New and Accurate Predictive Model for the Efficacy of Extracorporeal Shock Wave Therapy in Managing Patients With Chronic Plantar Fasciitis

Yin, Mengchen; Chen, Ni; Huang, Quan; Marla, Anastasia Sulindro; Ma, Jinghong; Ye, Jie; Mo, Wen

doi:10.1016/j.apmr.2017.05.016

Cited by 16 publications

(23 citation statements)

References 26 publications

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“…Previous studies have shown that the PF has complicated pathogenic mechanism and the etiology is also complex and multifactorial 33, 34 . Pain status was a robust predictor of treatment outcome in PF patients according to our previous and other relevant studies 21, 35–37 . In our study, patients with higher VAS had a poorer prognosis than we thought.…”

Section: Discussionsupporting

confidence: 69%

Development and Validation of a Novel Scoring System for Severity of Plantar Fasciitis

Yin

Yao

Tong

et al. 2020

Orthopaedic Surgery

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Objectives: Plantar fasciitis (PF) is the most common cause of heel pain. Though PF is self-limited, it can develop into chronic pain and thus treatment is needed. Early and accurate prognostic assessment of patients with PF is critically important for selecting the optimal treatment pathway. Nevertheless, there is no scoring system to determine the severity of PF and no prognostic model in choosing between conservative or surgical treatment. The study aimed to develop a novel scoring system to evaluate the severity of plantar fasciitis and predict the prognosis of conservative treatment. Methods: Data of consecutive patients treated from 2014 to 2018 were retrospectively collected. One hundred and eighty patients were eligible for the study. The demographics and clinical characteristics served as independent variables. The least follow-up time was 6 months. A minimal reduction of 60% in the visual analog scale (VAS) score from baseline was considered as minimal clinically important difference (MCID). Those factors significantly associated with achieving MCID in univariate analyses were further analyzed by multivariate logistic regression. A novel scoring system was developed using the best available literature and expert-opinion consensus. Inter-observer reliability and intraobserver reproducibility were evaluated. The appropriate cutoff points for the novel score system were obtained using receiver operating characteristic (ROC) curves. Results: The system score = VAS (0-3 point = 1; 3.1-7 point = 3; 7.1-10 point = 5) + duration of symptoms (<6 months = 1; ≥1 6 months = 2) + ability to walk without pain (>1 h = 1; ≤1 h = 4) + heel spur in X-ray (No = 0; Yes = 2) + high intensity zone (HIZ) in MRI (No = 0; Yes = 2). The total score was divided in four categories of severity: mild (2-4 points), moderate (5-8 points), severe (9-12 points), and critical (13-15 points). Inter-observer agreement with a value of 0.84 was considered as perfect reliability. Intra-observer reproducibility with a value of 0.92 was considered as perfect reproducibility. The optimum cutoff value was 10 points. The sensitivity of predictive factors was 86.

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Section: Discussionsupporting

confidence: 69%

Development and Validation of a Novel Scoring System for Severity of Plantar Fasciitis

Yin

Yao

Tong

et al. 2020

Orthopaedic Surgery

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“…Despite being helpful in double-checking and routine examinations, ANN cannot replace medical experts in decision-making. In this study, the results analyzed by ANN model were more precise and rigorous than those by our previous study 29 . ANN model can be considered accurate and reliable in predicting MCST for its overall accuracy of 92.5%, which is much higher than that of multiple stepwise logistic regression model.…”

Section: Discussionmentioning

confidence: 74%

“…Our previous publications show that ESWT is an effective and safe tool in the treatment of chronic plantar fasciitis and should be an alternative to surgery 44 . Second, it finds that high VAS score (symptomatized by severer pain on taking first steps in the morning, edema, and heel spur) significantly affected the outcome of the treatment 29 . In this study, we conducted a more reasonable and accurate statistical analysis to guarantee the comprehensiveness by ANN model.…”

Section: Discussionmentioning

confidence: 98%

Use of artificial neural networks to identify the predictive factors of extracorporeal shock wave therapy treating patients with chronic plantar fasciitis

Yin

et al. 2019

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The purpose of our study is to identify the predictive factors for a minimum clinically successful therapy after extracorporeal shock wave therapy for chronic plantar fasciitis. The demographic and clinical characteristics were evaluated. The artificial neural networks model was used to choose the significant variables and model the effect of achieving the minimum clinically successful therapy at 6-months’ follow-up. The multilayer perceptron model was selected. Higher VAS (Visual Analogue Score) when taking first steps in the morning, presence of plantar fascia spur, shorter duration of symptom had statistical significance in increasing the odd. The artificial neural networks model shows that the sensitivity of predictive factors was 84.3%, 87.9% and 61.4% for VAS, spurs and duration of symptom, respectively. The specificity 35.7%, 37.4% and 22.3% for VAS, spurs and duration of symptom, respectively. The positive predictive value was 69%, 72% and 57% for VAS, spurs and duration of symptom, respectively. The negative predictive value was 82%, 84% and 59%, for VAS, spurs and duration of symptom respectively. The area under the curve was 0.738, 0.882 and 0.520 for VAS, spurs and duration of symptom, respectively. The predictive model showed a good fitting of with an overall accuracy of 92.5%. Higher VAS symptomatized by short-duration, severer pain or plantar fascia spur are important prognostic factors for the efficacy of extracorporeal shock wave therapy. The artificial neural networks predictive model is reasonable and accurate model can help the decision-making for the application of extracorporeal shock wave therapy.

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“…In addition, other studies have used ESWT for plantar fasciitis, and although the ESWT treatment protocols are different with respect to energy and session details, the patients with plantar fasciitis demonstrated significant improvement in pain and function. 11,29 Chang et al 3 conducted a systematic review and meta-analysis and found that the use of different energy levels and radial shock wave therapy yielded satisfactory pain relief compared with a placebo. In addition, radial shock wave therapy may be a better treatment for a lower price, but with good efficacy.…”

Section: Discussionmentioning

confidence: 99%

Comparison Between Extracorporeal Shock Wave Therapy and Local Corticosteroid Injection for Plantar Fasciitis

Jiang

Huang

et al. 2019

Foot Ankle Int.

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Background: Extracorporeal shock wave therapy (ESWT) is a nonsurgical treatment for plantar fasciitis (PF) that has had satisfactory clinical outcomes. However, local corticosteroid injection (LCI) is often regarded as first-line treatment of PF, but there have been few studies comparing the 2 methods. Therefore, we compared the effect of ESWT and LCI on patients with PF. Methods: This was a block randomized controlled study comparing 49 patients treated with ESWT and 47 patients treated with LCI from January 2017 to December 2018 who were followed for 6 months. We evaluated the clinical outcomes in the 2 groups, including average pain, first-step pain, plantar fascia thickness, and Foot Function Index, Chinese version of the PF patients. Results: All patients had pain relief and function improvement after treatment, whereas the LCI group did not maintain significant clinical improvement at the 3-month follow-up. The patients in the ESWT group had a significantly better clinical outcome with better duration of improvement than the LCI group. Conclusion: For PF patients, both ESWT and LCI resulted in clinical improvement but EWST provided longer relief than LCI. Level of Evidence: Level II, prospective comparative study.

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New and Accurate Predictive Model for the Efficacy of Extracorporeal Shock Wave Therapy in Managing Patients With Chronic Plantar Fasciitis

Cited by 16 publications

References 26 publications

Development and Validation of a Novel Scoring System for Severity of Plantar Fasciitis

Development and Validation of a Novel Scoring System for Severity of Plantar Fasciitis

Use of artificial neural networks to identify the predictive factors of extracorporeal shock wave therapy treating patients with chronic plantar fasciitis

Comparison Between Extracorporeal Shock Wave Therapy and Local Corticosteroid Injection for Plantar Fasciitis

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