<span style="font-family:Verdana;">Background and Purpose: Plantar Fasciitis (PF) is a condition that affects the foot and causes complaints such as pain and stiffness. The most common symptom of this ...<span style="font-family:Verdana;">Background and Purpose: Plantar Fasciitis (PF) is a condition that affects the foot and causes complaints such as pain and stiffness. The most common symptom of this condition is pain. There are many treatment options to deal with this condition, such as conservative therapy, medications</span><span style="font-family:Verdana;">,</span><span style="font-family:Verdana;"> and surgical interventions in rare cases. This case study aims to investigate the potential impact of pain neuroscience education (PNE), combined with a conventional Physical Therapy (PT) program on a 37-year-old-patient with chronic plantar fasciitis. Case description: A 37-year-old male health care professional presented to an outpatient physical therapy clinic with a diagnosis of chronic PF for around two years. The participant had tried several treatment options with no improvement of his symptoms. After undergoing a physical therapy evaluation, he was given a plan of care for twelve sessions by a skilled physical therapist for a six-week period, with each session consisting of 30 minutes of conventional PT, followed by 5 to 15 minutes of PNE. Results: After completing the prescribed plan of care, the patient reported </span><span style="font-family:Verdana;">a </span><span style="font-family:Verdana;">reduction in subjective symptoms via the Visual Analog Scale (VAS). He also reported improvement with symptoms and functional independence via the Foot Function Index (FFI). The patient reported no change in </span><span style="font-family:Verdana;">the </span><span style="font-family:Verdana;">quality of sleep via Pittsburg Sleep Quality Index (PSQI). Lastly, he demonstrated no objective improvement in foot pressure with the Navicular Drop Test. Discussion: This case report indicates that PNE, combined with conventional PT for PF can have a positive impact on subjective pain and foot function. PNE should involve many topics about the physiology of pain and the nervous system and should be administered by a certified therapeutic pain specialist. Further studies are recommended to investigate the impact of this intervention in combination with traditional PT for PF in larger populations.</span>展开更多
目的探讨针刀松解(NKT)与体外冲击波(ESWT)治疗慢性跖筋膜炎型跟痛症(PHS-CPF)的临床疗效。方法收集2021年6月-2022年6月期间在南京医科大学金陵临床医学院骨科接受PHS-CPF治疗的48例患者,根据医患沟通结果和治疗方式分为NKT组(26例)和E...目的探讨针刀松解(NKT)与体外冲击波(ESWT)治疗慢性跖筋膜炎型跟痛症(PHS-CPF)的临床疗效。方法收集2021年6月-2022年6月期间在南京医科大学金陵临床医学院骨科接受PHS-CPF治疗的48例患者,根据医患沟通结果和治疗方式分为NKT组(26例)和ESWT组(22例),NKT组采用针刀松解治疗模式进行操作,ESWT组采用激痛点治疗模式进行操作。分别采用视觉模拟评分法(VAS)和压痛评分对2组治疗前及治疗后1周、1个月、3个月和6个月随访时的晨起足跟痛和足跟压痛进行评估。结果治疗后各随访时间节点,2组患者的晨起足跟痛和足跟压痛均较治疗前明显改善(P<0.05);2组治疗后1个月、3个月和6个月的晨起足跟痛和足跟压痛均低于治疗后1周(P<0.05);2组治疗后3个月和6个月的足跟压痛与治疗后1个月相比,差异不明显(P>0.05);NKT组治疗后3个月和6个月的晨起足跟痛均较治疗后1个月明显改善(1.88±0.71 vs 2.54±0.65,1.62±0.64 vs 2.54±0.65,P<0.05);与治疗后1个月相比,ESWT组治疗3个月后,晨起足跟痛无明显改善(P>0.05),而治疗6个月后,晨起足跟痛增加(4.32±0.78 vs 3.45±1.10,P<0.05)。治疗后1周时,NKT组的晨起足跟痛明显低于ESWT组(4.58±0.90 vs 5.27±0.98,P<0.05),而2组的足跟压痛差异不明显(P>0.05);治疗后1个月、3个月和6个月时,与ESWT组相比,NKT组在缓解晨起足跟痛(2.54±0.65 vs 3.45±1.10,1.88±0.71 vs 3.64±0.95,1.62±0.64 vs 4.32±0.78)和足跟压痛(0.58±0.58 vs 1.00±0.53,0.54±0.58 vs 1.09±0.61,0.73±0.53 vs 1.14±0.71)上更具优势(P<0.05)。结论NKT与ESWT治疗PHS-CPF的临床疗效确切,均能有效缓解晨起足跟痛和足跟压痛,并具有较好的维持治疗效果,但NKT的临床疗效更佳。展开更多
慢性和复发性一直是足底筋膜炎(PF)治疗的重难点,传统治疗往往关注局部炎症和疼痛感觉的消除,对于身体的整体生物力学再平衡缺乏关注。肌筋膜链理论强调人体肌肉、骨骼及结缔组织完整性,局部出现异常将引起其他组织代偿,这给PF临床治疗...慢性和复发性一直是足底筋膜炎(PF)治疗的重难点,传统治疗往往关注局部炎症和疼痛感觉的消除,对于身体的整体生物力学再平衡缺乏关注。肌筋膜链理论强调人体肌肉、骨骼及结缔组织完整性,局部出现异常将引起其他组织代偿,这给PF临床治疗提供了思路。该文检索中国知网、万方、PubMed、Web of science等中外数据库有关肌筋膜链理论和PF的文献资料,分析肌筋膜链与PF病理机制的可能关联,并总结肌筋膜链理论在PF相关治疗方法中的运用:筋膜因连续性、整体性以及力传导的功能,具有牵一发而动全身的特点。越来越多的研究证实,PF患者可能存在“后表链”的紧张导致的代偿,以及筋膜张力的异常传导。PF治疗除了处理足底局部痛点,缓解紧张的后表链也逐渐被关注,以求取得长期疗效。肌筋膜链理论在PF治疗中的应用体现在多种治疗方式中,包括体外冲击波、手法和牵伸、干针和针刺等,通过联合足底局部疼痛区及肌筋膜后表链进行整体治疗,相对于单纯处理局部痛点,具有更积极的远近期疗效。展开更多
文摘<span style="font-family:Verdana;">Background and Purpose: Plantar Fasciitis (PF) is a condition that affects the foot and causes complaints such as pain and stiffness. The most common symptom of this condition is pain. There are many treatment options to deal with this condition, such as conservative therapy, medications</span><span style="font-family:Verdana;">,</span><span style="font-family:Verdana;"> and surgical interventions in rare cases. This case study aims to investigate the potential impact of pain neuroscience education (PNE), combined with a conventional Physical Therapy (PT) program on a 37-year-old-patient with chronic plantar fasciitis. Case description: A 37-year-old male health care professional presented to an outpatient physical therapy clinic with a diagnosis of chronic PF for around two years. The participant had tried several treatment options with no improvement of his symptoms. After undergoing a physical therapy evaluation, he was given a plan of care for twelve sessions by a skilled physical therapist for a six-week period, with each session consisting of 30 minutes of conventional PT, followed by 5 to 15 minutes of PNE. Results: After completing the prescribed plan of care, the patient reported </span><span style="font-family:Verdana;">a </span><span style="font-family:Verdana;">reduction in subjective symptoms via the Visual Analog Scale (VAS). He also reported improvement with symptoms and functional independence via the Foot Function Index (FFI). The patient reported no change in </span><span style="font-family:Verdana;">the </span><span style="font-family:Verdana;">quality of sleep via Pittsburg Sleep Quality Index (PSQI). Lastly, he demonstrated no objective improvement in foot pressure with the Navicular Drop Test. Discussion: This case report indicates that PNE, combined with conventional PT for PF can have a positive impact on subjective pain and foot function. PNE should involve many topics about the physiology of pain and the nervous system and should be administered by a certified therapeutic pain specialist. Further studies are recommended to investigate the impact of this intervention in combination with traditional PT for PF in larger populations.</span>
文摘目的探讨针刀松解(NKT)与体外冲击波(ESWT)治疗慢性跖筋膜炎型跟痛症(PHS-CPF)的临床疗效。方法收集2021年6月-2022年6月期间在南京医科大学金陵临床医学院骨科接受PHS-CPF治疗的48例患者,根据医患沟通结果和治疗方式分为NKT组(26例)和ESWT组(22例),NKT组采用针刀松解治疗模式进行操作,ESWT组采用激痛点治疗模式进行操作。分别采用视觉模拟评分法(VAS)和压痛评分对2组治疗前及治疗后1周、1个月、3个月和6个月随访时的晨起足跟痛和足跟压痛进行评估。结果治疗后各随访时间节点,2组患者的晨起足跟痛和足跟压痛均较治疗前明显改善(P<0.05);2组治疗后1个月、3个月和6个月的晨起足跟痛和足跟压痛均低于治疗后1周(P<0.05);2组治疗后3个月和6个月的足跟压痛与治疗后1个月相比,差异不明显(P>0.05);NKT组治疗后3个月和6个月的晨起足跟痛均较治疗后1个月明显改善(1.88±0.71 vs 2.54±0.65,1.62±0.64 vs 2.54±0.65,P<0.05);与治疗后1个月相比,ESWT组治疗3个月后,晨起足跟痛无明显改善(P>0.05),而治疗6个月后,晨起足跟痛增加(4.32±0.78 vs 3.45±1.10,P<0.05)。治疗后1周时,NKT组的晨起足跟痛明显低于ESWT组(4.58±0.90 vs 5.27±0.98,P<0.05),而2组的足跟压痛差异不明显(P>0.05);治疗后1个月、3个月和6个月时,与ESWT组相比,NKT组在缓解晨起足跟痛(2.54±0.65 vs 3.45±1.10,1.88±0.71 vs 3.64±0.95,1.62±0.64 vs 4.32±0.78)和足跟压痛(0.58±0.58 vs 1.00±0.53,0.54±0.58 vs 1.09±0.61,0.73±0.53 vs 1.14±0.71)上更具优势(P<0.05)。结论NKT与ESWT治疗PHS-CPF的临床疗效确切,均能有效缓解晨起足跟痛和足跟压痛,并具有较好的维持治疗效果,但NKT的临床疗效更佳。
文摘慢性和复发性一直是足底筋膜炎(PF)治疗的重难点,传统治疗往往关注局部炎症和疼痛感觉的消除,对于身体的整体生物力学再平衡缺乏关注。肌筋膜链理论强调人体肌肉、骨骼及结缔组织完整性,局部出现异常将引起其他组织代偿,这给PF临床治疗提供了思路。该文检索中国知网、万方、PubMed、Web of science等中外数据库有关肌筋膜链理论和PF的文献资料,分析肌筋膜链与PF病理机制的可能关联,并总结肌筋膜链理论在PF相关治疗方法中的运用:筋膜因连续性、整体性以及力传导的功能,具有牵一发而动全身的特点。越来越多的研究证实,PF患者可能存在“后表链”的紧张导致的代偿,以及筋膜张力的异常传导。PF治疗除了处理足底局部痛点,缓解紧张的后表链也逐渐被关注,以求取得长期疗效。肌筋膜链理论在PF治疗中的应用体现在多种治疗方式中,包括体外冲击波、手法和牵伸、干针和针刺等,通过联合足底局部疼痛区及肌筋膜后表链进行整体治疗,相对于单纯处理局部痛点,具有更积极的远近期疗效。
