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  1. Professor Martin P Schwellnus
  1. University of Cape Town, South Africa

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    Thinner plantar fascia predicts decreased pain after extracorporeal shock wave therapy

    ▸ Liang H-W, Wang T-G, Chen W-S, Hou S-M. Clin Orthop Rel Res 2007;460:219–25.


    Chronic plantar fasciitis is associated with a thicker plantar fascia thickness — treatment of this condition may be associated with a reduced thickness and reduced pain.

    Research question/s:

    Does extracorporeal shock wave therapy decrease plantar fascia thickness, and is this associated with reduced pain?


    Subjects: 53 patients with plantar fasciitis (78 symptomatic feet).

    Experimental procedure: Subjects were assessed and then randomly assigned treatment with either lower-dose (LowD = 25, 0.12 mJ/mm2) or higher-dose (HighD = 28, 0.56 mJ/mm2) extracorporeal shock wave therapy (2000 shock waves, three consecutive sessions, applied at weekly intervals using no local anaesthetic). Pain, foot function, and the Short Form-36 Health Survey were assessed before and after 3 and 6 months. Ultrasonographic measurement of plantar fascia thickness was also measured before and after 3 and 6 months.

    Measures of outcome: Pain (VAS), foot function (Foot Function Index), SF-36 score, plantar fascial thickness.

    Main finding/s:

    Similar improvements in pain and function were observed in the HighD and the LowD groups.

    Plantar fascia thickness: there was less pain after treatment in the patients with thinner plantar fascia.


    Extracorporeal shock wave therapy (low and high-dose) is associated with reduction in pain and improved …

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