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

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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