Dose-related effect of extracorporeal shock wave therapy for plantar fasciitis

Ann Rehabil Med. 2013 Jun;37(3):379-88. doi: 10.5535/arm.2013.37.3.379. Epub 2013 Jun 30.

Abstract

Objective: To examine the dose-related effect of extracorporeal shock wave therapy (ESWT) for plantar fasciitis.

Methods: Sixty patients with plantar fasciitis despite conservative treatment were enrolled. The patients were divided into a low-energy group (group L: n=30, 1,000 shocks/session, energy flux density [EFD] per shock 0.08 mJ/mm(2)) and a medium-energy group (group M: n=30, 1,000 shocks/session, EFD 0.16 mJ/mm(2)). The main outcome measures were visual analogue scale (VAS), Roles and Maudsley (RM) score, and thickness of plantar fascia (PF). To compare the effects between each group, follow-up was carried out 1 week after 3 and 6 sessions, and 1 and 3 months after ESWT.

Results: Significant VAS and RM score improvement, and PF thickness reduction were observed in both groups (p<0.01). After 3 sessions of ESWT, group M showed significant improvement in the VAS and RM score than group L, whereas after 3 additional sessions applied in group L, the main outcomes were no longer significantly different in both groups (p>0.05).

Conclusion: Therapeutic effect might disclose a dose-related relationship; therefore, EFD and the times of the session are considerable factors when treating with ESWT.

Keywords: Dose-related Effect; Extracorporeal shock wave therapy; Plantar fasciitis.