Clinical rehabilitation · 2008
Comparison of two extracorporeal shock wave therapy techniques for the treatment of painful subcalcaneal spur. A randomized controlled study.
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Tornese Davide, Mattei Enrico, Lucchesi Giampaolo, Bandi Marco, Ricci Gabriele, Melegati Gianluca
Аннотация
OBJECTIVE: To describe and compare two extracorporeal shock wave therapy techniques for the treatment of painful subcalcaneal spur.
DESIGN: Random assignment to two groups of treatment with two and eight months follow-up.
SETTING: The data were collected in outpatients.
SUBJECTS: Forty-five subjects with a history of at least six months of heel pain were studied.
INTERVENTIONS: Each subject received a three-session ultrasound-guided extracorporeal shock wave therapy (performed weekly). Perpendicular technique was used in group A (n=22, mean age 59.3 +/- 12 years) and tangential technique was used in group B (n= 23, mean age 58.8 +/- 12.3 years).
MAIN OUTCOME MEASURES: Mayo Clinical Scoring System was used to evaluate each subject before the treatment and at two and eight months follow-up.
RESULTS: Mayo Clinical Scoring System pretreatment scores were homogeneous between the groups (group A 55.2 +/-18.7; group B 53.5 +/- 20; P>0.05). In both groups there was a significant (P<0.05) increase in the Mayo Clinical Scoring System score at two months (group A 83.9 +/- 13.7; group B 80 +/- 15,8) and eight months (group A 90 +/- 10.5; group B 90.2 +/-8.7) follow-up. No significant differences were obtained comparing the Mayo Clinical Scoring System scores of the two groups at two and eight months follow-up.
CONCLUSIONS: There was no difference between the two techniques of using extracorporeal shock wave therapy. The tangential technique was found to be better tolerated as regards treatment-induced pain, allowing higher energy dosages to be used.
DESIGN: Random assignment to two groups of treatment with two and eight months follow-up.
SETTING: The data were collected in outpatients.
SUBJECTS: Forty-five subjects with a history of at least six months of heel pain were studied.
INTERVENTIONS: Each subject received a three-session ultrasound-guided extracorporeal shock wave therapy (performed weekly). Perpendicular technique was used in group A (n=22, mean age 59.3 +/- 12 years) and tangential technique was used in group B (n= 23, mean age 58.8 +/- 12.3 years).
MAIN OUTCOME MEASURES: Mayo Clinical Scoring System was used to evaluate each subject before the treatment and at two and eight months follow-up.
RESULTS: Mayo Clinical Scoring System pretreatment scores were homogeneous between the groups (group A 55.2 +/-18.7; group B 53.5 +/- 20; P>0.05). In both groups there was a significant (P<0.05) increase in the Mayo Clinical Scoring System score at two months (group A 83.9 +/- 13.7; group B 80 +/- 15,8) and eight months (group A 90 +/- 10.5; group B 90.2 +/-8.7) follow-up. No significant differences were obtained comparing the Mayo Clinical Scoring System scores of the two groups at two and eight months follow-up.
CONCLUSIONS: There was no difference between the two techniques of using extracorporeal shock wave therapy. The tangential technique was found to be better tolerated as regards treatment-induced pain, allowing higher energy dosages to be used.