Comparison of radial versus focused extracorporeal shock waves in plantar fasciitis using functional measures.
BACKGROUND
Recent literature shows evidence for effective treatment for plantar fasciitis using either focused or radial shock waves. Up to now no research has been available which compares these different procedures. We hypothesized (H(0) Hypothesis) that for plantar fasciitis, outcomes following focused or radial shock wave treatment were equal.


METHODS
For this pilot study, 39 patients suffering from recalcitrant plantar fasciitis were randomized in two groups. Treatment was performed in three sessions. Once a week 2000 impulses of radial (0.17 mJ/mm(2)) or focused (0.20 mJ/mm(2)) shock waves were applied. Efficacy was determined by multivariate analysis of eight single variables including changes in Foot Functional Index, neuromuscular performance (Single leg drop and long jump, postural stability, isokinetic testing), and by a composite score from baseline to 12 weeks followup. Multivariate Wilcoxon tests (Wei-Lachin procedure) and formal meta-analytic procedure with adjustment for subgroups was performed to determine the adjusted effect sizes with their corresponding confidence intervals.


RESULTS
The overall result (;;Crude Pooling'') shows ;;small'' superiority of the focused extracorporeal shock wave therapy (MW = 0.55, LB-CI = 0.4644). Adjusted for age the focused treatment exhibited ;;more than small'' superiority (MW = 0.59, LB-CI > 0.5) and this result is statistically significant (LB-CI = 0.5067, benchmark for equality = 0.5).


CONCLUSIONS
This study provides some evidence for focused extracorporeal shock wave treatment being superior to radial extracorporeal shock wave therapy for recalcitrant plantar fasciitis.
Lohrer
Heinz
H
Institute of Sports Medicine Frankfurt, Otto-Fleck-Schneise 10, 60528 Frankfurt/Main, Germany. lohrer@sport.uni-frankfurt.de
Nauck
Tanja
T
Dorn-Lange
Nadja V
NV
Schöll
Jakob
J
Vester
Johannes C
JC
D000328:Adult; D000367:Age Factors; D000368:Aged; D004185:Disability Evaluation; D005080:Exercise Test; D036981:Fasciitis, Plantar / Q000628:therapy*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009119:Muscle Contraction; D010147:Pain Measurement; D010865:Pilot Projects; D004856:Postural Balance; D014464:Ultrasonic Therapy / Q000379:methods*