| Objective: To compare the clinical efficacy of extracorporeal shock wave therapy and corticosteroid injection in the treatment of plantar fasciitis through plantar pressure and gait analysis.Methods: A total of 52 patients with unilateral plantar fasciitis who were admitted to the Outpatient Service and Rehabilitation Center of the Department of Bone Joint and Sports Medicine of Eastern Branch of Qingdao Municipal Hospital from March 2019 to January 2020 were selected.The patients were randomly divided into 2 groups with 26 cases in each group by random number table method.One group was the extracorporeal shock wave group,including 14 males and 12 females.Left foot 11 cases,right foot 15cases;Patients aged 25-59 years old,mean age(44.65±9.77)years old.Patients were given extracorporeal shock wave therapy,2000 times per shock,frequency 5-10 Hz,treatment pressure 1.2-2.5bar,energy flow density 0.12-0.16 m J/mm~2,once a week,a total of 5 times.The other group was the corticosteroid group,with 15 males and 11 females.Left foot 14 cases,right foot 12 cases;Patients aged from 30-64 years old,mean age(46.81±10.38)years old.Patients were given 2% lidocaine 2m L+compound betamethasone injection(Diprospan)1m L local injection,a total of one treatment.All patients did not participate in vigorous physical activities,and avoided prolonged standing and excessive walking in 1 week after each treatment.Patients in the two groups were treated and followed up.The visual analogue score,plantar pressure distribution(the bipedal pressure difference)and gait(single support phase of affected foot,healthy foot step length / height)were compared before treatment,1 day after treatment,1 month after treatment and 3 months after treatment.Results:(1)All 52 patients completed the treatment and were followed up effectively.(2)There was no significant difference in general information between the two groups before treatment(P > 0.05).(3)There was no significant difference in visual analog score,plantar pressure distribution and gait between the two groups before treatment(P > 0.05).(4)Compared with those before treatment,the visual analog score,plantar pressure distribution and gait of the two groups were not significantly different after treatment(P< 0.001).(5)The visual analog scores of the extracorporeal shock wave group decreased with time(P < 0.001),but the visual analog scores of the corticosteroid group did not change at different time points after treatment(P > 0.05).The bipedal pressure difference in the extracorporeal shock wave group decreased with time(P < 0.001),and the bipedal pressure difference in the corticosteroid group at 3 months after treatment was higher than that at 1 month after treatment(P < 0.01).The single support phase of the affected foot of extracorporeal shock wave group increased with the prolongation of time(P < 0.001),and healthy foot step length / height increased with the prolongation of time(P < 0.001).In the corticosteroid group,there was a decrease in the single support phase of the affected foot and healthy foot step length / height at 3 months after treatment compared with 1 month after treatment(P<0.05).(6)One day after treatment,compared with extracorporeal shock wave group,the visual analog score of corticosteroid group was significantly lower(3.04±1.22vs5.04±1.18,P < 0.001),the bipedal pressure difference was significantly reduced(9.54±4.15vs13.96 ±2.60,P <0.001),the single support phase of the affected foot was significantly increased(31.19± 4.30vs25.00 ± 3.97,P < 0.001),and the healthy foot step length/height was significantly increased(0.31±0.03vs0.27±0.03,P < 0.001).One month after treatment,there were no significant differences in visual analog score,plantar pressure distribution and gait between 2 groups(P > 0.05).At 3 months after treatment,the visual analogue score of the extracorporeal shock wave group was lower than that of the corticosteroid group,the difference was statistically significant(1.54±0.86vs3.19±1.60,P < 0.001).The bipedal pressure difference in the extracorporeal shock wave group was lower than that in the corticosteroid group,and the difference was statistically significant(4.54±2.16vs11.58±4.94,P < 0.001).The single support phase of the affected foot in the extracorporeal shock wave group was higher than that in corticosteroid group,the difference was statistically significant(36.46 ± 2.86vs29.96 ± 5.09,P < 0.001).The healthy foot step length / height of extracorporeal shock wave group was higher than that of corticosteroid group,the difference was statistically significant(0.35 ±0.03vs0.29±0.05,P < 0.001).Conclusion: both extracorporeal shock wave therapy and corticosteroid injection could relieve the pain and improve the function of the affected foot after treatment;Corticosteroid injection had a rapid onset and a short course of treatment,and the efficacy was weakened 3 months after treatment;The effect of extracorporeal shock wave therapy is slow and the course of treatment is long,and it was more effective than corticosteroid injection 3 months after treatment. |
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