| Objective: To explore the therapeutic effect of extracorporeal shock wave on plantar fasciitis through myofascial chain trigger point combined with conventional tenderness point in order to discover a better therapeutic regimen,and increase both the efficiency rate and cure rate to provide theoretical reference for clinical practice.Methods: A total of 92 patients with plantar fasciitis treated with shockwave in our hospital from October 2019 to October 2021 were selected and randomly divided into 2 groups:control group and experimental group,with 46 patients in each group.Subjects in both groups received shock wave treatment targeted at the "plantar fasciitis tenderness point".The shock energy was 2-3bar,and specific adjustment was made according to patient tolerance.The shock frequency was 5Hz,and the shock frequency was 2000 times.In addition,the experimental group subjects received myofascial chain table line gastrocnemius muscle trigger points area after shock wave therapy,muscle trigger points including the medial head of the gastrocnemius muscle of the two and the lateral head of the gastrocnemius muscle,each muscle trigger points for 400 times shock wave treatment,between the trigger point along the table line walk line after treatment,400 times,2000 times,The impact energy is between 2 and3 bar,which can be adjusted according to patient tolerance.The impact frequency is 5Hz.Subjects in the control group also received shockwave treatment in the muscle trigger point region of the gastrocnemius muscle of the posterior surface line of the myofascial chain,but were treated with an empty gun,with an impact energy of 0bar,and other parameters were the same as those in the experimental group.All treatments were performed once a week for 3weeks.Subjects in both groups received routine exercises such as gastrocnemius muscle and soleus muscle drafting twice a day for 3 groups of 15 seconds each.The clinical efficacy,pain scale(VAS),range of motion(ROM),ankle-posterior Foot Scale(AOFAS)and maximum duration of walking were compared before treatment,2 weeks after treatment,4 weeks after treatment and 8 weeks after treatment.Results: Among 92 plantar fasciitis patients,6 patients did not complete the whole trial cycle and follow-up due to various reasons,with a loss to follow-up rate of 6.5%,and the rest of the patients completed the whole trial cycle.There were no significant differences in age,gender and disease course between the two groups(P > 0.05).VAS score: before treatment,there was no statistical difference between the VAS score of the experimental group and the control group(P =0.641,T =0.468).After 2 weeks of treatment,there was no statistical difference in VAS scores between the experimental group and the control group(P =0.094,T =-1.696).After 4 weeks of treatment,there was a statistical difference between the two groups(P < 0.001,t=-4.750).The statistical difference between the two groups remained(P < 0.001,t=-6.312).VAS scores of experimental groups were statistically different at four time points(P < 0.001,F=295.156).The VAS scores of the control group also showed statistical differences(P < 0.001,F=177.114),but there was no statistical difference between the VAS scores of the control group after 4 weeks of intervention and 8weeks of intervention(P =0.76)in multiple comparisons.AOFAS score: Before treatment: There was no statistical difference in AOFAS score between the experimental group and the control group(P =0.998,t=-0.002).After 2 weeks of treatment,there was a statistical difference in AOFAS scores between the two groups(P =0.002,T =3.187),4 weeks after treatment(P < 0.001,t=4.560)and 8 weeks after treatment(P < 0.001,t=7.410).There were significant differences in AOFAS scores among the four time nodes in the experimental group(P < 0.001,F=529.876),and there were also significant differences in AOFAS scores at the four time nodes in the control group(P <0.001,F=400.928).Longest duration of walking: Before treatment: there was no statistical difference between the longest duration of walking between the experimental group and the control group(P =0.634,T =0.470).After 2 weeks of treatment,there was a statistical difference in the maximum duration of walking between the two groups(P < 0.001,T =6.842),and there was still a statistical difference between the two groups after 4 weeks of treatment(P < 0.001,t=7.376)and 8 weeks of treatment(P < 0.001,T =16.704).There were statistical differences in the experimental group after 2 weeks,4 weeks,8 weeks and before treatment(P <0.001,F=524.150),and in the control group at each time node(P < 0.001,F=259.394).Dorsiflexion range of ankle: before treatment,there was no statistical difference in dorsiflexion range of ankle between the experimental group and the control group(P =0.548,T =-0.603).After 2 weeks of treatment,there was a statistical difference in ankle dorsiflexion range of motion between the two groups(P < 0.001,T =4.774),and there was still a statistical difference between the two groups after 4 weeks of treatment(P < 0.001,t=7.411)and 8 weeks of treatment(P < 0.001,t=10.492).There were statistically significant differences in ankle dorsiflexion range of motion at four time nodes in the experimental group(P <0.001,F=202.107),and there were statistically significant differences in ankle dorsiflexion range at four time nodes in the control group(P < 0.001,F=32.217).Conclusion: The shock wave via myofascial chain could improve the treatment of the plantar fasciitis.Meanwhile,shock wave therapy on the painful site of plantar fasciitis and the triggering point of the muscle on the posterior surface line of myofascial chain can relieve the pain of patients more quickly and effectively,improve the range of motion of the ankle joint and the function of the ankle,which is beneficial to the health recovery of plantar fasciitis patients,and is worthy of popularization and application. |
PDF Full Text Request