Efficacy of Shockwave Therapy Versus Therapeutic Exercises on Pain and Dynamic Balance in Patients with Plantar Fasciitis

Abstract
Background: Plantar fasciitis (PF) is a painful disorder of the plantar fascia. It is the most common cause of plantar heel pain and accounts for approximately 11-15% of foot symptoms presenting to physicians.
Aim of Study: The purpose of this study was to compare the effects of radial shock wave (RSW) alone, therapeutic exercises (stretching and strengthening) alone and RSW combined with therapeutic exercises (stretching and strength-ening) on pain severity and dynamic balance in patients with chronic plantar fasciitis (CPF).
Methods: Forty five males and females patients with unilateral CPF participated in this study; their age ranged from 40-50 years. Patients randomly assigned into three groups. Group (A): Received three sessions of RSW therapy. Group (B): Received stretching and strengthening exercises as a home program. Group (C): Received three sessions of RSW therapy (one session every week), stretching and strength-ening exercises as a home program. Patients were evaluated for pain and dynamic balance before 1st session and at the end of treatment program.
Results: There was a significant decrease in visual ana-logue scale (VAS) in favor of group C compared with that of group A and that of group B (p<0.01). Also, there was a significant decrease in VAS in favor of group A compared with that of group B (p<0.001). There was a significant increase in anterior, posterolateral and posteromedial excursion of Y balance test in favor of group A compared with that of group B (p<0.05); and a significant increase in anterior, posterolateral and posteromedial excursion in favor of group C compared with that of group B (p<0.001). However; there was no significant difference in anterior, posterolateral and posteromedial excursion between group A and C post treatment (p>0.05).
Conclusion: RSW therapy only or combined with thera-peutic exercises are more effective than therapeutic exercises only on pain and dynamic balance in patients with CPF.