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Trial registered on ANZCTR
Registration number
ACTRN12617000761369
Ethics application status
Approved
Date submitted
19/04/2017
Date registered
23/05/2017
Date last updated
1/05/2018
Type of registration
Prospectively registered
Titles & IDs
Public title
Efficacy of Extracorporeal shock wave and low level laser in the management of plantar fasciitis
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Scientific title
Clinical Effectiveness of Low-Level Laser Therapy as an Adjunct to Extracorporeal Shock wave therapy for the management of plantar fasciitis: A Randomized Controlled Trial
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Secondary ID [1]
291431
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None
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Universal Trial Number (UTN)
U1111-1194-1800
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Trial acronym
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Calcaneal spur
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plantar fasciitis
302450
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Condition category
Condition code
Musculoskeletal
302016
302016
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0
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Other muscular and skeletal disorders
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Physical Medicine / Rehabilitation
302017
302017
0
0
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Physiotherapy
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
After the physical examination and data collection, participants will then be randomly assigned into 4 groups.
Group A: 20 patient will receive Extracorporeal Shock Wave Therapy (ESWT) and low level laser therapy (LLLT) with stretching exercise and ice massage twice a week for 3 weeks.
Group B: 20 patient will receive ESWT with stretching exercise and ice massage twice a week for 3 weeks.
Group C: 20 patient will receive LLLTwith stretching exercise and ice massage twice a week for 3 weeks.
Group D: 20 patient in Control group will receive stretching exercise and ice massage twice a week for 3 weeks.
Treatment application:
Four blinded physical therapists with experience ranging from 3-5 years will deliver each treatment in each group. They will be blinded to other treatment groups, to the recruitment of subjects and as well as the physical examination. To monitor adherence to treatment sessions, each physical therapist will register attendance of sessions in a note book.
1- Extracorporeal Shock Wave Therapy (ESWT) application: Intellect RPW chattanoga (model 2074 - 230 V- , 50Hz Mexico) shockwave device will be used. Device specification includes a compressed air output of 1.4- 5 bar, power increment settings at 2 bar, pulse frequency 0.5-35 Hz and Pulse Width of Approx. 6 - 12 ms with a single or continuous mode. Patient will lie in the supine position; barefooted, the area treated will be marked. Ultra Sound gel will be then applied on the region that will receive the shock wave twice a week for 3 weeks. Dosage will be 3x3000 shock waves/session of high energy 0.2 mJ/mm2, 8hz and 2 bars for 15-20 minutes
2- LLLT will be administered with a gallium–arsenide (GaAs) laser with an infrared wavelength of 904 nm (Irradia medical laser, M/D Laser Professional, Stockholm, Sweden) with three infrared diodes. With the patient in a supine position and barefooted, laser emitting a divergent 635-nm (red) laser light generating a 17-mW output will be applied twice a week for 3 weeks. Exposure time during the LLLT will be 10 minutes across the dorsal foot, the myofascial junction of the heel, and the plantar aspect of the heel, simultaneously.
3- Stretching for plantar fascia: with the patient sitting, he will cross the affected leg over the other leg. then the therapist will hold the affected foot and pull the toes back towards shin. This creates tension/stretch in the arch of the foot/plantar fascia.
Therapist will then check for the appropriate stretch position by gently rubbing the thumb over the arch of the affected foot. The plantar fascia should feel firm, like a guitar string.
the stretch will be then held for a count of 20, and repeated 3-5 repetitions.
4- Ice Massage: using an ice cone, with the patient in seated position,he will cross the affected leg over the other leg the ice will be massaged around the whole plantar fascia in vertical, longitudinal and circular strokes for 10-15 minutes
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Intervention code [1]
297469
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Treatment: Devices
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Intervention code [2]
297990
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Treatment: Other
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Comparator / control treatment
Control group will take standard treatment of ice massage and stretching of planter fascia twice a week for 3 weeks
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Control group
Active
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Outcomes
Primary outcome [1]
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Pain will be assessed using the visual analogue scale
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Assessment method [1]
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Timepoint [1]
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Prior to the intervention as baseline measure and at the end of the 3 week intervention period
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Secondary outcome [1]
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Foot Functional Index
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Assessment method [1]
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Timepoint [1]
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Prior to the intervention as baseline measure and at the end of the 3 week intervention period
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Eligibility
Key inclusion criteria
1-Age ranged from 40-60 years old of both genders (Krukowska et al; 2016).
2-Participants suffering from pain for at least 3 months with no prior physical therapy for at least 3 months prior to the study and an unsuccessful treatment using non-steroidal anti-inflammatory drugs (NSAID)
3-Particiapents whom have plantar fasciitis due to calcaneal spur that is confirmed with a plain X-ray.
4- A positive windlass test
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Minimum age
40
Years
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Maximum age
60
Years
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Sex
Both males and females
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Can healthy volunteers participate?
No
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Key exclusion criteria
1- Muscloskeletal injuries at foot, ankle, knee or spine.
2- Diabetic foot
3- Pregnant female
4- Individuals whom receive local corticosteroid injection in the last two months.
5- Individuals that undergone physical therapy prior to the study in the past 3 months.
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Study design
Purpose of the study
Treatment
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Allocation to intervention
Randomised controlled trial
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Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
sealed opaque envelopes
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
Permuted block randomisation
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Masking / blinding
Blinded (masking used)
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Who is / are masked / blinded?
The people administering the treatment/s
The people assessing the outcomes
The people analysing the results/data
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Intervention assignment
Factorial
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Other design features
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Phase
Not Applicable
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Type of endpoint/s
Efficacy
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Statistical methods / analysis
Age, weight, height will be analyzed statistically by using descriptive statistics to calculate the mean and standard deviation of each group. Multiple-Way ANOVA will be used to compare between 4 groups. The level of significance will be set less than 0.05.
Power analysis will be performed from pervious reported data, based on an estimated 45% increase in VAS, with a power of 95%, type 1 error was set at o.o5, mean of 6.9 and 4 with a standard deviation of 2.7. The sample of each group was 20 subjects.
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Recruitment
Recruitment status
Completed
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Date of first participant enrolment
Anticipated
1/09/2017
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Actual
10/09/2017
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Date of last participant enrolment
Anticipated
1/10/2017
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Actual
11/11/2017
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Date of last data collection
Anticipated
22/10/2017
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Actual
2/12/2017
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Sample size
Target
80
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Accrual to date
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Final
80
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Recruitment outside Australia
Country [1]
8829
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Egypt
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State/province [1]
8829
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Cairo
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Funding & Sponsors
Funding source category [1]
295898
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Self funded/Unfunded
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Name [1]
295898
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Mary Kamal Nassif Takla
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Address [1]
295898
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School of Physical therapy, Cairo university 7 Ahmed Elzaiat St. Ben Elsaryat - EI Dokki-Giza - Egypt. 11432
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Country [1]
295898
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Egypt
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Primary sponsor type
University
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Name
School of Physical Therapy, Cairo University
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Address
School of Physical therapy, Cairo university 7 Ahmed Elzaiat St. Ben Elsaryat - EI Dokki-Giza - Egypt. 11432
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Country
Egypt
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Secondary sponsor category [1]
294772
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None
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Name [1]
294772
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Address [1]
294772
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Country [1]
294772
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
297178
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The Board Council of Higher Education of the School of Physical Therapy, Cairo university
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Ethics committee address [1]
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El-Tahrir st. - in front of Ben El- Sarayat Traffic - Dokki - Giza, Giza, 11432
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Ethics committee country [1]
297178
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Egypt
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Date submitted for ethics approval [1]
297178
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07/02/2017
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Approval date [1]
297178
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21/02/2017
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Ethics approval number [1]
297178
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Summary
Brief summary
Eighty participants with plantar fasciitis due to calcaneal spur will be selected from the outpatient clinic of the faculty of physical therapy, Cairo University. Participants then will undergo a physical examination and data collection by a blinded therapist to the treatment allocation and application and with more than 9 years of experience. A Plain X-ray will be performed to confirm the presence of calcaneal spur. Additionally, Windlass test will be used to determine plantar fascia abnormalities in weight bearing and non-weight bearing positions. Outcome measure will be collected prior to the first treatment session as a baseline measure and at the end of the 3-week intervention period as a post-intervention measure, and it will include pain assessed by a Visual analogue scale and Foot Functional Index. After the physical examination and data collection, participants will then be randomly assigned into 4 groups. Group A: 20 patients will receive Extracorporeal Shock Wave Therapy (ESWT) and low level laser therapy (LLLT) with stretching exercise and ice massage twice a week for 3 weeks. Group B: 20 patients will receive ESWT with stretching exercise and ice massage twice a week for 3 weeks. Group C: 20 patients will receive LLLT with stretching exercise and ice massage twice a week for 3 weeks. Group D: 20 patients in Control group will receive stretching exercise and ice massage twice a week for 3 weeks. Treatment application: Four blinded physical therapists with experience ranging from 3-5 years will deliver each treatment in each group. They will be blinded to other treatment groups, to the recruitment of subjects and as well as the physical examination. To monitor adherence to treatment sessions, each physical therapist will register attendance of sessions in a note book.
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Trial website
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Trial related presentations / publications
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Public notes
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Contacts
Principal investigator
Name
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A/Prof Mary Kamal Nassif Takla
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Address
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School of Physical therapy, Cairo university 7 Ahmed Elzaiat St. Ben Elsaryat - EI Dokki-Giza - Egypt. 11432
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Country
73246
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Egypt
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Phone
73246
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+201222817512
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Fax
73246
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Email
73246
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[email protected]
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Contact person for public queries
Name
73247
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Mary Kamal Nassif Takla
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Address
73247
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School of Physical therapy, Cairo university 7 Ahmed Elzaiat St. Ben Elsaryat - EI Dokki-Giza - Egypt. 11432
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Country
73247
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Egypt
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Phone
73247
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00201222817512
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Fax
73247
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Email
73247
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[email protected]
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Contact person for scientific queries
Name
73248
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Mary Kamal Nassif Takla
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Address
73248
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School of Physical therapy, Cairo university 7 Ahmed Elzaiat St. Ben Elsaryat - EI Dokki-Giza - Egypt. 11432
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Country
73248
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Egypt
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Phone
73248
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00201222817512
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Fax
73248
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Email
73248
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[email protected]
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No information has been provided regarding IPD availability
What supporting documents are/will be available?
No Supporting Document Provided
Results publications and other study-related documents
Documents added manually
No documents have been uploaded by study researchers.
Documents added automatically
Source
Title
Year of Publication
DOI
Embase
Clinical effectiveness of multi-wavelength photobiomodulation therapy as an adjunct to extracorporeal shock wave therapy in the management of plantar fasciitis: a randomized controlled trial.
2019
https://dx.doi.org/10.1007/s10103-018-2632-4
N.B. These documents automatically identified may not have been verified by the study sponsor.
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