Treatment of Chronic Plantar Fasciitis with Noninvasive Interactive Neurostimulation: A Prospective Randomized Controlled Study

Cristina Razzano; Stefano Carbone; Massimiliano Mangone; M Raffaella Iannotta; Alessandro Battaglia; Valter Santilli

doi:10.1053/j.jfas.2017.02.015

Treatment of Chronic Plantar Fasciitis with Noninvasive Interactive Neurostimulation: A Prospective Randomized Controlled Study

J Foot Ankle Surg. 2017 Jul-Aug;56(4):768-772. doi: 10.1053/j.jfas.2017.02.015.

Authors

Cristina Razzano¹, Stefano Carbone², Massimiliano Mangone³, M Raffaella Iannotta⁴, Alessandro Battaglia⁵, Valter Santilli⁶

Affiliations

¹ Resident, Department of Physical Medicine and Rehabilitation, Sapienza University of Rome, Rome, Italy; Resident, Department of Physical Medicine and Rehabilitation, Centro Medico Erre, Sant'Agata dei Goti, Italy.
² PhD Student, Department of Molecular Medicine, Sapienza University of Rome, Rome, Italy; FIMAC Onlus, Rome, Italy. Electronic address: stefcarbone@yahoo.it.
³ Medical Engineer, Biomechanics and Movement Analysis Laboratory, Department of Physical Medicine and Rehabilitation, Sapienza University of Rome, Rome, Italy.
⁴ Physical Therapist, Department of Physical Medicine and Rehabilitation, Centro Medico Erre, Sant'Agata dei Goti, Italy.
⁵ Chief of Department of Physical Medicine and Rehabilitation, Centro Medico Erre, Sant'Agata dei Goti, Italy.
⁶ Chief of Department of Physical Medicine and Rehabilitation, Sapienza University of Rome, Rome, Italy.

PMID: 28633774
DOI: 10.1053/j.jfas.2017.02.015

Abstract

The initial treatment of plantar fasciitis should be conservative, with most cases responding to standard physiotherapy, nonsteroidal anti-inflammatory drugs (NSAIDs), heel pads, and stretching. In cases of chronic refractory symptoms, more invasive treatment could be necessary. Noninvasive interactive neurostimulation (NIN) is a form of electric therapy that works by locating areas of lower skin impedance. The objective of the present prospective randomized controlled study was to evaluate whether the use of NIN for chronic plantar fasciitis could result in greater improvement in a foot functional score, lower levels of reported pain, reduced patient consumption of NSAIDs, and greater patient satisfaction compared with electric shockwave therapy in patients without a response to standard conservative treatment. The patients were randomized using random blocks to the NIN program (group 1) or electric shockwave therapy (group 2). The outcome measurements were the pain subscale of the validated Foot Function Index (PS-FFI), patient-reported subjective assessment of the level of pain using a standard visual analog scale, and daily intake of NSAID tablets (etoricoxib 60 mg). The study group was evaluated at baseline (time 0), week 4 (time 1), and week 12 (final follow-up point). Group 1 (55 patients) experienced significantly better results compared with group 2 (49 patients) in term of the PS-FFI score, visual analog scale score, and daily intake of etoricoxib 60 mg. NIN was an effective treatment of chronic resistant plantar fasciitis, with full patient satisfaction in >90% of cases. The present prospective randomized controlled study showed superior results for noninvasive neurostimulation compared with electric shockwave therapy, in terms of the functional score, pain improvement, and use of NSAIDs.

Keywords: 2; InterX(®); noninvasive interactive neurostimulation; plantar fasciosis; plantar heel pain; skin impedance.

Publication types

Randomized Controlled Trial

MeSH terms

Adult
Aged
Chronic Disease
Electric Stimulation Therapy*
Fasciitis, Plantar / therapy*
Female
Humans
Male
Middle Aged
Patient Satisfaction
Prospective Studies
Recovery of Function
Single-Blind Method
Treatment Outcome