Clinical effectiveness of multi-wavelength photobiomodulation therapy as an adjunct to extracorporeal shock wave therapy in the management of plantar fasciitis: a randomized controlled trial 46
Mary Kamal Nassif Takla and Soheir Shethata Rezk-Allah Rezk
Published in: Lasers in Medical Science, 2019 https://doi.org/10.1007/s10103-018-2632-4
This clinical trial evaluated the effectiveness of combining extracorporeal shockwave therapy (ESWT) with photobiomodulation therapy (PBMT) to treat pain and disability in patients with plantar fasciitis.
One hundred twenty patients with plantar fasciitis for more than 6 months and unresponsive to conservative treatment were enrolled in the trial. Patients were randomized to one of the following groups:
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ESWT: Patients in this group were treated with the Chattanooga® Intelect® Focus Shockwave. Treatment sessions were completed once a week for 3 weeks and consisted of 2000 pulses at an energy level between 0.22 and 0.28 mJ/mm 2 . PBMT: Patients in this group received photobiomodulation therapy at a dose of 2.8 J/cm 2 for 60 seconds at each session. Treatments were completed 3 times a week for 3 weeks.
• ESWT + PBMT: Treatment parameters for this group were the same as described for each of the single therapy groups. Patients received one ESWT and 3 PBMT treatments per week. Once per week, ESWT and PBMT were given consecutively with ESWT being administered prior to PBMT. • Sham PBMT: Patients in this group received
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sham PBMT 3 times a week for 3 weeks where no power was emitted from the device.
Study outcomes included pressure pain threshold (PPT), VAS pain score, and the functional foot index disability subscale (FFI-d). The ESWT, PBMT, and ESWT + PMBT groups showed improvement in all outcome scores after 3 weeks of treatment, with further improvement at the 12 week follow-up. The ESWT + PBMT group was superior to either treatment alone in reducing pain and disability.
VAS pain scores for the ESWT + PBMT group decreased by 90.5% at the 12 week follow-up and the FFI-d scores decreased by 56.2%! In comparison, the Sham PBMT group VAS pain scores increased by 3.8% and the FFI-d scores increased by 0.6%.
The authors concluded that both ESWT and PBMT are effective treatments for reducing pain and improving function in patients with plantar fasciitis. However, combining the two treatments gives the best results.
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