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European Journal of Physical and Rehabilitation Medicine 2021 Nov 17

DOI: 10.23736/S1973-9087.21.06814-3

Copyright © 2021 EDIZIONI MINERVA MEDICA

lingua: Inglese

Myofascial points treatment with focused extracorporeal shock waves (f-ESW) for plantar fasciitis: an open label randomized clinical trial

Lucrezia TOGNOLO 1 , Federico GIORDANI 2, Carlo BIZ 3, Andrea BERNINI 2, Pietro RUGGIERI 3, Carla STECCO 4, Anna C. FRIGO 5, Stefano MASIERO 1

1 Physical Medicine and Rehabilitation Unit, Department of Neurosciences, University of Padua, Padua, Italy; 2 Physical Medicine and Rehabilitation School, University of Padua, Padua, Italy; 3 Orthopaedics and Orthopaedic Oncology, Department of Surgery, Oncology and Gastroenterology (DiSCOG), University of Padova, Padova, Italy; 4 Department of Neurosciences, Institute of Human Anatomy, University of Padova, Padua, Italy; 5 Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padua, Padua, Italy


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BACKGROUND: Plantar fasciitis (PF) is a common cause of heel pain. Among the several conservative treatment options, Extracorporeal Shock Wave Therapy (ESWT) is considered the standard treatment. However, recent studies suggest that PF may be sustained by a myofascial impairment proximal to the pain area with a biomechanical disequilibrium of the entire limb and pelvis.
AIM OF THE STUDY: By combining the concepts of Fascial Manipulation and ESWT, the purpose of this study was to evaluate the effectiveness of the ESWT on myofascial points in a sample of subjects with PF.
STUDY DESIGN: Open label randomized controlled clinical trial.
SETTING: Outpatient clinic.
METHODS AND POPULATION: Patients with PF were randomly assigned to an Experimental treatment Group (EG), treated with focused ESWT on myofascial points, and a Control Group (CG), treated with the focused ESWT traditional approach on the medial calcaneal tubercle. Every patient underwent a 3-session program and follow-up after 1 and 4 months. Outcome measures included the Foot and Ankle Outcome Score (FAOS) and the Italian Foot Functional Index (17-iFFI).
RESULTS: Thirty patients were enrolled in the study. Four patients of the CG dropped out the study, therefore twenty-six patients were included in the final analysis. Improvement in 17-iFFI and FAOS scores was observed in both groups starting from the third treatment and confirmed at the 1-month and 4-month follow-ups, with earlier improvement in the score values observed in the EG.
CONCLUSIONS: ESWT on myofascial points could provide an interesting alternative with better outcomes in terms of time needed for recovery compared to traditional ESWT for the conservative management of PF.


KEY WORDS: Plantar fasciitis; Fascia; ESWT; Rehabilitation; Myofascial trigger points; Fascial manipulation

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