Plantar Fasiitte Radyal Ekstrakorporeal Şok Dalga Tedavisinde İki Farklı Doz Uygulamasının Karşılaştırmalı Klinik ve Fonksiyonel Sonuçları

Year 2019, Volume: 11 Issue: 2, 278 - 284, 28.06.2019

Mehmet Arıcan Yalçın Turhan Zekeriya Okan Karaduman

https://doi.org/10.18521/ktd.525118

Abstract

Comparative Clinical and Functional Outcomes of Two Different Dose Administration of Radial Extracorporeal Shock Wave Therapy in Plantar Fasciitis

Abstract

Amaç: Konservatif tedaviye
yanıt alınamayan plantar fasiit olgularında; iki farklı tedavi protokolü ile
uygulanan rESWT’nin (radial ekstrakorporeal şok dalga tedavisi) etkinliğinin
kıyaslanması amaçlanmıştır.

Gereç
ve Yöntem: 2010-2017 yılları arasında, tek merkezde
rESWT uygulanan ve dahil edilme kriterlerimize uyan 319 hasta değerlendirildi.
181 hastaya 1’er hafta ara ile 1.5 bar, 10Hz,1500 şok, toplam 5 seans(grup 1) ve
138 hastaya ise yine 1’er hafta ara ile 3 bar, 10Hz, 2000 şok, 5 seans(grup 2) rESWT uygulandı. Klinik ve fonksiyonel
sonuçlar tedaviden hemen önce, tedavinin 6. haftasında ve 6. ayında Görsel Analog
Skalası (VAS) ve Amerikan Ortopedik Ayak ve Ayak Bileği Skorlaması (AOFAS)  ile değerlendirildi. 

 Bulgular: Ortalama VAS
skoru grup 1’de 8,73(±1,10)’ten 3,20(±2,09)’ye (p=0,0001) ve grup 2’de
8,68(±1,17)’den 2,61(±1,68)’e (p=0,0001) geriledi. Ortalama AOFAS skoru da grup
1’de 55,85(± 11,73)’den 88,38(± 8,23)’e (p=0,0001) ve grup 2’de 58,74(±
12,74)’den 88,47(± 8,10)’ye (p=0,0001) yükseldi. Grup 1 ve 2’nin 6. hafta-6. ay
VAS skor değişimlerinde istatistiksel olarak anlamlı farklılık saptanmazken
(p=0,451), grup 1’in tedavi öncesi-6. hafta ve tedavi öncesi-6. ay VAS değer
değişimleri grup 2’den anlamlı derecede düşük bulundu (p=0,006, p=0,019).
Ayrıca grup 1 ve grup 2’nin tedavi öncesi-6. ay ve 6. hafta-6. ay AOFAS skor
değişimlerinde de istatistiksel olarak anlamlı farklılık saptanmazken (p=0,094,
p=0,174), grup 1’in tedavi öncesi-6. hafta AOFAS skor değişimi grup 2’den
anlamlı derecede düşük bulunuştur (p=0,029).

Sonuç: Her iki tedavi protokolünün
de ağrı ve fonksiyon kaybında azalmaya katkısı olmasına rağmen, 1’er hafta ara
ile 3 bar hava basınçlı ve 10Hz frekansında toplam 2000 şok ile uygulanan 5
seanslık rESWT’nin daha üstün olduğu söylenebilir.  

Keywords

plantar fasiit, farklı tedavi protokolü, ESWT

References

• 1.Speed CA. Extracorporeal shock-wave therapy in the management of chronic soft-tissue conditions. J Bone Joint Surg Br. 2004;86(2):165-71.
• 2.Ogden JA, Alvarez RG, Levitt R, et al. Shock wave therapy (Orthotripsy) in musculoskeletal disorders. Clin Orthop Relat Res. 2001;(387):22-40.
• 3.Schmitz C, Császár NB, Milz S, et al. Efficacy and safety of extracorporeal shock wave therapy for orthopedic conditions: a systematic review on studies listed in the PEDro database. Br Med Bull. 2015;116:115-38.
• 4.Speed C. A systematic review of shockwave therapies in soft tissue conditions: focusing on the evidence. Br J Sports Med. 2014;48(21):1538-42.
• 5.Gerdesmeyer L, Frey C, Vester J, et al. Radial extracorporeal shock wave therapy is safe and effective in the treatmentof chronic recalcitrant plantar fasciitis: results of a confirmatory randomized placebo-controlled multicenter study. Am J Sports Med. 2008;36(11):2100-9.
• 6.Ibrahim MI, Donatelli RA, Hellman M, et al. Long-term results of radial extracorporeal shock wave treatment for chronic plantar fasciopathy: A prospective, randomized, placebo-controlled trial with two years follow-up. J Orthop Res. 2017;35(7):1532-1538.
• 7.Marks W, Jackiewicz A, Witkowski Z, et al. Extracorporeal shock-wave therapy (ESWT) with a new-generation pneumatic device in the treatmentof heel pain. A double blind randomised controlled trial. Acta Orthop Belg. 2008;74(1):98-101.
• 8.Gollwitzer H, Saxena A, Di Domenico LA, et al. Clinically relevant effectiveness of focused extracorporeal shock wave therapy in the treatment ofchronic plantar fasciitis: a randomized, controlled multicenter study. J Bone Joint Surg Am. 2015 6;97(9):701-8.
• 9.Wang CJ, Wang FS, Yang KD, et al. Shock wavetherapy induces neovascularization at the tendon-bone junction. A study inrabbits. J Orthop Res. 2003;21(6):984-9.10.Orhan Z, Ozturan K, Guven A, et al. The effect of extracorporeal shock waves on a rat model of injury to tendo Achillis. A histological and biomechanical study. J Bone Joint Surg Br. 2004;86(4):613-8.
• 11.Storheim K, Gjersing L, Bølstad K, et al. Extracorporeal shock wavetherapy (ESWT) and radial extracorporeal shock wave therapy (rESWT) in chronicmusculoskeletal pain. Tidsskr Nor Laegeforen. 2010 2;130(23):2360-4.
• 12.ISMST. Home page of The İnternational Society for Medical Shockwave Treatment. https://www.shockwavetherapy.org/home/.
• 13.Lohrer H, Nauck T, Dorn-Lange NV, et al. Comparison of radial versus focused extracorporeal shock waves in plantar fasciitis using functional measures. Foot Ankle Int. 2010;31(1):1-9.
• 14.Ibrahim MI, Donatelli RA, Schmitz C, et al. Chronic plantar fasciitis treated with two sessions of radial extracorporeal shock wave therapy. Foot Ankle Int. 2010;31(5):391-7.
• 15.Hsu RW, Hsu WH, Tai CL, et al. Effect of shock-wave therapy on patellartendinopathy in a rabbit model. J Orthop Res. 2004;22(1):221-7.
• 16.Orhan Z, Cam K, Alper M, et al. The effects of extracorporeal shock waves on the rat Achilles tendon: is there a critical dose for tissue injury? Arch Orthop Trauma Surg. 2004;124(9):631-5.
• 17. Aqil A, Siddiqui MR, Solan M, et al. Extracorporeal shock wave therapy is effective in treating chronic plantar fasciitis: a meta-analysis of RCTs. Clin Orthop Relat Res. 2013;471(11):3645-52.
• 18.Speed CA, Nichols D, Wies J, et al. Extracorporeal shock wave therapy for plantar fasciitis. A double blind randomised controlled trial. J Orthop Res. 2003;21(5):937-40.
• 19.Chow IH, Cheing GL. Comparison of different energy densities of extracorporealshock wave therapy (ESWT) for the management of chronic heel pain. Clin Rehabil. 2007;21(2):131-41.
• 20.Buchbinder R, Ptasznik R, Gordon J, et al. Ultrasound-guided extracorporeal shock wave therapy for plantar fasciitis: arandomized controlled trial. JAMA. 2002;288(11):1364-72.
• 21.Kudo P, Dainty K, Clarfield M, et al. Randomized, placebo-controlled, double-blind clinical trial evaluating the treatment of plantar fasciitis with an extracoporeal shockwave therapy (ESWT) device: a North American confirmatory study. J Orthop Res. 2006;24(2):115-23.
• 22.Gollwitzer H, Diehl P, von Korff A, et al. Extracorporealshock wave therapy for chronic painful heel syndrome: a prospective, doubleblind, randomized trial assessing the efficacy of a new electromagnetic shockwave device. J Foot Ankle Surg. 2007;46(5):348-57.
• 23.Buch M, Knorr U, Fleming L, et al. Extracorporeal shock wave therapy in symptomatic heel spurs. An overview. Orthopade. 2002;31(7):637-44.
• 24.Haake M, Buch M, Schoellner C, et al. Extracorporeal shock wave therapy for plantar fasciitis: randomised controlled multicentre trial. BMJ. 2003;327(7406):75.
• 25.Rompe JD, Decking J, Schoellner C, et al. Shock wave application for chronic plantar fasciitis in running athletes. A prospective, randomized, placebo-controlled trial. Am J Sports Med. 2003;31(2):268-75.
• 26.Theodore GH, Buch M, Amendola A, et al. Extracorporeal shock wave therapy for the treatment of plantar fasciitis. FootAnkle Int. 2004;25(5):290-7.
• 27.Rompe JD, Cacchio A, Weil L Jr, et al. Plantar fascia-specific stretching versus radial shock-wave therapyas initial treatment of plantar fasciopathy. J Bone Joint Surg Am. 2010;92(15):2514-22.
• 28.Grecco MV, Brech GC, Greve JM. One-year treatment follow-up of plantar fasciitis: radial shockwaves vs. conventional physiotherapy. Clinics (Sao Paulo).2013;68(8):1089-95.
• 29.Greve JM, Grecco MV, Santos-Silva PR. Comparison of radial shockwaves and conventional physiotherapy for treating plantar fasciitis. Clinics (Sao Paulo).2009;64(2):97-103.