Comparison of effect of High intensity LASER therapy, Extracorporeal shockwave therapy, and Ultrasound therapy on pain and foot function in patients with Plantar fasciitis: A randomized controlled trial

Abstract: PURPOSE AND RELEVANCE: Ultrasound therapy (UST) is one of the common modalities available for treatment of plantar fasciitis (PF). Recent technological advancements have led to the development of new modalities such as high-intensity LASER therapy (HILT) and Extracorporeal Shockwave therapy (ESWT), available for treatment of PF. There is a lack of evidence as to suggest which modality is superior in the treatment of PF. Hence, the purpose of the study was to observe the effect of HILT, ESWT, and UST on pain and function in patients with PF. PARTICIPANTS: A total of 120 participants fulfilling the inclusion/exclusion criteria were recruited after obtaining informed consent and were randomly assigned to 3 study groups of 40 each, and allocation was done using sealed envelope. METHODS: Assigned treatment modality as per the prescribed dosage, along with the exercise program, was given for period of 2 weeks. Outcome measures-Visual Analog Scale (VAS), Pain perception threshold (PPT), and Foot function index (FFI) were taken prior to and after completion of treatment. ANALYSIS AND RESULTS: While comparing VAS, PPT and FFI values of all 3 groups using one-way ANOVA, between group analysis showed statistically significant difference among the groups for VAS ( F = 4.44; P = 0.0140) and PPT ( F = 5.651; P = 0.0047) not for FFI ( F = 1.292; P = 0.2790). Post hoc analysis data revealed statistically significant difference for UST in PPT than HILT ( P = 0.0112) and ESWT ( P = 0.0156) and for UST in VAS than HILT ( P = 0.0110). Rest all comparison was not statistically significant (VAS: P =0.2859 and P = 0.6004; PPT: P >0.9999). Within the group analysis using paired t -test showed statistically significant improvement in all 3 groups ( P < 0.0001 for all groups). CONCLUSION: All three modalities are effective in reducing pain and improving function in patients with PF. UST seems to be better in reducing the pain, but in improving function, none of the modality was found to be superior to other. IMPLICATION: UST can be a preferred modality in alleviating the pain in patients with PF as it’s easily available and cost-effective over the new expensive modalities.