Dextrose prolotherapy versus radial extracorporeal shock wave therapy in the treatment of chronic plantar fasciitis: A randomized,controlled clinical trial |
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| Institution: | 1. Exercise Physiology Research Center, Baqiyatallah University of Medical Sciences, Tehran, Iran;2. Department of Physical Medicine and Rehabilitation, Iran University of Medical Sciences, Tehran, Iran;3. Medicine, Quran and Hadith Research Center, Baqiyatallah University of Medical Sciences, Tehran, Iran;4. Health Management Research Center, Baqiyatallah University of Medical Sciences, Tehran, Iran;1. Trauma and Orthopaedics Department, Sheffield Teaching Hospitals NHS Trust, Herries Rd, Sheffield S5 7AU, UK;2. Academic Unit of Bone Metabolism, The University of Sheffield, Sheffield S10 2RX, UK;3. Trauma and Orthopaedics Department, Warrington and Halton Hospitals NHS Foundation Trust, Lovely Ln, Warrington WA5 1QG, UK;4. Royal Berkshire Hospital, London Rd, Reading, RG1 5AN, UK;1. Department of Orthopaedic Surgery, Amsterdam University Medical Centers, University of Amsterdam, Amsterdam Movement Sciences, Amsterdam, The Netherlands;2. Academic Center for Evidence-Based Sports Medicine (ACES), Amsterdam, The Netherlands;3. Amsterdam Collaboration on Health & Safety in Sports (ACHSS), AMC/VUmc IOC Research Center, Amsterdam, The Netherlands;4. Department of General Surgery, Amsterdam University Medical Centers, Academical Medical Center, University of Amsterdam, Amsterdam, The Netherlands;5. FIFA Medical Centre of Excellence Ripoll-dePrado-vanDijk SportClinic Madrid, Spain;6. FIFA Medical Centre of Excellence Clinica do Dragao Porto, Portugal;1. Department of Orthopaedics, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, 465 Kajii-cho, Kawaramachi-Hirokoji, Kamigyo-ku, Kyoto 602-8566, Japan;2. Department of Rehabilitaion Medicine, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, 465 Kajii-cho, Kawaramachi-Hirokoji, Kamigyo-ku, Kyoto 602-8566, Japan;1. Department of Orthopaedic Surgery, Changi General Hospital, 2 Simei St 3, 529889, Singapore;2. Department of Epidemiology, Singapore Clinical Research Institute, 31 Biopolis Way, 138669, Singapore;3. Department of Orthopaedic Surgery, Seoul National University Hospital, Seoul, Republic of Korea;1. Department of Rehabilitation Medicine, Changi General Hospital, Singapore;2. Rehabilitation Medicine, SingHealth Residency, Singapore;3. Department of Rehabilitation Medicine, Singapore General Hospital, Singapore;1. Private Practice, 4740 El Monte Roeland Park, KS 66205, USA;2. Department of Physical Medicine and Rehabilitation, University of Kansas Medical Center, 3901 Rainbow Blvd, Kansas City, KS 66160, USA;3. The Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, 30-32 Ngan Shing Street, School of Public Health Building, Prince of Wales Hospital, Shatin, New Territory, Hong Kong;4. Department of Family Medicine and Community Health, University of Wisconsin School of Medicine and Public Health, 1100 Delaplaine Ct, Madison, WI 53715, USA |
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| Abstract: | In the recent years, prolotherapy is increasingly being used in the field of musculoskeletal medicine. However, few studies have investigated its effectiveness in plantar fasciitis (PF). The purpose of this study was to compare the effectiveness of ultrasound-guided dextrose prolotherapy with radial extracorporeal shock wave therapy (ESWT) in the treatment of chronic PF. This randomized controlled trial was conducted on 59 patients with chronic PF. Patients were randomly assigned into two groups receiving three sessions of radial ESWT (29 patients) vs. two sessions of ultrasound-guided intrafascial 2 cc dextrose 20% injection (30 patients). The following outcome measures were assessed before and then six weeks and 12 weeks after the treatments: pain intensity by visual analog scale (VAS), daily life and exercise activities by Foot and Ankle Ability Measure (FAAM), and the plantar fascia thickness by ultrasonographic imaging. The VAS and FAAM scales showed significant improvements of pain and function in both study groups 6 weeks and 12 weeks after the treatments. A significant reduction was noted for plantar fascia thickness at these intervals (all p < .05). The inter-group comparison revealed that except for the FAAM-sport subscale which favored ESWT, the interaction effects of group and time were not significant for other outcome measures. Dextrose prolotherapy has comparable efficacy to radial ESWT in reducing pain, daily-life functional limitation, and plantar fascia thickness in patients with PF. No serious adverse effects were observed in either group.Level of evidenceLevel I, randomized controlled trial. |
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| Keywords: | Fasciitis Plantar Prolotherapy Extracorporeal shockwave therapy Ultrasonography |
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