Extracorporeal Pulse-Activated Therapy versus Injection: Treatment of Recalcitrant Plantar Fasciitis

2019 ◽  
Vol 109 (2) ◽  
pp. 108-112
Author(s):  
John Grady ◽  
Yelena Boumendjel ◽  
Kathryn LaViolette ◽  
Trevor Smolinski
Keyword(s):  
Visual Analog Scale ◽  
Treatment Modality ◽  
Functional Outcomes ◽  
Plantar Fasciitis ◽  
Corticosteroid Injection ◽  
Inclusion Criteria ◽  
Analog Scale ◽  
Vas Score ◽  
Clinical Presentations ◽  
American Orthopaedic

Background: Plantar fasciitis is one of the most common clinical presentations seen by podiatric clinicians today. With corticosteroid injection being a classic treatment modality and extracorporeal pulse-activated therapy (EPAT) technology improving, the purpose of this study was to retrospectively compare pain and functional outcomes of patients with plantar fasciitis treated with either injection or EPAT. Methods: Between November 1, 2014, and April 30, 2016, 60 patients who met the inclusion criteria were treated with either corticosteroid injection or EPAT. Patients were evaluated with both the visual analog scale (VAS) and the American Orthopaedic Foot & Ankle Society Hindfoot Score at each visit. Results: The EPAT was found to reduce pain on the VAS by a mean of 1.98 points, whereas corticosteroid injection reduced pain by a mean of 0.94 points. This was a significant reduction in the VAS score for EPAT compared with corticosteroid injection (P = .035). Conclusions: Extracorporeal pulse-activated therapy is as effective as corticosteroid injection, if not more so, for the treatment of recalcitrant plantar fasciitis and should be considered earlier in the treatment course of plantar fasciitis.

scholarly journals Gambaran skala visual analog dan hemodinamik pada pasien yang diberikan kombinasi tramadol dan ketorolak pasca bedah laparotomi

e-CliniC ◽  
2016 ◽  
Vol 4 (1) ◽  
Author(s):  
Galuh R. Mufti ◽  
Harold F. Tambajong ◽  
Diana Lalenoh
Keyword(s):  
Visual Analog Scale ◽  
Tissue Damage ◽  
Recovery Room ◽  
Analogue Scale ◽  
Diastolic Pressure ◽  
Emotional Experience ◽  
Systolic Pressure ◽  
Inclusion Criteria ◽  
Analog Scale ◽  
Vas Score

Abstract: Pain as an unpleasant sensory and emotional experience associated with tissue damage or potential tissue damage or a condition that indicates tissue damage. This study aimed to describe the visual analogue scale (VAS) and hemodynamic among patients given combination of tramadol and ketorolac post laparotomy. Evaluation of pain was assessed by using VAS. This was a descriptive prospective study and was carried out in the recovery room (RR) postoperation and in inpatient A and D instalations of Prof. Dr. R. D. Kandou Hospital Manado from December 2015 to March 2016. There were 20 respondents that were handled with laparotomy and had met the inclusion criteria. The results showed that the average VAS score at the 2nd hour was 5, while the average VAS score at the 4th hour and the 6th hour were 6.4 and 8.5 respectively. The average systolic pressure at the 2nd hour was 124 mmHg, the 4th hour was 126 mmHg, and the 6th hour was 131.6 mmHg. The average diastolic pressure at the 2nd hour was 78 mmHg, at the 4th was 80 mmHg, and at the 6th was 85 mmHg. The average pulse rate at the 2nd hour was 85.4 per minute, at the 4th was 86.7 per minute, and at the 6th was 90.3 per minute. The average MAP at the 2nd hour was 91 mmHg, at the 4th was 91.3 mmHg, and at the 6th was 94 mmHg. Keywords: visual analog scale, haemodynamic, ketorolac, tramadol Abstrak: Nyeri adalah suatu pengalaman sensoris dan emosional yang tidak menyenangkan dihubungkan dengan adanya kerusakan jaringan atau potensial terjadinya kerusakan jaringan atau suatu keadaan yang menunjukan kerusakan jaringan. Penelitian ini bertujuan untuk mengetahui gambaran skala analog visual dan hemodinamik pada pasien yang diberikan kombinasi tramadol dan ketorolak pascabedah laparotomi. Gambaran nyeri dinilai dengan menggunakan visual analog scale (VAS). Jenis penelitian ini deskriptif prospektif dan dilakukan di ruang pemulihan recovery room (RR) pascabedah dan di Instalasi Rawat Inap A dan D RSUP Prof. Dr. R. D. Kandou Manado pada bulan Desember 2015-Maret 2016. Jumlah sampel yaitu 20 orang yang dilakukan operasi laparotomi yang memenuhi kriteria inklusi. Hasil penelitian menunjukkan bahwa rerata skor VAS pada jam ke-2 ialah 5 sedangkan rerata skor VAS pada jam ke-4 dan jam ke-6 ialah 6,4 dan 8,5 secara berurutan. Rerata tekanan sistolik pada jam ke-2 ialah 124 mmHg, jam ke-4 ialah 126 mmHg dan jam ke-6 menjadi 131,6 mmHg. Rerata tekanan diastolik pada jam ke-2 ialah 78 mmHg, jam ke-4 ialah 80 mmHg, dan jam ke-6 menjadi 85 mmHg. Rerata laju nadi pada jam ke-2 ialah 85,4 x/menit, jam ke-4 ialah 86,7 x/menit, dan jam ke-6 menjadi 90,3 x/menit mmHg. Rerata MAP pada jam ke-2 ialah 91 mmHg, jam ke-4 ialah 91,3 mmHg, dan jam ke-6 menjadi 94 mmHg.Kata kunci: visual analog scale, hemodinamik, ketorolak, tramadol

Comparison of High-Dose Extracorporeal Shockwave Therapy and Intralesional Corticosteroid Injection in the Treatment of Plantar Fasciitis

2010 ◽  
Vol 100 (2) ◽  
pp. 105-110 ◽  
Author(s):  
Istemi Yucel ◽  
Kutay Engin Ozturan ◽  
Yavuz Demiraran ◽  
Erdem Degirmenci ◽  
Gursel Kaynak
Keyword(s):  
Visual Analog Scale ◽  
Plantar Fasciitis ◽  
Therapeutic Response ◽  
Corticosteroid Injection ◽  
High Dose ◽  
Analog Scale ◽  
Extracorporeal Shockwave Therapy ◽  
Extracorporeal Shockwave ◽  
Shockwave Therapy ◽  
Significant Difference

Background: The aim of this study was to evaluate the results of high-dose extracorporeal shockwave therapy applied with an ankle block and corticosteroid injection in patients with plantar fasciitis whose symptoms persisted for more than 6 months. Methods: Sixty patients were assessed clinically at presentation and at 3-month follow-up with a patient-assessed 100-mm visual analog scale of pain and a physician-assessed heel tenderness index. A therapeutic response rate was evaluated. A decrease of at least 50% from baseline to 3 months in visual analog scale or heel tenderness index scores was accepted as a successful result. Results: Extracorporeal shockwave therapy and corticosteroid injection provided significant improvements in visual analog scale and heel tenderness index scores, but between the two groups there was no significant difference in the visual analog scale score change 3 months after treatment (P > .05). Twenty-seven of 33 patients (82%) in the extracorporeal shockwave therapy group and 23 of 27 (85%) in the corticosteroid injection group had a successful therapeutic response after 3 months. Conclusions: Corticosteroid injection and extracorporeal shockwave therapy are successful treatment modalities for plantar fasciitis. Corticosteroid injection treatment is cost effective compared with extracorporeal shockwave therapy, and corticosteroid injection may be the first treatment choice according to these results. (J Am Podiatr Med Assoc 100(2): 105–110, 2010)

scholarly journals Sublingual immunotherapy increases Treg/Th17 ratio in allergic rhinitis

Open Medicine ◽  
2021 ◽  
Vol 16 (1) ◽  
pp. 826-832
Author(s):  
Jiarong Wang ◽  
Liansheng Qiu ◽  
Yimin Chen ◽  
Minyun Chen
Keyword(s):  
T Cells ◽  
Allergic Rhinitis ◽  
Retrospective Study ◽  
Regulatory T Cells ◽  
Visual Analog Scale ◽  
Peripheral Blood ◽  
Sublingual Immunotherapy ◽  
Analog Scale ◽  
Vas Score ◽  
Medication Score

Abstract Background Few studies investigated the effects of sublingual immunotherapy (SLIT) on the peripheral regulatory T cells (Tregs)/Th17 ratio. Objective To investigate the effectiveness of SLIT in children with allergic rhinitis (AR) and the effects on the Tregs/Th17 ratio. Methods This was a retrospective study of children who were treated for AR between April 2017 and March 2018 at one hospital. The patients were grouped according to the treatments they received: SLIT + pharmacotherapy vs pharmacotherapy alone. Results Eighty children (51 boys and 29 girls; 40/group) were included. The visual analog scale (VAS) and medication scores at 1 year in the SLIT + pharmacotherapy group were 2.70 ± 1.08 and 1.1 ± 0.8, respectively, which were lower than at baseline (7.7 ± 1.2 and 3.6 ± 1.0, respectively) (both Ps < 0.05). For the pharmacotherapy group, the VAS score was decreased at 1 year vs baseline (3.3 ± 1.2 vs 7.4 ± 1.0; P < 0.05), but the medication score did not change (P > 0.05). In the SLIT + pharmacotherapy group, the Treg percentage increased, while the Th17 percentage decreased at 1 year (both Ps < 0.01). The percentages of Tregs and Th17s did not change in the pharmacotherapy group (both Ps > 0.05). Conclusions SLIT + pharmacotherapy can increase the Treg percentage and decrease the Th17 percentage in the peripheral blood of children with AR.

scholarly journals Spinal cord stimulation for chronic intractable trunk or limb pain: study protocol for a Chinese multicenter randomized withdrawal trial (CITRIP study)

2020 ◽  
Author(s):  
Yang Lu ◽  
Peng Mao ◽  
Guihuai Wang ◽  
Wei Tao ◽  
Donglin Xiong ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Visual Analog Scale ◽  
Spinal Cord Stimulation ◽  
Pulse Generator ◽  
Short Form ◽  
Control Group ◽  
Withdrawal Period ◽  
Analog Scale ◽  
Limb Pain ◽  
Vas Score

Abstract Background: Although effective results of many studies support the use of spinal cord stimulation in the chronic pain patients, no randomized controlled trial has been undertaken in China to date. CITRIP is a multicenter, prospective, randomized, withdrawal study designed to evaluate the clinical effectiveness and safety of spinal cord stimulation plus remote programming management in patients with intractable trunk or limb pain.Method：Participants will be recruited in approximately 10 centers across China. Eligible participants with intractable trunk or limb and an average Visual Analog Scale (VAS) score ≥ 5 will undergo spinal cord stimulation test. Participants with VAS score reduction ≥ 50% could move forward to receive implantation of an implanted pulse generator. In the withdrawal period at 3-months follow-up visit, participants randomized to the experimental group (EG) will undergo continuous stimulation while ceasing the stimulation in the control group (CG). The outcome assessment will occur at baseline and at 1, 3 (pre and post randomization) and 6 months. The primary outcome is the difference of maximal visual analog scale (VAS) score between EG and CG in the withdrawal period compared with baseline before the withdrawal period. Additional outcomes include VAS score change at 1, 3 and 6-month follow-ups, responder rate (VAS score improving by 50%), achievement rate of a desirable pain state (VAS score ≤ 4), awake times during sleep, Beck Depression Inventory for depression evaluation, short-form 36 for quality of life evaluation, drug usage, satisfaction rating of the device. Adverse events will be collected. The primary analysis will follow the intention-to-treat principle. Discussion：The CITRIP study seeks to evaluate the effectiveness and safety of a randomized withdrawal trial of spinal cord stimulation for patients with intractable trunk or limb pain.Trial registration: NCT03858790, clinicaltrials.gov, registered on March 1st, 2019, retrospectively registered, https://clinicaltrials.gov/ct2/show/NCT03858790

The Effect of Dry Needling on Pain, Range of Motion of Ankle Joint, and Ultrasonographic Changes of Plantar Fascia in Patients With Plantar Fasciitis

2021 ◽  
pp. 1-6
Author(s):  
Afsaneh Moosaei Saein ◽  
Ziaeddin Safavi-Farokhi ◽  
Atefeh Aminianfar ◽  
Marzieh Mortezanejad
Keyword(s):  
Range Of Motion ◽  
Ankle Joint ◽  
Visual Analog Scale ◽  
Plantar Fasciitis ◽  
Plantar Flexion ◽  
Plantar Fascia ◽  
Trigger Points ◽  
Dry Needling ◽  
Analog Scale ◽  
Significant Difference

Context: Plantar fasciitis (PF) is a common and devastating disease. Despite different treatments, there is no clear evidence for the effect of these treatments on PF. One of the therapy methods used in physiotherapy is dry needling (DN). So the purpose of this study is to investigate the effect of DN on the pain and range of motion of the ankle joint and plantar fascia thickness in subjects with PF who are suffering from the trigger points of the gastrocnemius and soleus muscles. Methods: In this study, 20 volunteer females with PF were randomly assigned into DN treatment and control groups. Measurements were range of motion in dorsiflexion and plantar flexion, plantar fascia thickness, and visual analog scale measured before, immediately, and 1 month after the end of the intervention in both groups. Results: There were significant differences in the plantar fascia thickness and visual analog scale between the 2 groups. Plantar fascia thickness (P = .016) and visual analog scale (P = .03) significantly decreased in the treatment group. However, there was no significant difference in plantar flexion (P = .582) and dorsiflexion range of motion (P = .173) between groups. Conclusion: The result of this study showed that DN can reduce pain and plantar fascia thickness in women with PF who are suffering from trigger points of the gastrocnemius and soleus muscles. Level of evidence: Level 1, randomized controlled trial.

scholarly journals Hállux Rígidus: estudo prospectivo da substituição articular com hemiartroplastia

2013 ◽  
Vol 21 (2) ◽  
pp. 71-75 ◽  
Author(s):  
Alexandre Leme Godoy dos Santos ◽  
Fernando Aires Duarte ◽  
Carlos Augusto Itiu Seito ◽  
Rafael Trevisan Ortiz ◽  
Marcos Hideyo Sakaki ◽  
...  
Keyword(s):  
Visual Analog Scale ◽  
Hallux Rigidus ◽  
Foot And Ankle ◽  
Analog Scale ◽  
American Orthopaedic

OBJETIVO: Relatar os resultados com médio prazo de seguimento após a implantação de Arthrosurface-HemiCap® em pacientes com diagnóstico de hállux rígidus (HR). MÉTODO: Onze pacientes foram submetidos à artroplastia parcial da primeira metatarso-falangeana. Seis mulheres e cinco homens com idade média de 51,9 anos (46 a 58 anos) e média de seguimento pós-operatório de 3,73 anos (3-4 anos); foram classificados através do sistema de Kravitz e avaliados pelas escalas da american orthopaedic foot and ankle society (AOFAS) para hállux, visual analog scale (VAS) - analógico funcional de dor - e pela amplitude de movimento da primeira articulação metatarsofalangeana no periodo pré-operatório, pós-operatório de seis meses e pós-operatório atual. RESULTADOS: Os resultados revelam melhora significativa dos três parâmetros analisados no estudo, tanto para análise global como para comparações pré e pós-operatórias individuais. A análise comparativa de cada variável nos períodos pós-operatórios de seis meses e atual não mostram diferença estatística o que indica manutenção dos parâmetros durante esse intervalo. CONCLUSÃO: A hemiartroplastia da primeira metatarsofalangeana é opção reprodutível e segura para o tratamento cirúrgico do hállux rígidus II e III, com significativa melhora dos parâmetros avaliados para a população estudada. Nível de Evidência IV, Série de casos.

The Visual Analog Scale for Pain

2001 ◽  
Vol 95 (6) ◽  
pp. 1356-1361 ◽  
Author(s):  
Carol A. Bodian ◽  
Gordon Freedman ◽  
Sabera Hossain ◽  
James B. Eisenkraft ◽  
Yaakov Beilin
Keyword(s):  
Visual Analog Scale ◽  
Outcome Measure ◽  
Patient Controlled Analgesia ◽  
Analog Scale ◽  
Full Spectrum ◽  
Vas Score ◽  
Vas Scores ◽  
Relevant Outcome ◽  
Apparent Influence ◽  
Research Studies

Background The visual analog scale is widely used in research studies, but its connection with clinical experience outside the research setting and the best way to administer the VAS forms are not well established. This study defines changes in dosing of intravenous patient-controlled analgesia as a clinically relevant outcome and compares it with VAS measures of postoperative pain. Methods Visual analog scale measurements were obtained from 150 patients on the morning after intraabdominal surgery. On the same afternoon, 50 of the patients provided a VAS score on the same form used in the morning, 50 on a new form, and 50 were not asked for a second VAS measurement. Results Visual analog scale values and changes in value were similar for patients who were given a new VAS form in the afternoon and those who used the form that showed the morning value. The proportions of patients requesting additional analgesia were 4, 43, and 80%, corresponding to afternoon VAS scores of 30 or less, 31-70, and greater than 70, respectively. Change from morning VAS score had no apparent influence on patient-controlled analgesic dosing for patients with afternoon values of 30 or less or greater than 70, but changes in VAS scores of at least 10 did discriminate among patients whose afternoon values were between 31 and 70. Conclusions When pain is an outcome measure in research studies, grouping final VAS scores into a small number of categories provides greater clinical relevance for comparisons than using the full spectrum of measured values or changes in value. Seeing an earlier VAS form has no apparent influence on later values.

Cheilectomy as a First-Line Surgical Treatment Option Yields Good Functional Results in Grade III Hallux Rigidus

2016 ◽  
Vol 106 (1) ◽  
pp. 22-26 ◽  
Author(s):  
Engin Cetinkaya ◽  
Merter Yalcinkaya ◽  
Sami Sokucu ◽  
Abdulkadir Polat ◽  
Ufuk Ozkaya ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Visual Analog Scale ◽  
Functional Results ◽  
Hallux Rigidus ◽  
Wilcoxon Test ◽  
Foot And Ankle ◽  
First Line ◽  
Analog Scale ◽  
American Orthopaedic ◽  
Grade Iii

Background: This study aimed to analyze the functional results of cheilectomy in the surgical treatment of grade III hallux rigidus and to evaluate whether cheilectomy is a preferable first-line treatment over other surgical methods. Methods: Of 29 patients with moderate daily physical activity who underwent cheilectomy between 2009 and 2012 on being diagnosed as having grade III hallux rigidus according to the Coughlin-Shurnas grading system, 21 patients (14 women and 7 men; mean age, 59.2 years; age range, 52–67 years) (22 feet) with regular follow-up and complete medical records were included in the study. The patients were evaluated in the preoperative and postoperative periods using a visual analog scale for pain and the American Orthopaedic Foot and Ankle Society metatarsophalangeal assessment forms. Results: The preoperative mean American Orthopaedic Foot and Ankle Society score of 53 (range, 29–67) improved to 78 (range, 57–92) postoperatively (Wilcoxon test P = .001). The preoperative mean visual analog scale score of 89 (range, 60–100) improved to 29 (range, 0–70) in the postoperative period (Wilcoxon test P = .001). Conclusions: As a simple and repeatable procedure that allows for further joint-sacrificing surgical procedures when required, cheilectomy is a preferable method to be applied as a first-line option for the surgical treatment of grade III hallux rigidus.

scholarly journals A comparative study of effectiveness of local injection of autologous platelet rich plasma and injection corticosteroid solution in treatment of plantar fasciitis

2019 ◽  
Vol 5 (2) ◽  
pp. 335
Author(s):  
Vithal Prakash Puri ◽  
Anil Kumar Gaur
Keyword(s):  
Plantar Fasciitis ◽  
Platelet Rich Plasma ◽  
Corticosteroid Injection ◽  
Care Center ◽  
Tertiary Care ◽  
Vas Score ◽  
Visual Analog Scales ◽  
Group A ◽  
Group B

<p class="abstract"><strong>Background:</strong> The heel pain is the most common problem worldwide and it was associated with plantar fasciitis (PF). The condition of treatment is very complex. Platelet-rich plasma (PRP) and injection of corticosteroids is the treatment of PF. This study was designed to access the effect of local PRP and local corticosteroid injection in PF patients.</p><p class="abstract"><strong>Methods:</strong> Sixty patients (between 29 to 60 years of age) with chronic PF were randomized prospectively in single tertiary care center in India. The study conducted from December 2013 to December 2015. All the patients were enrolled according to inclusion criteria and divided into two groups randomized. In group A (n=30) received PRP and group B (n=30) received corticosteroids injections. Visual analog scales (VAS) were filled by all the included patients. The follow-up scheduled at one and six months after complete enrolment of patients.<strong></strong></p><p class="abstract"><strong>Results:</strong> Between both the groups the significantly different observed at one and six months follow-up from the baseline. At one month follow-up significantly improvement in mean VAS score were observed in group B (p&lt;0.001). At six months follow-up significantly improvement in mean VAS score were observed in group A (p&lt;0.001).</p><p class="abstract"><strong>Conclusions:</strong> The present study concluded from the significance difference between both the groups proved promising form of treatment in chronic PF patients. Both the treatment was safe and effective in relieving pain improving function at different time period.</p><p> </p>

scholarly journals The Effect of Myofascial Release Technique and Stretching Versus Myofascial Release Technique and Taping in Patients with Chronic Plantar Fasciitis

2021 ◽  
Vol 11 (9) ◽  
pp. 1-9
Author(s):  
Pradeep Krishnareddy ◽  
Sharvari Shahane ◽  
Yashodhara S Joshi
Keyword(s):  
Pain Intensity ◽  
Visual Analog Scale ◽  
Plantar Fasciitis ◽  
Analog Scale ◽  
Myofascial Release ◽  
Function Index ◽  
Release Technique ◽  
Foot Function ◽  
Group 2 ◽  
Group 1

Background and Objective: Plantar fasciitis is the most common cause for inferior heel pain. This study was done to assess the effectiveness of myofascial release technique (MFR) and stretching versus MFR and taping in patients with chronic plantar fasciitis. Method: 60 plantar fasciitis patients were randomly divided into two groups with n= 30 in each group. Group 1- received MFR and stretching, where Group 2- received MFR and taping. The treatment was given one session per day for 10 consecutive days for both the groups. Outcome Measures: The patients were evaluated on day 1, day 5 and day 10. They were requested to come for a follow up after 1 week of treatment program. All the patients were assessed for pain and foot function by taking their Visual Analog Scale (VAS) and Foot Function Index (FFI). Results: Group 1 which received MFR and stretching showed great improvements from baseline to week 1, after day 10 on pain intensity and foot function assessed using VAS and FFI respectively. Group 2 showed improvements from baseline to day 10 but there was increase in pain levels and decreased foot function in measurements in 1 week. After analysis group 1 showed significance with P = 0.001. Conclusion: MFR with stretching and MFR with taping both were effective in reducing the pain intensity and increasing the foot function but MFR with stretching showed a superior hand over MFR with taping. Key words: Plantar Fasciitis, Myofascial Release Technique, Stretching, Taping, Visual Analog Scale, Foot Function Index.

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