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Comparison of two extracorporeal shock wave therapy techniques for the treatment of painful subcalcaneal spur. A randomized controlled study [with consumer summary]
Tornese D, Mattei E, Lucchesi G, Bandi M, Ricci G, Melegati G
Clinical Rehabilitation 2008 Sep;22(9):780-787
clinical trial
6/10 [Eligibility criteria: Yes; Random allocation: Yes; Concealed allocation: No; Baseline comparability: Yes; Blind subjects: No; Blind therapists: No; Blind assessors: Yes; Adequate follow-up: Yes; Intention-to-treat analysis: No; Between-group comparisons: Yes; Point estimates and variability: Yes. Note: Eligibility criteria item does not contribute to total score] *This score has been confirmed*

OBJECTIVE: To describe and compare two extracorporeal shock wave therapy techniques for the treatment of painful subcalcaneal spur. DESIGN: Random assignment to two groups of treatment with two and eight months follow-up. SETTING: The data were collected in outpatients. SUBJECTS: Forty-five subjects with a history of at least six months of heel pain were studied. INTERVENTIONS: Each subject received a three-session ultrasound-guided extracorporeal shock wave therapy (performed weekly). Perpendicular technique was used in group A (n = 22, mean age 59.3 +/- 12 years) and tangential technique was used in group B (n = 23, mean age 58.8 +/- 12.3 years). MAIN OUTCOME MEASURES: Mayo Clinical Scoring System was used to evaluate each subject before the treatment and at two and eight months follow-up. RESULTS: Mayo Clinical Scoring System pretreatment scores were homogeneous between the groups (group A 55.2 +/- 18.7; group B 53.5 +/- 20; p > 0.05). In both groups there was a significant (p < 0.05) increase in the Mayo Clinical Scoring System score at two months (group A 83.9 +/- 13.7; group B 80 +/- 15,8) and eight months (group A 90 +/- 10.5; group B 90.2 +/- 8.7) follow-up. No significant differences were obtained comparing the Mayo Clinical Scoring System scores of the two groups at two and eight months follow-up. CONCLUSIONS: There was no difference between the two techniques of using extracorporeal shock wave therapy. The tangential technique was found to be better tolerated as regards treatment-induced pain, allowing higher energy dosages to be used.

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