Heel Spur Clinical Trial
Official title:
A Comparison of the Analgesic Efficacies of Ultrasound and Shock Wave Therapy in the Patients With Calcaneal Spur
Heel spur is a troublesome disorder. Its formation is accompanied by pain in the area of
heel and it makes walking limited or even impossible.
The aim of the study is to analyze analgesic efficacy of ultrasound and shock wave therapy
in patients with heel spur.
The study included 52 patients of both sexes, aged 38-86 (average 57.39) with plantar heel
spur confirmed radiographically. The patients were randomly divided into two groups;in Group
1 the patients underwent ultrasound procedure (10 treatments)and in Group 2 - radial shock
wave procedure(6 treatments). The researchers assessed pain three times (prior to the
therapy, after the first and then the second week of treatment). In order to do this they
used a modified form of the Laitinen pain indicators questionnaire (results expressed in
points) and VAS - visual analogue scale (results given in milimeters). The results were
statistically analyzed. In the studied periods of time a decrease in pain was observed (both
in the Laitinen questionnaire and in the VAS scale). The most rapid change was noted in both
the groups after the first week of treatment. Ultrasound and shock wave therapies show a
comparably significant analgesic efficacy in patients with heel spur. Shock wave therapy has
an advantage over ultrasound therapy. A smaller number of procedures is required to obtain
comparable results, which makes the therapy less expensive. No side effects were observed
during and after the treatment.
The study was conducted on a group of 52 patients of both sexes, aged 38-86 years (mean
57.39; SD-11.5) with a plantar calcaneal spur confirmed by X-ray images. Patients were
treated in the Department of Physical Medicine and Rehabilitation Day Unit of the University
Hospital im. WAM - Central Veterans Hospital in Lodz and Municipal Health Clinic of
Andrespol. In order to compare the effectiveness of the two forms of physiotherapy,
ultrasound and radial shock wave therapy, the patients were randomly assigned (using a
simple randomization) into two groups:
- Group 1 - ultrasound therapy group: 22 patients aged 38-86 years (mean 58.64;
SD-12.99),
- Group 2 - radial shock wave group: 30 patients aged 40-71 years (mean 56.13; SD-10.02).
Ultrasound (US) was performed with a BTL 5840 S device, using labile technique, targeting
the calcaneal tumor and attachment of the plantar aponeurosis (pain points); the power
setting was 1,5 W/cm2, 80% fill factor, at a frequency of 1 MHz (head 4cm2). The duration of
a single treatment was four minutes, and the coupling substance used was paraffin oil.
Treatment sessions were performed daily Monday through Friday for a period of two weeks in a
series of 10 treatments.
The shock wave therapy (SWT) was performed on the affected area using a BTL-5000 SWT device
connected to a 15 mm diameter applicator according to the producer's recommendations; during
therapy, 2000 strokes were applied with a frequency of 10 Hz and a capacity of 2.5 bar.
Therapy took place for two weeks in a series of 6 treatments with a two-day interval between
treatments.
In addition, all patients underwent kinesitherapy - exercises to strengthen the muscles that
bending plantar and supinated foot to improve the mobility of the feet and to maintain the
normal longitudinal arch of the foot. SPR orthopedic inserts with a pit on the painful area
was used to support the longitudinal foot arch and relieve the medial ridge of the calcaneal
tumor.
In all patients, pain intensity was assessed three times: before therapy, and after the
first and second week of treatment. A modified form of the Laitinen indicators of pain
question-shem was used [12]. On the basis of their subjective feelings, patients evaluated
pain intensity, frequency of occurrence, use of analgesics, and the impact of pain on their
physical activity. In addition, pain intensity was also assessed on the Huskisson visual -
analogue scale (VAS) [13]; patients marked a point on a 100 mm line which corresponded to
the current pain sensations - the results being given in millimeters.
The results were analyzed by Student's t-test for dependent and independent tests, with a
significance level of p <0.05. The results are presented as arithmetic mean and standard
deviation.
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Observational Model: Case Control, Time Perspective: Retrospective
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