Plantar Fasiitte Radyal Ekstrakorporeal Şok Dalga Tedavisinde İki Farklı Doz Uygulamasının Karşılaştırmalı Klinik ve Fonksiyonel Sonuçları
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Tarih
2019
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Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Amaç: Konservatif tedaviye yanıt alınamayan plantar fasiit olgularında; iki farklı tedavi protokolü ile uygulanan rESWT‘nin (radial ekstrakorporeal şok dalga tedavisi) etkinliğinin kıyaslanması amaçlanmıştır. Gereç ve Yöntem: 2010-2017 yılları arasında, tek merkezde rESWT uygulanan ve dahil edilme kriterlerimize uyan 319 hasta değerlendirildi. 181 hastaya 1‘er hafta ara ile 1.5 bar, 10Hz,1500 şok, toplam 5 seans(grup 1) ve 138 hastaya ise yine 1‘er hafta ara ile 3 bar, 10Hz, 2000 şok, 5 seans(grup 2) rESWT uygulandı. Klinik ve fonksiyonel sonuçlar tedaviden hemen önce, tedavinin 6. haftasında ve 6. ayında Görsel Analog Skalası (VAS) ve Amerikan Ortopedik Ayak ve Ayak Bileği Skorlaması (AOFAS) ile değerlendirildi. Bulgular: Ortalama VAS skoru grup 1‘de 8,73(±1,10)‘ten 3,20(±2,09)‘ye (p=0,0001) ve grup 2‘de 8,68(±1,17)‘den 2,61(±1,68)‘e (p=0,0001) geriledi. Ortalama AOFAS skoru da grup 1‘de 55,85(± 11,73)‘den 88,38(± 8,23)‘e (p=0,0001) ve grup 2‘de 58,74(± 12,74)‘den 88,47(± 8,10)‘ye (p=0,0001) yükseldi. Grup 1 ve 2‘nin 6. hafta-6. ay VAS skor değişimlerinde farklılık saptanmazken (p=0,451), grup 1‘in tedavi öncesi-6. hafta ve tedavi öncesi-6. ay VAS değer değişimleri grup 2‘den düşük bulundu (p=0,006, p=0,019). Ayrıca grup 1 ve grup 2‘nin tedavi öncesi-6. ay ve 6. hafta-6. ay AOFAS skor değişimlerinde de farklılık saptanmazken (p=0,094, p=0,174), grup 1‘in tedavi öncesi-6. hafta AOFAS skor değişimi grup 2‘den düşük bulunuştur (p=0,029). Sonuç: Her iki tedavi protokolünün de ağrı ve fonksiyon kaybında azalmaya katkısı olmasına rağmen, 1‘er hafta ara ile 3 bar hava basınçlı ve 10Hz frekansında toplam 2000 şok ile uygulanan 5 seanslık rESWT‘nin daha üstün olduğu söylenebilir.
Objective: To investigate and compare the efficacy of two different protocol of r-ESWT (radial extracorporeal shock wave therapy) in plantar fasiitis unresponsive to conservative treatment. Methods: 319 patients who met eligibility criteria were included in 2010–2017 years in a same department center. 181 patients;1500 impulses, 10 Hz, 1.5 bar, five sessions at 1 week intervals (group 1) and 138 patients;2000 impulses,10 Hz, 3 bar, five sessions at 1 week intervals (group 2) were applied. Results were assessed pretreatment, at 6th week and at 6th months with Visual Analogue Scale (VAS) and American Orthopaedics Foot and Ankle Score (AOFAS). Results: The mean VAS score had decreased in group 1 from 8,73±1,10 to 3,20±2,09 (p=0,0001) and 8,68±1,17 to 2,61±1,68 in group 2 (p=0,0001). The mean AOFAS score had increased in group 1 from 55,85±11,73 to 88,38±8,23(p=0,0001) and 58,74±12,74 to 88,47±8,10 in group 2 (p=0,0001). While no significant difference averages was observed between VAS 6th weeks-6th months of group 1 and group 2 (p = 0,451), the mean difference of VAS Pretreatment - 6th weeks and pretreatment-6th months of group 1 was lover than group 2 (p=0,006,p=0,019). And also while no significant difference averages was observed between AOFAS pretreatment-6th months and 6thweeks-6th months of group 1 and group 2 (p=0,094,p=0,174), the mean difference of AOFAS Pretreatment-6th weeks of group 1 was lover than group 2 (p=0,029). Conclusions: Although, both r-ESWT regimes cause a decrease pain and function, superior protocol for r-ESWT appears to be 5 sessions at 1 week intervals, 2000 impulses of 10 Hz per session and 3 bar.
Objective: To investigate and compare the efficacy of two different protocol of r-ESWT (radial extracorporeal shock wave therapy) in plantar fasiitis unresponsive to conservative treatment. Methods: 319 patients who met eligibility criteria were included in 2010–2017 years in a same department center. 181 patients;1500 impulses, 10 Hz, 1.5 bar, five sessions at 1 week intervals (group 1) and 138 patients;2000 impulses,10 Hz, 3 bar, five sessions at 1 week intervals (group 2) were applied. Results were assessed pretreatment, at 6th week and at 6th months with Visual Analogue Scale (VAS) and American Orthopaedics Foot and Ankle Score (AOFAS). Results: The mean VAS score had decreased in group 1 from 8,73±1,10 to 3,20±2,09 (p=0,0001) and 8,68±1,17 to 2,61±1,68 in group 2 (p=0,0001). The mean AOFAS score had increased in group 1 from 55,85±11,73 to 88,38±8,23(p=0,0001) and 58,74±12,74 to 88,47±8,10 in group 2 (p=0,0001). While no significant difference averages was observed between VAS 6th weeks-6th months of group 1 and group 2 (p = 0,451), the mean difference of VAS Pretreatment - 6th weeks and pretreatment-6th months of group 1 was lover than group 2 (p=0,006,p=0,019). And also while no significant difference averages was observed between AOFAS pretreatment-6th months and 6thweeks-6th months of group 1 and group 2 (p=0,094,p=0,174), the mean difference of AOFAS Pretreatment-6th weeks of group 1 was lover than group 2 (p=0,029). Conclusions: Although, both r-ESWT regimes cause a decrease pain and function, superior protocol for r-ESWT appears to be 5 sessions at 1 week intervals, 2000 impulses of 10 Hz per session and 3 bar.
Açıklama
Anahtar Kelimeler
Genel ve Dahili Tıp, Tıbbi Araştırmalar Deneysel, Ortopedi
Kaynak
KONURALP TIP DERGİSİ
WoS Q Değeri
Scopus Q Değeri
Cilt
11
Sayı
2
