运动贴扎联合体外冲击波治疗足底筋膜炎的疼痛、功能活动及足底压力评估

关键词：足底筋膜炎  运动贴扎  体外冲击波治疗  足底压力评估  疼痛  生物力学机制

Keywords:plantar fasciitis  Kinesio taping  extracorporeal shock wave treatment  plantar pressure assessment  pain  biomechanical mechanism

摘要：

      摘要 目的：结合足底压力评估，探究运动贴扎联合体外冲击波治疗足底筋膜炎的临床疗效。 方法：本研究纳入67例来院就诊的单侧足底筋膜炎患者，随机分为对照组和试验组，两组患者均予以健康宣教及体外冲击波治疗（ESWT） ，试验组在此基础上联合运动贴扎（KT）治疗。采用疼痛视觉模拟评分、AOFAS踝与后足功能评分量表，评估患者疼痛程度及功能活动；采用鞋垫式足底压力测量系统测量患者足底各区压力峰力值。比较治疗前、治疗第3周、治疗第5周的临床疗效及患侧足底压力变化。 结果：治疗前两组患者各项指标差异均无显著性意义（P>0.05）。与治疗前相比，治疗第3周、治疗第5周，两组患者的疼痛程度及功能活动的量表评分、足底压力均出现明显改善，差异有显著性意义（P<0.05）。治疗第3周，两组患者的疼痛程度及功能活动的量表评分的组间差异不显著（P>0.05），而足底压力分析存在显著性差异（P<0.05），运动贴扎联合治疗组足跟内侧的峰力值体重比显著大于对照组。治疗第5周，两组患者的疼痛程度及功能活动的量表评分、足底压力的组间差异均存在显著性意义（P<0.05），运动贴扎联合治疗组在疼痛改善情况、功能活动情况显著优于对照组，中足、后足负重也显著高于对照组。 结论：相比单纯的体外冲击波治疗，辅以运动贴扎进行联合治疗能够更好地缓解疼痛、改善后足功能、纠正异常的足底负重、改善患者步态。

Abstract:

      Abstract Objective：To explore the clinical efficacy of Kinesio taping combined with extracorporeal shock wave and the plantar pressure evaluation in the treatment of plantar fasciitis. Method：A total of 67 patients with unilateral plantar fasciitis were randomly divided into the control group （ESWT group） and the experimental group （KT combined group）. The patients in the two groups were given the same health education and extracorporeal shock wave treatment （ESWT）， and the experimental group was treated with Kinesio taping（KT）. The pain and functional activity were evaluated by pain visual analogue scale and AOFAS ankle and hind-foot function scale； The insole plantar pressure measuring system was used to measure the peak pressure values of each plantar regions. The clinical efficacy and plantar pressure of the affected side were compared before treatment， the 3rd week of treatment and 5th week of treatment. Result：There was no significant difference in various indcators of the measurements between the two groups before treatment（P>0.05）. The score of pain rating， functional activity scale score and plantar pressure of patients in both groups were significantly improved at the 3rd week and the 5th week of treatment（P<0.05）, compared with those before treatment. At the 3rd week of treatment， there was no significant difference between the two groups in pain degree and functional activity scale score（P>0.05）， but there was statistical difference in plantar pressure analysis（P<0.05）. The peak force weight ratio of the medial heel in the KT combined group was significantly greater than that in the control group. At the 5th week of treatment， there were statistically significant differences between the two groups in the score of pain rating， functional activity scale score and plantar pressure（P<0.05）. The KT combined treatment group was significantly better than the control group in the pain improvement and functional activity， and the weight bearing of the middle foot and hind foot was also significantly higher than the control group. Conclusion：Compared with the simple extracorporeal shock wave therapy， the combination of KT therapy can better relieve pain， improve the function of hind foot， correct abnormal foot weight bearing， and improve the gait of patients.