management of plantar fasciitis in the outpatient setting. Singapore Med J. 2016;57(4):168-71.
Díaz López AM, Guzmán Carrasco P. Efectividad de distintas terapias físicas en el tratamiento conservador de la fascitis plantar: revisión sistemática [Effectiveness of different physical therapy in conservative treatment of plantar fasciitis: systematic review]. Rev Esp Salud Publica. 2014;88(1):157-78. Spanish