器具辅助软组织松解术联合体外冲击波疗法治疗足底筋膜炎的短期疗效观察

Short-term efficacy of instrument-assisted soft tissue mobilization combined with extracorporeal shock wave therapy on plantar fasciitis

目的探讨器具辅助软组织松解术(instrument-assisted soft tissue mobilization,IASTM)联合体外冲击波疗法(extracorporeal shock wave therapy,ESWT)对足底筋膜炎(plantar fasciitis,PF)的短期疗效。方法选择2019年5月至2021年4月在复旦大学附属中山医院康复医学科就诊的足底筋膜炎患者41例,随机分为对照组(n=20)和观察组(n=21)。对照组仅接受ESWT治疗,观察组接受IASTM与ESWT联合治疗。所有患者分别于治疗前、治疗4周后采用视觉模拟评分(visual analogue scale,VAS)、无痛承重负荷(painless weight-bearing load,PWBL)以及足踝功能评估(foot and ankle ability measure,FAAM)中的日常生活活动(activities of daily living,ADL)分量表评估2组治疗效果并比较。结果治疗后,对照组和观察组的VAS评分分别由(5.58±1.92)分和(5.63±1.73)分降低至(3.69±1.55)分(P<0.001)和(2.26±1.40)分(P<0.001);PWBL分别由(45.19±21.15)kg和(43.53±12.88)kg提高至(52.41±14.27)kg(P<0.05)和(61.64±12.47)kg(P<0.001);FAAM-ADL评分分别由(71.92±13.64)分和(70.57±13.11)分提高至(80.99±10.92)分(P<0.05)和(87.71±8.06)分(P<0.001)。观察组各项指标比对照组改善更显著(P<0.05)。结论IASTM联合ESWT治疗可在短期内显著改善PF患者步行时足底疼痛的程度,提高痛阈并提高足踝功能。

Objective To explore the short-term efficacy of instrument-assisted soft tissue mobilization(IASTM)combined with extracorporeal shock wave therapy(ESWT)on plantar fasciitis(PF).Methods From May 2019 to April 2021,41 patients with PF visiting the Department of Rehabilitation Medicine of Zhongshan Hospital,Fudan University were selected and randomly assigned to the control group(n=21)or the observation group(n=21).The control group received ESWT only while the observation group received IASTM combined with ESWT.All of the patients were evaluated through the visual analogue scale(VAS),painless weight-bearing load(PWBL)and the activities of daily living(ADL)subscale of foot and ankle ability measure(FAAM)at baseline and 4 weeks after treatment respectively.Results After treatment,the VAS score in the control group and the observation group decreased from(5.58±1.92)points and(5.63±1.73)points to(3.69±1.55)points(P<0.001)and(2.26±1.40)points(P<0.001)respectively.Meanwhile,PWBL increased from(45.19±21.15)kg and(43.53±12.88)kg to(52.41±14.27)kg(P<0.05)and(61.64±12.47)kg(P<0.001)respectively.Moreover,the FAAM-ADL score increased from(71.92±13.64)points and(70.57±13.11)points to(80.99±10.92)points(P<0.05)points and(87.71±8.06)points(P<0.001)respectively.All outcomes of the observation group were improved more significantly than those of the control group(P<0.05).Conclusions IASTM combined with ESWT can significantly relieveheel pain during ambulation,increase the pain threshold and improve the function of the foot in the patients with PF in a short time.