Extracorporeal Shock Wave Therapy Versus Low Level Laser Therapy in The Treatment of Plantar Fasciitis: A Randomized Controlled Trial.

Abstract

Plantar fasciitis (PF) is predominantly treated conservatively through some modalities such as extracorporeal shock wave therapy (ESWT) and low-level laser therapy (LLLT), yet the short effect of these modalities on pain and function is still ambiguous. This study aims to compare the short-term effectiveness of ESWT and LLLT on pain and function in patients with PF. Participants (n=47) were randomly assigned into 2 groups as ESWT (n=27) and LLLT (n=20). ESWT (once a week) and LLLT (three times a week) were administered to the participants for 3 weeks. Foot function index (FFI) including pain, disability, and activity limitation subscales was administered at baseline and post-treatment. A reduction of one point in total scores was considered as a minimum clinically important difference. Repeated measures of ANOVA were used to analyze the changes in outcomes and compare the groups. There were significant main effects of time, and significant interaction effects between group and time on pain (P<0.001), disability (P<0.001), and activity limitation (P<0.05). The main effect of the group was not significant for all subscales (P=0.811, P=0.481, P=0.865, respectively). The LLLT group showed a significant decline in pain (P<0.001), disability (P<0.001), and activity limitation (P<0.001) while there was no change in the ESWT group over time (P=0.319, P=0.711, P=1.0 respectively). Consistently, 95% of participants in the LLLT had CID in the pain subscale whereas 48% of the ESWT group had. LLLT was found to be superior to ESWT as an effective approach in the short-term management of PF.