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

Eren TimurtaşMarmara University, Health Science Faculty, Department of Physiotherapy and Rehabilitation, Istanbul, Turkey.

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 PT, PhD
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Eda ÇinarUniversité de Sherbrooke, Centre de recherche du CHUS, Département de Psychoéducation, Sherbrooke, Canada

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Halit SelçukMarmara University, Health Science Faculty, Department of Physiotherapy and Rehabilitation, Istanbul, Turkey.

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Ender Ersin AvciMarmara University, Health Science Faculty, Department of Physiotherapy and Rehabilitation, Istanbul, Turkey.

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Suat BatarUniversity of Health Sciences, Ümraniye Training and Research Hospital, Department of Orthopedics and Traumatology, Istanbul, Turkey.

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İlkşan DemirbükenMarmara University, Health Science Faculty, Department of Physiotherapy and Rehabilitation, Istanbul, Turkey.

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Mine Gülden PolatMarmara University, Health Science Faculty, Department of Physiotherapy and Rehabilitation, Istanbul, Turkey.

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 PT, PhD

Abstract

Background: 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.

Methods: 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.

Results: 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.

Conclusions: LLLT was found to be superior to ESWT as an effective approach in the short-term management of PF.

Corresponding author: Eren Timurtaş, PhD, PT, Marmara University, Faculty of Health Science, Department of Physiotherapy and Rehabilitation, Başıbüyük Cd. No:9, 34854 Maltepe/İstanbul/Turkey. (E-mail: fzteren@gmail.com)