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Shock Wave Therapy for Sural Myofascial Pain Associated to Chronic Heel Pain

Primary Purpose

Tendinopathy

Status
Completed
Phase
Not Applicable
Locations
Study Type
Interventional
Intervention
Shock wave therapy on plantar fascia extended to the gastrocnemius-soleus trigger points
Shock wave therapy on plantar fascia only
Sponsored by
Foundation IRCCS San Matteo Hospital
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Tendinopathy focused on measuring Myofascial pain syndrome

Eligibility Criteria

18 Years - 75 Years (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  • Adult age (18 to 75 years) and written informed consent;
  • Unilateral heel pain of four weeks or longer duration;
  • Pain to digital pressure in the insertional area of the plantar fascia at the calcaneum;
  • Sonographic examination showing a plantar fascia thickness greater than 3.8mm (see procedures for details);
  • Concomitant presence of a sural myofascial pain syndrome (SMPS), diagnosed on the basis of the finding, at the physical examination, of trigger points of the gastrocnemius-soleus muscle complex, according to Travel and Simons' original description.

Exclusion Criteria:

  • No corticosteroid injections or other physical therapies since the onset of the current pain episode (except pharmacological pain treatments and foot orthoses);
  • No general contraindication to shock wave therapy (pregnancy, bleeding disorders or anticoagulant drug usage, cancer in the focal area);
  • No clinical signs of lumbar radiculopathy at physical examination;
  • No ankle osteoarthritis, diagnosed on the basis of clinical and radiographic findings;
  • No previous fractures or surgery in the affected ankle and foot;
  • No rheumatologic diseases, no plantar fibromatosis

Sites / Locations

    Arms of the Study

    Arm 1

    Arm 2

    Arm Type

    Experimental

    Active Comparator

    Arm Label

    Experimental group:shock waves extended to gastrocnemius TrP

    Control group: shock waves not extended to gastrocnemius TrP

    Arm Description

    Focused shock wave therapy was extended from the plantar fascia to the gastrocnemius-soleus trigger points.

    A standard focused shock wave therapy exclusively targeted at the plantar fascia

    Outcomes

    Primary Outcome Measures

    Change in FFI-foot function index
    Foot Function Index is self-administered questionnaire designed to measure foot performances in relation to symptoms. Foot Function Index is structured in two sections of nine items each, investigating foot pain (FFI-A) and function (FFI-B) respectively. The total score of each section ranges from zero (no pain/no functional limitation) to 100 (intolerable pain/complete inability). The two scores were separately analysed.

    Secondary Outcome Measures

    Change in PPT-pressure pain threshold
    Pressure pain threshold (PPT) of the gastrocnemius-soleus trigger points was assessed by means of a digital hand-held algometer (see procedures for details). PPT is the minimal force that induces pain and its measurement is useful to quantitatively evaluate the effect of a treatment on trigger points

    Full Information

    First Posted
    May 5, 2020
    Last Updated
    May 11, 2020
    Sponsor
    Foundation IRCCS San Matteo Hospital
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    1. Study Identification

    Unique Protocol Identification Number
    NCT04385329
    Brief Title
    Shock Wave Therapy for Sural Myofascial Pain Associated to Chronic Heel Pain
    Official Title
    Shock Wave Therapy for Sural Myofascial Pain Syndrome Associated With Plantar Fasciitis: a Pilot Randomized Controlled Trial
    Study Type
    Interventional

    2. Study Status

    Record Verification Date
    May 2020
    Overall Recruitment Status
    Completed
    Study Start Date
    July 4, 2016 (Actual)
    Primary Completion Date
    July 4, 2018 (Actual)
    Study Completion Date
    November 3, 2018 (Actual)

    3. Sponsor/Collaborators

    Responsible Party, by Official Title
    Principal Investigator
    Name of the Sponsor
    Foundation IRCCS San Matteo Hospital

    4. Oversight

    5. Study Description

    Brief Summary
    The aim of this randomized controlled study in to investigate if a shock wave treatment extended to the gastrocnemius-soleus trigger points (TrP) is more effective than a standard treatment exclusively targeted at the plantar fascia in a population affected by unilateral plantar fasciitis with concomitant sural myofascial pain syndrome.

    6. Conditions and Keywords

    Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
    Tendinopathy
    Keywords
    Myofascial pain syndrome

    7. Study Design

    Primary Purpose
    Treatment
    Study Phase
    Not Applicable
    Interventional Study Model
    Parallel Assignment
    Masking
    Outcomes Assessor
    Allocation
    Randomized
    Enrollment
    55 (Actual)

    8. Arms, Groups, and Interventions

    Arm Title
    Experimental group:shock waves extended to gastrocnemius TrP
    Arm Type
    Experimental
    Arm Description
    Focused shock wave therapy was extended from the plantar fascia to the gastrocnemius-soleus trigger points.
    Arm Title
    Control group: shock waves not extended to gastrocnemius TrP
    Arm Type
    Active Comparator
    Arm Description
    A standard focused shock wave therapy exclusively targeted at the plantar fascia
    Intervention Type
    Other
    Intervention Name(s)
    Shock wave therapy on plantar fascia extended to the gastrocnemius-soleus trigger points
    Intervention Description
    Enrolled subjects were treated with focused shock wave therapy, once a week for three consecutive weeks, by a specialized physician with more than five years of expertise, using a device powered by a piezoelectric generator (PIEZOSON 100PLUS, Richard Wolf®). At each treatment session, with the patients lying in prone decubitus position, the enthesis of the plantar fascia and the gastrocnemius-soleus trigger points were clinically targeted and treated with a perpendicular technique.
    Intervention Type
    Other
    Intervention Name(s)
    Shock wave therapy on plantar fascia only
    Intervention Description
    Enrolled subjects were treated with focused shock wave therapy, once a week for three consecutive weeks, by a specialized physician with more than five years of expertise, using a device powered by a piezoelectric generator (PIEZOSON 100PLUS, Richard Wolf®). At each treatment session, with the patients lying in prone decubitus position, the enthesis of the plantar fascia was clinically targeted and treated with a perpendicular technique.
    Primary Outcome Measure Information:
    Title
    Change in FFI-foot function index
    Description
    Foot Function Index is self-administered questionnaire designed to measure foot performances in relation to symptoms. Foot Function Index is structured in two sections of nine items each, investigating foot pain (FFI-A) and function (FFI-B) respectively. The total score of each section ranges from zero (no pain/no functional limitation) to 100 (intolerable pain/complete inability). The two scores were separately analysed.
    Time Frame
    FFI was administered at baseline, at two months time point and at three months time point
    Secondary Outcome Measure Information:
    Title
    Change in PPT-pressure pain threshold
    Description
    Pressure pain threshold (PPT) of the gastrocnemius-soleus trigger points was assessed by means of a digital hand-held algometer (see procedures for details). PPT is the minimal force that induces pain and its measurement is useful to quantitatively evaluate the effect of a treatment on trigger points
    Time Frame
    PPT was recorded at baseline, at two months time point and at three months time point

    10. Eligibility

    Sex
    All
    Minimum Age & Unit of Time
    18 Years
    Maximum Age & Unit of Time
    75 Years
    Accepts Healthy Volunteers
    No
    Eligibility Criteria
    Inclusion Criteria: Adult age (18 to 75 years) and written informed consent; Unilateral heel pain of four weeks or longer duration; Pain to digital pressure in the insertional area of the plantar fascia at the calcaneum; Sonographic examination showing a plantar fascia thickness greater than 3.8mm (see procedures for details); Concomitant presence of a sural myofascial pain syndrome (SMPS), diagnosed on the basis of the finding, at the physical examination, of trigger points of the gastrocnemius-soleus muscle complex, according to Travel and Simons' original description. Exclusion Criteria: No corticosteroid injections or other physical therapies since the onset of the current pain episode (except pharmacological pain treatments and foot orthoses); No general contraindication to shock wave therapy (pregnancy, bleeding disorders or anticoagulant drug usage, cancer in the focal area); No clinical signs of lumbar radiculopathy at physical examination; No ankle osteoarthritis, diagnosed on the basis of clinical and radiographic findings; No previous fractures or surgery in the affected ankle and foot; No rheumatologic diseases, no plantar fibromatosis

    12. IPD Sharing Statement

    Plan to Share IPD
    No

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