A comparison of the effectiveness of extracorporeal shock wave therapy and ultrasound therapy in managing heel pain

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A comparison of the effectiveness of extracorporeal shock wave therapy and ultrasound therapy in managing heel pain

 

Author: Chang, Hua
Title: A comparison of the effectiveness of extracorporeal shock wave therapy and ultrasound therapy in managing heel pain
Degree: M.Sc.
Year: 2002
Subject: Hong Kong Polytechnic University -- Dissertations
Musculoskeletal system -- Wounds and injuries -- Treatment
Heel bone -- Wounds and injuries -- Treatment
Extracorporeal shock wave therapy
Ultrasonic waves -- Therapeutic use
Department: Multi-disciplinary Studies
Dept. of Rehabilitation Sciences
Pages: xi, 70 leaves : ill. (some col.) ; 30 cm
Language: English
InnoPac Record: http://library.polyu.edu.hk/record=b1658991
URI: http://theses.lib.polyu.edu.hk/handle/200/670
Abstract: Ultasound therapy is a very common physiotherapy modality for treating musculoskeletal disorders including heel pain. However, a recent systematic review found that the effectiveness of using ultasound therapy for treating musculoskeletal disorders remains controversial (Robertson and Baker 2001). Extracorporeal shock wave therapy (ESWT) is a recently developed modality for treating musculoskeletal disorders. This study examined the relate effectivesness of ESWT and ultasound therapy, as compared to a control group in managing hell pain. Thirty-seven patients were divided into three groups. One group received ESWT once a week for 3 consecutive weeks. Parameters were set at a frequency of 4Hz with a total of 1000 impulses, intensity at 0.23 to 0.37mJ/mm2. Group 2 received continuous ultrasound therapy for 5 minutes in each session, three times a week for three consecutive weeks. Parameters were set at 1MHz, intensity level at 1W/mm2. Group 3 was the control group and no treatment was given during the study period. The intensity of morning pain on weight bearing, pain triggered by prolonged walking/standing, pain on tension and palpation were assessed by Visual Analogue Scale (VAS) before each treatment session, including a 3-week follow-up session. In addition, Mayo Clinical Scoring System (MCSS) and maximum tolerable duration in prolonged walking/standing were evaluated. Repeated measures ANOVA was used for data analysis. After 3 weeks of treatment, the ultrasound group onlky showed significant difference in one outcome measure as compared to the control group, that was the reduction of heel pain on palpation (P=0.011). However, the ESWT group showed significantly greater improvements than the other two groups in 2 outcome measures, including the maximum tolerable duration in prolonged walking/standing (P <= 0.001) and the intensity of heel pain on palpation (P <= 0.002). By week 3, there was a 157.14% cumulative increase in the maximum tolerable duration of walking in the ESWT group, as compared to 24.24% in the ultrasound group, and 18.15% in the control group. On the other hand, the intensity of heel pain on palpation was reduced by 37.34% in the ESWT group, and by 23.73% in the ultrasound group by week 3. The treatment effects for both treatment groups were maintained at least up to follow-ip session. For the control group, there was no significant change in any of the above outcome measures (all P<0.05). Ultrasound therapy produced marginal therapeutic effects in managing heel pain, but was less effective than that of ESWT. Three sessions of ESWT significantly reduced the intensity of heel pain and improved the walking tolerance of the patients. The therapeutic effects achieved by 3 sessions of ESWT were maintained till the 3-week follow-up session.

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