Shockwave Phonophoresis on Calcaneal Spur Patients

Study Overview
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Brief Summary
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The Low energy shockwave has a significant effect on the permeability of tissue. Consequently, it might be used to deliver a substance such as Acetic acid. Accordingly, Shockwave might help to improve the outcomes with calcaneal spur patients. Therefore, the present study might help in the treatment of calcaneal spur patients and also might improve the quality of life in a fast and efficient way.

Official Title
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Effect of Acetic Acid Shockwave Phonophoresis on Calcaneal Spur Patients: A Randomized Controlled Trial

Conditions
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Calcaneal Spur

Intervention / Treatment
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* Device: Acetic acid shockwave phonophoresis therapy
* Device: Shock wave Therapy
* Other: conventional physical therapy program


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Heel pain with a calcaneal spur. Calcaneal spur in a lateral calcaneal x-ray. Patient's age ranged from 30 to 65 years. Patients with a calcaneal spur. Patients with intact sensory perception. At least 6 weeks from last corticosteroid injection; 4 weeks from the last local anaesthetic injection, iontophoresis, ultrasound, and electrotherapy Exclusion Criteria: History of fracture or surgery of the heel or ankle. Presence of inflammatory joint disease. Marked osteoporotic patient. Presence of ankylosing spondylitis or other inflammatory joint diseases. Heart pacemaker use. Patient on anticoagulant and coagulation disease. Skin wound or ulcers.

Ages Eligible for Study
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Minimum Age: 35 Years
Maximum Age: 65 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Single


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Shock wave Therapy<br>This group will be composed of subjects who represented the experimental group 1. They will receive shock wave therapy | Device: Shock wave Therapy<br>* This group composed of subjects and represented the control group who will receive shock wave therapy<br>|
| Experimental: Acetic acid shockwave phonophoresis therapy<br>This group will be composed of subjects who represented the experimental group 2. They will take 6 sessions with Time between sessions 5-7 days plus exercise and dietary advice | Device: Acetic acid shockwave phonophoresis therapy<br>* This group composed of subjects. They will take 6 sessions with Time between sessions 5-7 days plus exercise and dietary advice<br>|
| Active Comparator: conventional physical therapy program<br>This group will be composed of subjects who represented the control group Exercise program: Standing calf-stretching exercise Towel stretch: stretching exercise Ice bottle Towel pickup exercise Marble pickups exercise Calf raises exercises -Static and dynamic balance exercise | Other: conventional physical therapy program<br>* Exercise program: Standing calf-stretching exercise Towel stretch: stretching exercise Ice bottle Towel pickup exercise Marble pickups exercise Calf raises exercises -Static and dynamic balance exercise<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| calcaneal spur length by X-ray (mm) | X-ray on the affected foot to measure the length of the calcaneal spur | three months | 
| calcaneal spur width by X-ray (mm) | X-ray on the affected foot to measure the width of the calcaneal spur | three months | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| FPX 50 wagner Pressure pain threshold (PPT) | this device used to measure the pressure pain threshold | three months | 
| Activity of daily living: by Foot and Ankle Ability Measure scale | This scale formed from 29 item, the minimum score for each item is 0 and maximum score is 4 , the Higher scores represent higher levels of function for each subscale, with 100% representing no dysfunction | three months | 
| visual analogue scale. | this scale for pain intensity level assessment and contain minimum score is 0 and maximum score is 100 mm, the higher score indicate more pain (sever dysfunction) | three months |