title: 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.
abstract: Despite numerous publications and clinical trials, the results of treatment of recalcitrant chronic plantar fasciitis with extracorporeal shockwave therapy (ESWT) still remain equivocal as to whether or not this treatment provides relief from the pain associated with this condition. The objective of this study was to determine whether extracorporeal shock wave therapy can safely and effectively relieve the pain associated with chronic plantar fasciitis compared to placebo treatment, as demonstrated by pain with walking in the morning. This was set in a multicenter, randomized, placebo-controlled, double-blind, confirmatory clinical study undertaken in four outpatient orthopedic clinics. The patients, 114 adult subjects with chronic plantar fasciitis, recalcitrant to conservative therapies for at least 6 months, were randomized to two groups. Treatment consisted of approximately 3,800 total shock waves (+/-10) reaching an approximated total energy delivery of 1,300 mJ/mm(2) (ED+) in a single session versus placebo treatment. This study demonstrated a statistically significant difference between treatment groups in the change from baseline to 3 months in the primary efficacy outcome of pain during the first few minutes of walking measured by a visual analog scale. There was also a statistically significant difference between treatments in the number of participants whose changes in Visual Analog Scale scores met the study definition of success at both 6 weeks and 3 months posttreatment; and between treatment groups in the change from baseline to 3 months posttreatment in the Roles and Maudsley Score. The results of this study confirm that ESWT administered with the Dornier Epos Ultra is a safe and effective treatment for recalcitrant plantar fasciitis.
authors.affiliation: Fowler Kennedy Sport Medicine Clinic, 3M Centre University of Western Ontario, London, Ontario N6A 3K7, Canada.
authors.forename: Patricia
authors.initials: P
authors.lastname: Kudo
authors.forename: Katie
authors.initials: K
authors.lastname: Dainty
authors.forename: Michael
authors.initials: M
authors.lastname: Clarfield
authors.forename: Larry
authors.initials: L
authors.lastname: Coughlin
authors.forename: Pauline
authors.initials: P
authors.lastname: Lavoie
authors.forename: Constance
authors.initials: C
authors.lastname: Lebrun
mesh_terms: D000203:Activities of Daily Living; D004311:Double-Blind Method; D036981:Fasciitis, Plantar / Q000150:complications / Q000000981:diagnostic imaging / Q000628:therapy*; D005260:Female; D006365:Heel / Q000503:physiopathology; D019220:High-Energy Shock Waves / Q000627:therapeutic use*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009656:North America; D010146:Pain / Q000209:etiology / Q000503:physiopathology; D059408:Pain Management; D010147:Pain Measurement; D015203:Reproducibility of Results; D016896:Treatment Outcome; D014463:Ultrasonography