One-year treatment follow-up of plantar fasciitis: radial shockwaves
<i>vs.</i> conventional physiotherapy

Grecco, Marcus Vinicius; Brech, Guilherme Carlos; Greve, Júlia Maria D'Andrea

doi:10.6061/clinics/2013(08)05

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Sumário

Clinical Sciences • Clinics 68 (8) • 2013 • https://doi.org/10.6061/clinics/2013(08)05 copy

One-year treatment follow-up of plantar fasciitis: radial shockwaves vs. conventional physiotherapy

Authorship SCIMAGO INSTITUTIONS RANKINGS

OBJECTIVE:

To compare radial shockwave treatment with conventional physiotherapy for plantar fasciitis after 12 months of follow-up.

METHOD:

This was a randomized, prospective, comparative clinical study. Forty patients with a diagnosis of plantar fasciitis were divided randomly into two treatment groups: group 1, with 20 patients who underwent ten physiotherapy sessions comprising ultrasound, kinesiotherapy and guidance for home-based stretching; and group 2, with 20 patients who underwent three applications of radial shockwaves, once a week, and guidance for home-based stretching. All patients were assessed regarding pain and functional abilities before treatment, immediately after and 12 months after treatment. The mean age was 49.6 ±11.8 years (range: 25-68 years), 85% were female, 88% were overweight, 63% were affected bilaterally, and 83% used analgesics regularly.

RESULTS:

At the 12-month follow-up, both treatments were effective for improving pain and functional ability among the patients with plantar fasciitis. The improvement with shockwaves was faster.

CONCLUSION:

Shockwave treatment was not more effective than conventional physiotherapy treatment 12 months after the end of the treatment.

Plantar Fasciitis; Shockwave Therapy; Physiotherapy

Weekly frequency of pain	Group 1
	Evaluation 1	Evaluation 2	Evaluation 3	Evaluation 4	p-value^* *Friedman test comparing the four evaluations within each group. )
No pain	0 (0%)	9 (45%)	10 (50%)	9 (45%)
Pain once a week	0 (0%)	2 (10%)	3 (15%)	2 (10%)	0.000
Pain twice a week or more	20 (100%)	9 (45%)	7 (35%)	9 (45%)

	Group 2
	Evaluation 1	Evaluation 2	Evaluation 3	Evaluation 4	p-value^* *Friedman test comparing the four evaluations within each group. )
No pain	0 (0%)	8 (40%)	9 (45%)	14 (70%)
Pain once a week	0 (0%)	0 (0%)	1 (5%)	0 (0%)	0.000
Pain twice a week or more	20 (100%)	12 (60%)	10 (50%)	6 (30%)

VAS	Group 1
	Evaluation 1	Evaluation 2	Evaluation 3	Evaluation 4	p-value^* *Group 1 - ten physiotherapy sessions (ultrasound and kinesiotherapy); Group 2 - three shockwave therapy sessions; Evaluation 1 - before treatment; Evaluation 2 - immediately after treatment; Evaluation 3 - three months after treatment; Evaluation 4 - one year after treatment. )
Good (0-1)	0 (0%)	11 (55%)	13 (65%)	16 (80%)
Fair (2-5)	1 (5%)	5 (25%)	5 (25%)	2 (10%)	0.000
Poor (6-10)	19 (95%)	4 (20%)	2 (10%)	2 (10%)

	Group 2
	Evaluation 1	Evaluation 2	Evaluation 3	Evaluation 4	p-value^* *Group 1 - ten physiotherapy sessions (ultrasound and kinesiotherapy); Group 2 - three shockwave therapy sessions; Evaluation 1 - before treatment; Evaluation 2 - immediately after treatment; Evaluation 3 - three months after treatment; Evaluation 4 - one year after treatment. )
Good (0-1)	2 (10%)	10 (50%)	14 (70%)	17 (85%)
Fair (2-5)	4 (20%)	5 (25%)	4 (20%)	2 (10%)	0.000
Poor (6-10)	14 (70%)	5 (25%)	2 (10%)	1 (5%)

VAS	Group 1
	Evaluation 1	Evaluation 2	Evaluation 3	Evaluation 4	p-value^* *Friedman test comparing the four evaluations within each group. )
Good (0-1)	2 (10%)	14 (70%)	15 (75%)	19 (95%)
Fair (2-5)	4 (20%)	3 (15%)	3 (15%)	0 (0%)	0.000
Poor (6-10)	14 (70%)	3 (15%)	2 (10%)	1 (5%)

	Group 2
	Evaluation 1	Evaluation 2	Evaluation 3	Evaluation 4	p-value^* *Friedman test comparing the four evaluations within each group. )
Good (0-1)	2 (10%)	11 (55%)	14 (70%)	15 (75%)
Fair (2-5)	4 (20%)	3 (15%)	3 (15%)	2 (10%)	0.000
Poor (6-10)	14 (70%)	6 (30%)	3 (15%)	3 (15%)

Fischer's algometer (calcaneus)	Group 1
	Evaluation 1	Evaluation 2	Evaluation 3	Evaluation 4	p-value^* *Friedman test comparing the four evaluations within each group. )
Up to 4 kg	5 (16%)	0 (0%)	0 (0%)	0 (0%)
More than 4 and up to 6 kg	8 (25%)	1 (3%)	0 (0%)	0 (0%)
More than 6 and up to 8 kg	14 (44%)	5 (16%)	3 (9%)	2 (6%)	0.000
More than 8 and up to 10 kg	3 (9%)	9 (28%)	1 (3%)	5 (16%)
No pain	2 (6%)	17 (53%)	28 (88%)	25 (78%)

	Group 2
	Evaluation 1	Evaluation 2	Evaluation 3	Evaluation 4	p-value^* *Friedman test comparing the four evaluations within each group. )
Up to 4 kg	6 (18%)	1 (3%)	0 (0%)	0 (0%)
More than 4 and up to 6 kg	14 (42%)	0 (0%)	0 (0%)	0 (0%)
More than 6 and up to 8 kg	10 (30%)	4 (12%)	0 (0%)	1 (3%)	0.000
More than 8 and up to 10 kg	3 (9%)	6 (18%)	5 (15%)	5 (15%)
No pain	0 (0%)	22 (67%)	28(85%)	27 (82%)

Fischer's algometer (gastrocnemius)	Group 1
	Evaluation 1	Evaluation 2	Evaluation 3	Evaluation 4	p-value^* *Friedman test comparing the four evaluations within each group. )
Up to 4 kg	9 (28%)	2 (6%)	3 (9%)	2 (6%)
More than 4 and up to 6 kg	8 (25%)	4 (13%)	5 (16%)	13 (41%)
More than 6 and up to 8 kg	2 (6%)	7 (22%)	4 (13%)	9 (28%)	0.000
More than 8 and up to 10 kg	0 (0%)	4 (13%)	3 (9%)	3 (9%)
No pain	13 (41%)	15 (47%)	17 (53%)	5 (16%)

	Group 2
	Evaluation 1	Evaluation 2	Evaluation 3	Evaluation 4	p-value^* *Friedman test comparing the four evaluations within each group. )
Up to 4 kg	16 (48%)	5 (15%)	4 (12%)	0 (0%)
More than 4 and up to 6 kg	7 (21%)	6 (18%)	7 (21%)	10 (30%)
More than 6 and up to 8 kg	1 (3%)	3 (9%)	7 (31%)	16 (48%)	0.000
More than 8 and up to 10 kg	0 (0%)	2 (6%)	0 (0%)	5 (15%)
No pain	9 (27%)	17 (52%)	15 (45%)	2 (6%)

	Patients who ceased using analgesics within one year after the treatment		Patients who were using analgesics before the treatment^† †Three patients in Group 1 and four in Group 2 were not using analgesics before the treatment. )	p-value^* *Fisher's exact test. )
	Yes	No
Treatment 1	14 (82.4%)	3 (17.6%)	17 (100%)	1.000
Treatment 2	13 (81.3%)	3 (18.8%)	16 (100%)

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E-mail: clinics@hc.fm.usp.br

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[1] Grecco MV collected and analyzed the data and prepared the manuscript. Brech GC analyzed the data and prepared the manuscript. Greve JM supervised the study and revised the manuscript.