Effect Of Infrared Thermal Imaging In Shock Wave Therapy Of Plantar Fasciitis

Objective:To explore the effect of infrared thermal imaging technology in extracorporeal shock wave therapy for patients with plantar fasciitis,so as to provide imaging guidance for shock wave therapy of plantar fasciitis and improve the treatment efficiency and satisfaction of patients.Methods:A total of 66 patients who were treated with unilateral plantar fasciitis by external shock wave in the pain outpatient department of our hospital from October 2021 to October 2022 were selected,among which 4 patients refused follow-up and 2 patients changed treatment methods.A total of 60 patients were finally included in the trial.The patients were divided into experimental group and control group by random number table method,with 30 cases in each group.Before treatment,two groups of patients were examined by infrared thermal imaging by the same professional technician to mark abnormal high temperature points of calf gastrocnemius muscle and plantar fascia.The control group received manual palpation of calf gastrocnemius muscle and plantar fascia by another experienced clinician and marked trigger points.After the examination,the two groups received shockwave therapy（shock energy 2.0bar,frequency 6.0Hz,number of shocks 2000）directed at the marked points by the same professional physician,once a week,for a total of 3 treatments.During the interval of treatment,the patients were instructed to stretch and release the gastrocnemius muscle of the plantar and calf.General data of patients（age,sex,BMI,course of disease,diseased side）were collected.The outcome measures were Visual analogue scale（VAS）,American Orthopedic Foot and Ankle Society Score（AOFAS）,the maximum walking distance,the range of motion of the dorsiflexor ankle joint,and the mean temperature difference between the abnormal high temperature point and the symmetric area of the healthy side on infrared thermal imaging were collected before treatment and after 1,2,and 3 weeks treatment.Measurement data with normal distribution mean±standard（（?）±s）deviation said,the two independent sample t test statistical analysis;The skewed distribution data were described by median（interquartile distance）[M(P₂₅,P₇₅)],and statistically analyzed by rank-sum test of two independent samples.The rate of count data（%）was represented by Chi-square test for statistical analysis,and the difference of each time node in the group was compared by repeated measurement analysis of variance.Results:1.There were no statistical differences in the general information and the main observation indicators before treatment between the two groups（P>0.05）,indicating comparability.2.VAS score after treatment:There was a statistical difference in VAS score between the two groups after 1 week of treatment（t=-2.227,P=0.003）,and this difference lasted until 3 weeks after treatment（t=-4.038,P<0.001）.Repeated measurement variance analysis at four times nodes of the experimental group showed statistical difference（F=392.217,P<0.001）,and repeated measurement variance analysis at four time nodes of the control group also showed statistical difference（F=343.985,P<0.001）,and pin-pair comparison within the group showed statistical difference.3.AOFAS score after treatment:There was a statistical difference in AOFAS score between the two groups after 1 week of treatment（Z=-2.637,P=0.008）,and this difference lasted until 3 weeks after treatment（Z=-2.896,P=0.004）.Repeated measurement ANOVA showed statistically significant differences in AOFAS scores at four times nodes of the experimental group（F=101.058,P<0.001）and four times nodes of the control group（F=61.030,P<0.001）,and pairwise comparison within the group showed statistically significant differences.4.Range of motion of dorsiflexor ankle joint after treatment:There was a statistical difference in the range of motion of dorsiflexor ankle joint between the two groups after 1week of treatment（t=11.668,P<0.001）,and this difference lasted until 3 weeks after treatment（t=4.635,P<0.001）.Repeated measurement variance analysis showed statistically significant differences in ankle dorsiflexor joint motion at four times nodes of the experimental group（F=3686.873,P<0.001）and four times nodes of the control group（F=1837.523,P<0.001）,and pairwise comparison within the group showed statistically significant differences.5.Farthest walking distance after treatment:The farthest walking distance after 1week of treatment was statistically different between the two groups（t=4.234,P<0.001）,and this difference lasted until 3 weeks after treatment（t=10.501,P<0.001）.The maximum walking distance of the four times nodes in the test group was statistically different by repeated measurement variance analysis（F=1543.380,P<0.001）,and the four times nodes in the control group were also statistically different（F=1423.414,P<0.001）,and the pairwise comparison within the group was statistically different.6.Temperature difference of infrared thermal imaging images after treatment:there was a statistical difference in temperature difference of infrared thermal imaging images between the two groups after treatment for 2 weeks（t=-4.745,P<0.001）,and there was still a statistical difference 3 weeks after treatment（t=-8.232,P<0.001）.The temperature difference values of infrared thermal imaging images at four times nodes of the experimental group showed statistical difference（F=449.756,P<0.001）by repeated measurement variance analysis,and the four times nodes of the control group also showed statistical difference（F=75.041,P<0.001）,and pairwise comparison within the group showed statistical difference（P<0.05）.Conclusion:The recognition of trigger points by infrared thermal imaging is more effective than palpation recognition in the treatment of plantar fasciitis by extracorporeal shock wave.Meanwhile,shock wave inactivation trigger points are an effective means for the treatment of plantar fasciitis.