Studies of F-ESWT and RPT in chronic recalcitrant plantar fasciitis: 12-week follow-up
| Treatment | Ref | Study design | System type | N | Regime | Significant benefit at 12 weeks (or other time frame as stated)? |
|---|---|---|---|---|---|---|
| F-ESWT low to high as tolerated | 21 | DB-RCT | EH | 172 | 1 session, 3800 pulses, starting at low dose, increasing to high as tolerated* | Yes. Mean reduction in pain at 3 months 3.39 (TG) vs 1.78 (CG); p<0.001 |
| 22 | DB-RCT | EM | 178 | 3 once weekly sessions, 2000–2500 shocks from 0.02 mJ/mm2 increasing as tolerated* | No. Mean (SD) change in pain: 26.3(34.8) (TG) vs 25.7 (34.9) | |
| F-ESWT low | 23 | DB RCT | EM | 227 | 3 once weekly sessions, 4000 shocks, 0.08 mJ/mm2 | No. ‘Success’ in 34% (TG) vs 30% (CG); 95% CI: –8 to 15% |
| 13 | DB RCT | EM | 88 | 3 once monthly sessions, 1500 shocks, 0.12 mJ/mm2 | No. Mean (SD) VAS Pain: 73.6 (20.1; 23–100) to 41.4 (27.4; 0–97) in TG vs 70 (20.1; 9–98) to 47.1 (31.5; 0–100). Those achieving 50% improvement form baseline 37% (TG) vs 24% (CG) | |
| F-ESWT high | 24 | DB RCT | EH | 293 | 100 shocks @ 0.12, 1400@0.22 mJ/mm2 | Yes. Mean pain: 8.02 baseline to 3.48 12 weeks (TG) vs 8.14 to 4.20 (CG) |
| 25 | DB-RCT | EM | 150 | 3800 shocks (3500 shocks @ 0.36 mJ/mm2 | Yes. Mean (SD) change in pain VAS TG: 3.4(2.7) vs CG: 4.1 (3.1), p=0.0435 | |
| 26 | DB RCT | EM | 40 | 3 once weekly sessions, 2000 @ 0.25 mJ/mm2 | Yes. % reduction in VAS composite score: 73.2% (TG) vs 40.5% (CG), p=0.0302. MW effect size 0.6737 | |
| 27 | DB-RCT | EM | 114 | 1 session, 3800 shocks @ 0.34 mJ/mm2 (implied) | Yes. Mean (SD) VAS pain: 7.5(1.5) to 3.9 (3.2) vs 7.9 (1.5) to 5.3 (2.7); p<0.0001 | |
| RPT | 28 | DB-RCT | RPT | 245 | 3 sessions once every 2 weeks of 2000 pulses @ 0.16 mJ/mm2 | Yes. Reduction in VAS composite score 72.1% vs 44.7%, p=0.0220. MW effect size 0.5753 |
| 29 | DB-RCT | 50 | 2 sessions, 1 week apart, of 2000 shocks @ 0.16 mJ/mm2 | Yes, at 24 weeks. Mean (SD) VAS pain 8.5 (0.3) to 1.1 (0.3) (TG) vs 8.9 (0.2) to 7.7 (0.2) |
N=total number of patients DB-RCT.
*High variation in total dose administered between patients.
CG, control group; DB-RCT, double-blind randomised controlled trial; EH, electrohydraluic; EM, electromagnetic; F-ESWT, focused extracorporeal shockwave therapy; RPT, radial pulse therapy; SB, single-blind randomised controlled trial; TG, treatment group.