[Sereda Andrey]

Апдейт. Экстракорпоральная ударно-волновая терапия набирает все большую легитимность. Вышло свежее исследование:
В качестве начального лечения предпочтительны стретч-упражнения.

Plantar Fascia-Specific Stretching Versus Radial Shock-WaveTherapyasInitial Treatment of Plantar Fasciopathy
JBJS 11/2010
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Background: Whether plantar fascia-specific stretching or shock-wave therapy is effective as an initial treatment for
proximal plantar fasciopathy remains unclear. The aim of this study was to test the null hypothesis of no difference in the
effectiveness of these two forms of treatment for patients who had unilateral plantar fasciopathy for a maximum duration
of six weeks and which had not been treated previously.
Methods: One hundred and two patients with acute plantar fasciopathy were randomly assigned to perform an eight-
week plantar fascia-specific stretching program (Group I, n = 54) or to receive repetitive low-energy radial shock-wave
therapy without local anesthesia, administered weekly for three weeks (Group II, n = 48). All patients completed the seven-
item pain subscale of the validated Foot Function Index and a patient-relevant outcome questionnaire. Patients were
evaluated at baseline and at two, four, and fifteen months after baseline. The primary outcome measures were a mean
change in the Foot Function Index sum score at two months after baseline, a mean change in item 2 (pain during the first
few steps of walking in the morning) on this index, and satisfaction with treatment.
Results: No difference in mean age, sex, weight, or duration of symptoms was found between the groups at baseline. At
two months after baseline, the Foot Function Index sum score showed significantly greater changes for the patients
managed with plantar fascia-specific stretching than for those managed with shock-wave therapy (p < 0.001), as well as
individually for item 2 (p = 0.002). Thirty-five patients (65%) in Group I versus fourteen patients (29%) in Group II were
satisfied with the treatment (p < 0.001). These findings persisted at four months. At fifteen months after baseline, no
significant between-group difference was measured.
Conclusions: A program of manual stretching exercises specific to the plantar fascia is superior to repetitive low-energy
radial shock-wave therapy for the treatment of acute symptoms of proximal plantar fasciopathy.
Level of Evidence: Therapeutic Level I. See Instructions to Authors for a complete description of levels of evidence.

Поскольку сама методика стретч-упражнений в этой теме была расписано скудновато, то полезной будет эта ссылка.
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