Demographic and clinical factors predict focused shockwave therapy results on patients with plantar fasciitis. A multilevel analysis

Abstract

Background. Plantar fasciitis (PF) is one of the most common causes of heel pain. The use of ESWT is approved in the treatment of chronic PF. The aim of this study was to conduct a retrospective analysis to create models for a pre-treatment evaluation in people with PF, and to assess whether demographic and clinical features could be used to predict medium-term outcomes six months after fESWT. Methods. 183 cases of plantar fasciitis were treated with fESWT. The outcome was NRS variation at three and six months. Age, gender, Likert scale and FAOS were the predictive factors evaluated. Results. A significant improvement in the mean values ​of NRS and FAOS was observed at the follow up controls. Patients with unfavorable characteristics association (age ≥ 56 years, FAOS < 66.7, Likert scale 3-4) showed higher NRS values, instead ​patients with favorable characteristics association (age < 56 years, FAOS ≥ 66.7, Likert scale 1-2) showed lower NRS values. Conclusions. The multilevel modeling creates clinical models for a pre-treatment evaluation of patients with PF, predicting a better or worse medium-term after fESWT. The patient presenting a combination of unfavorable characteristics could be informed about a worst therapeutic response, and modification on therapy protocol or association of different therapies could be considered.