AB0647 THE EFFECT OF EXTRACORPOREAL SHOCK WAVE THERAPY (ESWT) ON PLANTAR FASCIITIS IN PATIENTS WITH AXIAL SPONDYLOARTHROPATHIES: DOUBLE-BLIND, RANDOMIZED CONTROLLED TRIAL
Authors: S. Güneş, Ö. C. Caner, D. Gökmen, Ş. Ataman, Ş. Kutlay
Journal: Annals of the Rheumatic Diseases (2020)

Background: The effectiveness and safety of radial extracorporeal shock wave therapy (r-ESWT) on chronic plantar fasciitis (PF) in patients with axial spondyloarthropathies (SpA) remains unclear. Objectives: To investigate the efficacy and tolerability of r-ESWT in patients with PF in axial-SpA on the clinical and radiological parameters. Methods: In this double-blind, randomized controlled trial, 22 axial-SpA patients with PF whom have heel pain above 5 according to Visual Analog Scale (VAS) over 3 months were randomly divided into two groups: r-ESWT (1.8 bar pressure, 10 Hertz frequency, 500 pulse intensity) and sham ESWT. Both groups received a total of 3 treatments at one week intervals. All patients were assessed by using the VAS, heel pressure algometry, Foot Function Index and plantar fascia ultrasonography (thickness, convexity, echogenicity of PF, presence of perifascial fluid and subcutaneous tissue edema) at baseline, one week after each session and 4 th and 8 th week after the last therapy. A decrease of more than two units on the VAS and improvements on plantar fascia ultrasonographic assessments was considered as primary and secondary endpoints respectively. Results: Descriptive data of the patients are presented in table 1. Both groups showed significant improvements in all assessment parameters (p&lt;0.05) after the therapy sessions and at the 4 th and 8 th week follow-up. No serious adverse event was observed in any patient. When two groups were compared regarding the differences in improvements, no statistically significant difference was found between the r-ESWT and sham ESWT groups in any of the parameters (p&gt;0.05). Table 1. Baseline demographic characteristics of patients r-ESWT group (n:10 ) Sham group (n:12 ) Sex (n, %) Female 7 (%70) 9 (%75) Age* (year) 43.8±8.23 48.5 ± 7.62 Height* (cm) 163.1±7.17 160.75±11.71 Weight *(kg) 80.1±9.38 81.67±22.31 BMI* (kg/cm 2 ) 30.2±3.92 31.11±5.42 Duration of heel pain n, (%) &gt;6 month 8 (%80) 10 (%83.3) 3-6 month 2 (%20) 2 (%16.7) VAS (0-10) 8.22 ± 1.394 7.82 ± 0.603 FFI scores* Right Left Right Left Pain 60.66±22.20 51.11±33.37 61.18±21.55 63.18±9.83 Disability 66.66±16.34 51.55±34.20 60.33±31.35 68.09±27.23 72.27±18.74 Activity restriction 44.77±41.08 58.72±35.51 62.36±29.28 Total 62.66±15.06 49.14±31.60 62.54±25.05 65.90±15.89 Pressure algometry (kg/cm 2 ) Right Left Right Left 2.07 ± 1.58 3.86 ± 4.09 3.70 ± 3.17 3.60 ± 3.23 US measurements* Right Left Right Left PF thickness (mm) 3.60± 0.73 3.40± 0.71 4.15± 1.07 4.04± 1.12 Increased PF convexity n (%) 4 (40) 2 (20) 4 (33.3) 5 (41.7) Decreased echogenicity n (%) 2 (20) 3 (30) 6 (50) 8 (66.7) Perifascial fluid (+) n (%) 2 (20) 0 (0) 3 (25) 4 (33.3) Subcutaneus tissue edema (+) n (%) 8 (80) 6 (60) 8 (66.7) 9 (75) Conclusion: To the best of our knowledge, this is the first study evaluating the clinical and radiological efficacy and tolerability of r-ESWT in patients with PF in axial-SpA. Radial extracorporeal shock wave therapy is safe and tolerable treatment on chronic PF in patients with axial-SpA. References: [1]Dizon JN, Gonzalez-Suarez C, Zamora MT, Gambito ED. Effectiveness of extracorporeal shock wave therapy in chronic plantar fasciitis: a meta-analysis. Am J Phys Med Rehabil. 2013 Jul;92(7):606-20 Acknowledgments: None Disclosure of Interests: None declared