Einfluss von Lokalanästhesie und Energieflussdichte bei niederenergetischer Extrakorporaler Stoßwellentherapie der chronischen Plantaren Fasziitis

Autor:	G. Labek, M. Ziernhöld, V. Auersperg, N. Poulios, N. Böhler
Rok vydání:	2005
Předmět:	Systematic error medicine.medical_specialty business.industry Visual analogue scale Outcome measures Plantar fasciitis Extracorporeal shock wave Group B Surgery Shock (circulatory) Anesthesia Medicine Orthopedics and Sports Medicine Local anesthesia medicine.symptom business
Zdroj:	Zeitschrift für Orthopädie und ihre Grenzgebiete. 143:240-246
ISSN:	1438-941X 0044-3220
Popis:	BACKGROUND The efficacy of low energy extracorporeal shock wave treatment (ESWT) for chronic plantar fasciitis is discussed controversially. It is unclear whether the simultaneous application of local anesthesia (LA) interferes with clinical outcome. METHODS 60 patients with a chronic plantar fasciitis were enrolled in a triple-arm (20 patients per group), prospective randomized and observer-blinded pilot trial. The patients were randomly assigned to receive either active ESWT without LA (;3 x 1 500 shocks, total energy flux density [EFD] per shock 0.09 mJ/mm(2) [Group A]), ESWT with LA (3 x 1 500 shocks, EFD 0.18 mJ/mm(2) per shock [Group B]) or ESWT with LA (3 x 1 500 shocks, EFD 0.09 mJ/mm(2) [Group C]). Main outcome measures were: pain during first stepps in the morning (measured on a 0-10 point visual analogue scale) and number of patients with > 50 % reduction of pain and no further therapy needed, measured at 6 weeks after the last ESWT. RESULTS Group A improved in the VAS from 6.4 (SD: 1.7) to 2.2 (SD: 2.6) points, group B from 6.7 (SD: 1.5) to 4.1 (SD: 2.4) points, group C from 6.2 (SD: 1.6) to 3.8 (SD: 2.5) points. A reduction of pain of at least 50 % was achieved in 60 % of group A, in 36 % of group B and in 30 % of group C. Group A without LA showed a significantly higher improvement in the VAS and subjective evaluation than groups B (p = 0.007) and C (p = 0.016). CONCLUSION At 6 weeks success rates after low-energy ESWT with local anesthesia were significantly lower than after identical low-energy ESWT without local anesthesia. Higher energy levels could not balance the disadvantage of this effect. LA significantly influenced the clinical results after low energy ESWT in a negative way. Blinding patients by LA in ESWT studies must therefore be considered a systematic error in study design.
Databáze:	OpenAIRE
Externí odkaz:	https://explore.openaire.eu/search/publication?articleId=doi_________::ab6833d56621ebb86ac75769c6b6d533 https://doi.org/10.1055/s-2004-832379 Zobrazit plný text záznamu