Evaluation Effects of Laser Therapy and Extracorporeal Shock Wave Therapy with Clinical Parameters and Magnetic Resonance Imaging for Treatment of Plantar Fasciitis in Patients with Spondyloarthritis: A Randomized Controlled Trial.

Kezban Armagan Alpturker,Ayse Beyhan Lale Cerrahoglu,Ihsan Sebnem Orguc

doi:10.1155/2020/4386361

Kezban Armagan Alpturker, Ayse Beyhan Lale Cerrahoglu + Show 1 more

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https://doi.org/10.1155/2020/4386361

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Abstract

Objective Low-level laser therapy (LLLT) and extracorporeal shock wave therapy (ESWT) is applied in the conservative treatment of inflammatory plantar fasciitis, which is also a characteristic feature of spondyloarthritis (SpA) (Gill, 1997 and Roxas, 2005). We determined and compared the effectiveness of LLLT and ESWT using magnetic resonance imaging (MRI). Methods This study is a prospective, randomized, comparative, single-blind clinical study. Voluntarily followed 40 patients with the diagnosis of SpA and having pain at the heels at least for 6 months. Patients were divided randomly into two treatment groups. One group undertook 14 sessions of infrared Ga-Al-As LLLT, and the other group undertook 3 sessions ESWT. Feet functions of the patients were evaluated by American Orthopaedic Foot and Ankle Society (AOFAS) and Roles and Maudsley Scoring; VAS was evaluated for foot pain and function. In clinical assessment, disease activity was carried out by applying the BASDAI, the functional assessment was evaluated through the BASFI, and the patient quality of life was evaluated through the ASQoL; enthesitis was scored according to MASES assessment, performed before and at 1 month after treatment. The thickness of the plantar fascia was measured with MRI before and 1 month after treatment. Results Compared with the pretherapy, progress in the feet function by AOFAS and Roles-Maudsley scoring and decrease in VAS levels were statistically significant in both groups (p < 0.001). Only the VAS exercise score was superior to LLLT (p < 0.05). The thickness of the plantar fascia had decreased significantly on MRI in all two groups. Conclusion The treatment of plantar fasciitis with LLLT and ESWT was more successful in pain improvement and functional outcomes with the dose, frequency, and duration used in our study.

Highlights

Plantar fasciitis (PF), a frequent cause of heel pain, is a chronic inflammatory disorder of the fascial enthesis
Results were statistically significant in favor of treatment (p < 0:05)
Patients followed with SpA diagnosis and having heel pain at least 6 months, diagnosed with PF differentially by physical examination, and with symptoms that did not regress with first step conservative treatment are divided into two groups randomized

Summary

Introduction

Plantar fasciitis (PF), a frequent cause of heel pain, is a chronic inflammatory disorder of the fascial enthesis. Degenerative, inflammatory, and traumatic causes are defined as enthesopathy while inflammatory enthesopathy is called “enthesitis” [1,2,3]. The clinical course of axial spondyloarthritis (SpA) is variable and characterized by spinal involvement and extraspinal manifestations, such as peripheral enthesitis [3, 4]. Peripheral enthesitis is most commonly found in the calcaneus plantar fascia and the Achilles tendon. It is thought that the repetitive mechanical loads and tendon movements are the reason why it is most often seen in the lower extremity. Clinical diagnosis of plantar fasciitis is based on anamnesis and physical examination. Magnetic resonance imaging (MRI), expensive, is a very sensitive imaging method to evaluate

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