Abstract
We determined and compared the effectiveness of low-level laser therapy (LLLT), therapeutic
ultrasound (US) therapy, and extracorporeal shock wave therapy (ESWT) using magnetic
resonance imaging (MRI). We performed a randomized, prospective, comparative clinical
study. A total of 60 patients with a diagnosis of chronic plantar fasciitis were divided
randomly into 3 treatment groups: group 1 underwent 15 sessions of LLLT (8 J/cm2; 830 nm); group 2 underwent 15 sessions of continuous US (1 mHz; 2 W/cm2); and group 3 underwent 3 sessions of ESWT (2000 shocks). All patients were assessed
using the visual analog scale (VAS), heel tenderness index (HTI), American Orthopaedic
Foot and Ankle Society (AOFAS) ankle-hindfoot scale, Roles–Maudsley score, and MRI
before and 1 month after treatment. The primary efficacy success criterion was the
percentage of decrease in heel pain of >60% from baseline at 1 month after treatment
for ≥2 of the 3 heel pain (VAS) measurements. Significant improvement was measured
using the mean VAS, AOFAS scale, and HTI scores for all 3 groups. The thickness of
the plantar fascia had decreased significantly on MRI in all 3 groups. The treatment
success rate was 70.6% in the LLLT group, 65% in the ESWT group, and 23.5% in the
US group. LLLT and ESWT proved significantly superior to US therapy using the primary
efficacy criterion (p = .006 and p = .012, respectively), with no significant difference between the LLLT and ESWT groups
(p > .05). The treatment of chronic plantar fasciitis with LLLT and ESWT resulted in
similar outcomes and both were more successful than US therapy in pain improvement
and functional outcomes.
Level of Clinical Evidence
Keywords
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Article info
Footnotes
Financial Disclosure: This research was supported by Celal Bayar University Scientific Research Project Coordination (Grant 2012-095).
Conflict of Interest: None reported.
Dr. Ulusoy is currently at the Department of Physical Medicine and Rehabilitation, Urla State Hospital, Izmir, Turkey.
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© 2017 Mayo Foundation for Medical Education and Research
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- Not All Extracorporeal Shock Wave Therapies Are Equal: A Comment on Ulusoy et al. J Foot Ankle Surg 2017;56:762-767The Journal of Foot and Ankle SurgeryVol. 57Issue 3
- PreviewI read with interest the article by Ulusoy et al (1) titled “Magnetic resonance imaging and clinical outcomes of laser therapy, ultrasound therapy, and extracorporeal shock wave therapy for treatment of plantar fasciitis: a randomized controlled trial.” The authors concluded that their study showed that treatment of chronic plantar fasciitis with low-level laser therapy and extracorporeal shock wave therapy (ESWT) resulted in similar outcomes. In my view, this is a scientifically improper generalization of the interpretation of their data.
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