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

Year 2019, , 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

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