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14-6-2019
1
Workshop Fyzzio NT-e
Niek Vink
Nieknt-enl
Diagnose en behandeling van een plantaire fasciopathie
Even voorstellen
14-6-2019
2
Revalidatie van een tendinopathische pees
bull Primaire interventiebull Pees belasten is essentieel niet teveel ontlasten
bull Mechanotransductie
bull Dit item moet dus altijd in zitten combineren met
Secundaire interventies
Oefentherapie hoogste mate van evidentie
Bron BJSM 2009 Khan
Revalidatie van een tendinopathische pees
bull Primaire interventiebull Pees belasten is essentieel niet teveel ontlasten
bull Mechanotransductie
bull Dit item moet dus altijd in zitten combineren met
Secundaire interventies
Gecombineerd met
bull Secundairbull Chronisch (gt 3 maanden) dan regeneratieve interventie
bull Shockwave therapie
bull Percutane electrolyse (epte)
bull Oefentherapie voor actieve houdingscorrectie (ingezakt voetgewelf navicular drop)
bull Steunzolen statiek schoeisel
bull Medicatie
bull Taping en andere passieve modaliteiten
bull Etc
14-6-2019
3
Aandoening Consensus Aandoening Consensus
Tendinopathieeumln 3 Morton-Neuroom 2 gt 3
Synovitis 3 Haglund deformiteit 2
Tendovaginitis 3 Lig deltoideum 1 gt 2
Dislocatie peroneii 3 Lig Calcaneonaviculare (spring lig) 1 gt 2
Calcificerende tendinitis 3 Benige avulsies 2
Retrocalcaneare bursitis 3 Loose bodies 1 gt 2
Distensie gewrichtskapsel 3 Enkelgewricht instabiliteit 2
Lig Tibiofibulaire anterior 3 Plantaire plaat 2
Lig calcaneofibulaire 3 Kraakbeenschade 0 gt 1
Fasciitis plantaris 3 Lig Tibiofibulaire posterior 0
Ganglia (cysten) 3 Intra-articulaire aandoeningen 0
Consensus ESSR tav indicatie voor MSU 0 = niet geindiceerd 1= Geindiceerd mits er geen andere beeldvormende techniek geschikt is 2= MSU is gelijk aan andere beeldvormende technieken 3 = MSU is de eerste keuze voor onderzoek
Het begint met een diagnose Echografie enkelvoet
Sconfienza et al Clinical indications for musculoskeletal ultrasound updated in 2017 by European Society of Musculoskeletal
Radiology (ESSR) consensus Eur Radiol (2018)
Rood = verandering consensus of nieuwkomer op de lijst tov consensus 2012
Electrolyse
Therapie - regeneratieve therapievormen
14-6-2019
4
Therapie - oefeningen
Therapie - Belasting opbouwen
14-6-2019
5
bull Werking
bull Evidentie
Shockwave
Shock Wave Behandeling
Micro-damaging disorganisatie verlaagde cell-viability
Toegenomen cel-metabolisme (calcium resorptie)
Proliferatie en Remodulatie = Regeneratie
Pijnvermindering en functieverbetering = Herstel
Werking ndash regeneratieve prikkel + pijndemping
14-6-2019
6
Evidentie
- Veel onderzoeken
van varieumlrende
kwaliteit
- 2018 systematic
review in BR J
Sports Med
bull Werking
bull Evidentie
Percutane electrolyse
14-6-2019
7
bull Chemische reactie agv de elektrolyse door alkalische reactie bij kathode
bull Beiumlnvloeden PH waarde ndash basisch
bull Lokale fysiologische ontstekingsreactie door oa VEGFVEGF 2 factoren
bull Fibroblasten stimuleren door mechanotransuctie (naaldrotatie)
bull Vrijkomen van PPAR-Y na 10-14 dagen (pro-inflammatoire cytokines naar
beneden brengen)
bull MMPrsquos en TIMPrsquos in balans krijgen
Werking regeneratieve prikkel + pijndemping
Prospective Randomized Trial of Electrolysis for
Chronic Plantar Heel Pain
Foot Ankle Int 2018 May 1
Fernaacutendez-Rodriacuteguez T12 Fernaacutendez-Rolle Aacute1 Truyols-Domiacutenguez
S1 Beniacutetez-Martiacutenez JC3 Casantildea-Granell J3
BACKGROUND
Chronic plantar heel pain (CPHP) is a common condition with high prevalence rates and a projected cost of treatment of US$192 to US$376 million There are several
therapeutic approaches and there is increased interest in treatments aimed at the regeneration of tissues with poor healing potential Our purpose was to investigate the
effectiveness of ultrasound-guided percutaneous needle electrolysis in chronic plantar heel pain
METHODS
A total of 73 patients with a clinical and ultrasonographic diagnosis of plantar heel pain unrelated to systemic inflammatory disease who had not received any other treatment in
the previous 6 months on the affected foot were randomly allocated to receive either ultrasound-guided percutaneous needle electrolysis of the fascia (experimental group n
= 39) or placebo puncture (control group n = 34) The primary outcome was pain scored with an 11-point numeric pain rating scale (0 = no pain 10 = maximum pain)
Secondary outcomes were function and disability measured by the 21-item activities of daily living subscale of the Foot and Ankle Ability Measure questionnaire and fascia
thickness measured by ultrasound Outcomes were measured at 1 12 and 24 weeks
RESULTS
The mixed-model analysis of covariance observed significant group x time interactions from all variables pain in numeric pain rating scale ( P lt 001) FAAM Activities of Daily
Living Subscale scale ( P lt 002) and ultrasonographic measures of the plantar heel ( P lt 002) Patients in the experimental group had better results posttreatment at 12 and
24 weeks compared with the control group
CONCLUSION
With chronic plantar heel pain ultrasound-guided percutaneous needle electrolysis
improved pain and function This treatment may also decrease fascia thickness
14-6-2019
8
Kom je een keer vrijblijvend kennismaken
bull Gratis kennismakingsbijeenkomst echografiebull 25 september 0900 ndash 1200u
bull Gratis kennismakingsbijeenkomst shockwave therapiebull 25 september 1300 ndash 1600u
bull Update tendinopathieeumln en andere spier-peesproblemenbull 1400 ndash 2030u
15
Basisopleiding echografie voor podotherapeuten en podologen
Lisette de Graauw16
14-6-2019
2
Revalidatie van een tendinopathische pees
bull Primaire interventiebull Pees belasten is essentieel niet teveel ontlasten
bull Mechanotransductie
bull Dit item moet dus altijd in zitten combineren met
Secundaire interventies
Oefentherapie hoogste mate van evidentie
Bron BJSM 2009 Khan
Revalidatie van een tendinopathische pees
bull Primaire interventiebull Pees belasten is essentieel niet teveel ontlasten
bull Mechanotransductie
bull Dit item moet dus altijd in zitten combineren met
Secundaire interventies
Gecombineerd met
bull Secundairbull Chronisch (gt 3 maanden) dan regeneratieve interventie
bull Shockwave therapie
bull Percutane electrolyse (epte)
bull Oefentherapie voor actieve houdingscorrectie (ingezakt voetgewelf navicular drop)
bull Steunzolen statiek schoeisel
bull Medicatie
bull Taping en andere passieve modaliteiten
bull Etc
14-6-2019
3
Aandoening Consensus Aandoening Consensus
Tendinopathieeumln 3 Morton-Neuroom 2 gt 3
Synovitis 3 Haglund deformiteit 2
Tendovaginitis 3 Lig deltoideum 1 gt 2
Dislocatie peroneii 3 Lig Calcaneonaviculare (spring lig) 1 gt 2
Calcificerende tendinitis 3 Benige avulsies 2
Retrocalcaneare bursitis 3 Loose bodies 1 gt 2
Distensie gewrichtskapsel 3 Enkelgewricht instabiliteit 2
Lig Tibiofibulaire anterior 3 Plantaire plaat 2
Lig calcaneofibulaire 3 Kraakbeenschade 0 gt 1
Fasciitis plantaris 3 Lig Tibiofibulaire posterior 0
Ganglia (cysten) 3 Intra-articulaire aandoeningen 0
Consensus ESSR tav indicatie voor MSU 0 = niet geindiceerd 1= Geindiceerd mits er geen andere beeldvormende techniek geschikt is 2= MSU is gelijk aan andere beeldvormende technieken 3 = MSU is de eerste keuze voor onderzoek
Het begint met een diagnose Echografie enkelvoet
Sconfienza et al Clinical indications for musculoskeletal ultrasound updated in 2017 by European Society of Musculoskeletal
Radiology (ESSR) consensus Eur Radiol (2018)
Rood = verandering consensus of nieuwkomer op de lijst tov consensus 2012
Electrolyse
Therapie - regeneratieve therapievormen
14-6-2019
4
Therapie - oefeningen
Therapie - Belasting opbouwen
14-6-2019
5
bull Werking
bull Evidentie
Shockwave
Shock Wave Behandeling
Micro-damaging disorganisatie verlaagde cell-viability
Toegenomen cel-metabolisme (calcium resorptie)
Proliferatie en Remodulatie = Regeneratie
Pijnvermindering en functieverbetering = Herstel
Werking ndash regeneratieve prikkel + pijndemping
14-6-2019
6
Evidentie
- Veel onderzoeken
van varieumlrende
kwaliteit
- 2018 systematic
review in BR J
Sports Med
bull Werking
bull Evidentie
Percutane electrolyse
14-6-2019
7
bull Chemische reactie agv de elektrolyse door alkalische reactie bij kathode
bull Beiumlnvloeden PH waarde ndash basisch
bull Lokale fysiologische ontstekingsreactie door oa VEGFVEGF 2 factoren
bull Fibroblasten stimuleren door mechanotransuctie (naaldrotatie)
bull Vrijkomen van PPAR-Y na 10-14 dagen (pro-inflammatoire cytokines naar
beneden brengen)
bull MMPrsquos en TIMPrsquos in balans krijgen
Werking regeneratieve prikkel + pijndemping
Prospective Randomized Trial of Electrolysis for
Chronic Plantar Heel Pain
Foot Ankle Int 2018 May 1
Fernaacutendez-Rodriacuteguez T12 Fernaacutendez-Rolle Aacute1 Truyols-Domiacutenguez
S1 Beniacutetez-Martiacutenez JC3 Casantildea-Granell J3
BACKGROUND
Chronic plantar heel pain (CPHP) is a common condition with high prevalence rates and a projected cost of treatment of US$192 to US$376 million There are several
therapeutic approaches and there is increased interest in treatments aimed at the regeneration of tissues with poor healing potential Our purpose was to investigate the
effectiveness of ultrasound-guided percutaneous needle electrolysis in chronic plantar heel pain
METHODS
A total of 73 patients with a clinical and ultrasonographic diagnosis of plantar heel pain unrelated to systemic inflammatory disease who had not received any other treatment in
the previous 6 months on the affected foot were randomly allocated to receive either ultrasound-guided percutaneous needle electrolysis of the fascia (experimental group n
= 39) or placebo puncture (control group n = 34) The primary outcome was pain scored with an 11-point numeric pain rating scale (0 = no pain 10 = maximum pain)
Secondary outcomes were function and disability measured by the 21-item activities of daily living subscale of the Foot and Ankle Ability Measure questionnaire and fascia
thickness measured by ultrasound Outcomes were measured at 1 12 and 24 weeks
RESULTS
The mixed-model analysis of covariance observed significant group x time interactions from all variables pain in numeric pain rating scale ( P lt 001) FAAM Activities of Daily
Living Subscale scale ( P lt 002) and ultrasonographic measures of the plantar heel ( P lt 002) Patients in the experimental group had better results posttreatment at 12 and
24 weeks compared with the control group
CONCLUSION
With chronic plantar heel pain ultrasound-guided percutaneous needle electrolysis
improved pain and function This treatment may also decrease fascia thickness
14-6-2019
8
Kom je een keer vrijblijvend kennismaken
bull Gratis kennismakingsbijeenkomst echografiebull 25 september 0900 ndash 1200u
bull Gratis kennismakingsbijeenkomst shockwave therapiebull 25 september 1300 ndash 1600u
bull Update tendinopathieeumln en andere spier-peesproblemenbull 1400 ndash 2030u
15
Basisopleiding echografie voor podotherapeuten en podologen
Lisette de Graauw16
14-6-2019
3
Aandoening Consensus Aandoening Consensus
Tendinopathieeumln 3 Morton-Neuroom 2 gt 3
Synovitis 3 Haglund deformiteit 2
Tendovaginitis 3 Lig deltoideum 1 gt 2
Dislocatie peroneii 3 Lig Calcaneonaviculare (spring lig) 1 gt 2
Calcificerende tendinitis 3 Benige avulsies 2
Retrocalcaneare bursitis 3 Loose bodies 1 gt 2
Distensie gewrichtskapsel 3 Enkelgewricht instabiliteit 2
Lig Tibiofibulaire anterior 3 Plantaire plaat 2
Lig calcaneofibulaire 3 Kraakbeenschade 0 gt 1
Fasciitis plantaris 3 Lig Tibiofibulaire posterior 0
Ganglia (cysten) 3 Intra-articulaire aandoeningen 0
Consensus ESSR tav indicatie voor MSU 0 = niet geindiceerd 1= Geindiceerd mits er geen andere beeldvormende techniek geschikt is 2= MSU is gelijk aan andere beeldvormende technieken 3 = MSU is de eerste keuze voor onderzoek
Het begint met een diagnose Echografie enkelvoet
Sconfienza et al Clinical indications for musculoskeletal ultrasound updated in 2017 by European Society of Musculoskeletal
Radiology (ESSR) consensus Eur Radiol (2018)
Rood = verandering consensus of nieuwkomer op de lijst tov consensus 2012
Electrolyse
Therapie - regeneratieve therapievormen
14-6-2019
4
Therapie - oefeningen
Therapie - Belasting opbouwen
14-6-2019
5
bull Werking
bull Evidentie
Shockwave
Shock Wave Behandeling
Micro-damaging disorganisatie verlaagde cell-viability
Toegenomen cel-metabolisme (calcium resorptie)
Proliferatie en Remodulatie = Regeneratie
Pijnvermindering en functieverbetering = Herstel
Werking ndash regeneratieve prikkel + pijndemping
14-6-2019
6
Evidentie
- Veel onderzoeken
van varieumlrende
kwaliteit
- 2018 systematic
review in BR J
Sports Med
bull Werking
bull Evidentie
Percutane electrolyse
14-6-2019
7
bull Chemische reactie agv de elektrolyse door alkalische reactie bij kathode
bull Beiumlnvloeden PH waarde ndash basisch
bull Lokale fysiologische ontstekingsreactie door oa VEGFVEGF 2 factoren
bull Fibroblasten stimuleren door mechanotransuctie (naaldrotatie)
bull Vrijkomen van PPAR-Y na 10-14 dagen (pro-inflammatoire cytokines naar
beneden brengen)
bull MMPrsquos en TIMPrsquos in balans krijgen
Werking regeneratieve prikkel + pijndemping
Prospective Randomized Trial of Electrolysis for
Chronic Plantar Heel Pain
Foot Ankle Int 2018 May 1
Fernaacutendez-Rodriacuteguez T12 Fernaacutendez-Rolle Aacute1 Truyols-Domiacutenguez
S1 Beniacutetez-Martiacutenez JC3 Casantildea-Granell J3
BACKGROUND
Chronic plantar heel pain (CPHP) is a common condition with high prevalence rates and a projected cost of treatment of US$192 to US$376 million There are several
therapeutic approaches and there is increased interest in treatments aimed at the regeneration of tissues with poor healing potential Our purpose was to investigate the
effectiveness of ultrasound-guided percutaneous needle electrolysis in chronic plantar heel pain
METHODS
A total of 73 patients with a clinical and ultrasonographic diagnosis of plantar heel pain unrelated to systemic inflammatory disease who had not received any other treatment in
the previous 6 months on the affected foot were randomly allocated to receive either ultrasound-guided percutaneous needle electrolysis of the fascia (experimental group n
= 39) or placebo puncture (control group n = 34) The primary outcome was pain scored with an 11-point numeric pain rating scale (0 = no pain 10 = maximum pain)
Secondary outcomes were function and disability measured by the 21-item activities of daily living subscale of the Foot and Ankle Ability Measure questionnaire and fascia
thickness measured by ultrasound Outcomes were measured at 1 12 and 24 weeks
RESULTS
The mixed-model analysis of covariance observed significant group x time interactions from all variables pain in numeric pain rating scale ( P lt 001) FAAM Activities of Daily
Living Subscale scale ( P lt 002) and ultrasonographic measures of the plantar heel ( P lt 002) Patients in the experimental group had better results posttreatment at 12 and
24 weeks compared with the control group
CONCLUSION
With chronic plantar heel pain ultrasound-guided percutaneous needle electrolysis
improved pain and function This treatment may also decrease fascia thickness
14-6-2019
8
Kom je een keer vrijblijvend kennismaken
bull Gratis kennismakingsbijeenkomst echografiebull 25 september 0900 ndash 1200u
bull Gratis kennismakingsbijeenkomst shockwave therapiebull 25 september 1300 ndash 1600u
bull Update tendinopathieeumln en andere spier-peesproblemenbull 1400 ndash 2030u
15
Basisopleiding echografie voor podotherapeuten en podologen
Lisette de Graauw16
14-6-2019
4
Therapie - oefeningen
Therapie - Belasting opbouwen
14-6-2019
5
bull Werking
bull Evidentie
Shockwave
Shock Wave Behandeling
Micro-damaging disorganisatie verlaagde cell-viability
Toegenomen cel-metabolisme (calcium resorptie)
Proliferatie en Remodulatie = Regeneratie
Pijnvermindering en functieverbetering = Herstel
Werking ndash regeneratieve prikkel + pijndemping
14-6-2019
6
Evidentie
- Veel onderzoeken
van varieumlrende
kwaliteit
- 2018 systematic
review in BR J
Sports Med
bull Werking
bull Evidentie
Percutane electrolyse
14-6-2019
7
bull Chemische reactie agv de elektrolyse door alkalische reactie bij kathode
bull Beiumlnvloeden PH waarde ndash basisch
bull Lokale fysiologische ontstekingsreactie door oa VEGFVEGF 2 factoren
bull Fibroblasten stimuleren door mechanotransuctie (naaldrotatie)
bull Vrijkomen van PPAR-Y na 10-14 dagen (pro-inflammatoire cytokines naar
beneden brengen)
bull MMPrsquos en TIMPrsquos in balans krijgen
Werking regeneratieve prikkel + pijndemping
Prospective Randomized Trial of Electrolysis for
Chronic Plantar Heel Pain
Foot Ankle Int 2018 May 1
Fernaacutendez-Rodriacuteguez T12 Fernaacutendez-Rolle Aacute1 Truyols-Domiacutenguez
S1 Beniacutetez-Martiacutenez JC3 Casantildea-Granell J3
BACKGROUND
Chronic plantar heel pain (CPHP) is a common condition with high prevalence rates and a projected cost of treatment of US$192 to US$376 million There are several
therapeutic approaches and there is increased interest in treatments aimed at the regeneration of tissues with poor healing potential Our purpose was to investigate the
effectiveness of ultrasound-guided percutaneous needle electrolysis in chronic plantar heel pain
METHODS
A total of 73 patients with a clinical and ultrasonographic diagnosis of plantar heel pain unrelated to systemic inflammatory disease who had not received any other treatment in
the previous 6 months on the affected foot were randomly allocated to receive either ultrasound-guided percutaneous needle electrolysis of the fascia (experimental group n
= 39) or placebo puncture (control group n = 34) The primary outcome was pain scored with an 11-point numeric pain rating scale (0 = no pain 10 = maximum pain)
Secondary outcomes were function and disability measured by the 21-item activities of daily living subscale of the Foot and Ankle Ability Measure questionnaire and fascia
thickness measured by ultrasound Outcomes were measured at 1 12 and 24 weeks
RESULTS
The mixed-model analysis of covariance observed significant group x time interactions from all variables pain in numeric pain rating scale ( P lt 001) FAAM Activities of Daily
Living Subscale scale ( P lt 002) and ultrasonographic measures of the plantar heel ( P lt 002) Patients in the experimental group had better results posttreatment at 12 and
24 weeks compared with the control group
CONCLUSION
With chronic plantar heel pain ultrasound-guided percutaneous needle electrolysis
improved pain and function This treatment may also decrease fascia thickness
14-6-2019
8
Kom je een keer vrijblijvend kennismaken
bull Gratis kennismakingsbijeenkomst echografiebull 25 september 0900 ndash 1200u
bull Gratis kennismakingsbijeenkomst shockwave therapiebull 25 september 1300 ndash 1600u
bull Update tendinopathieeumln en andere spier-peesproblemenbull 1400 ndash 2030u
15
Basisopleiding echografie voor podotherapeuten en podologen
Lisette de Graauw16
14-6-2019
5
bull Werking
bull Evidentie
Shockwave
Shock Wave Behandeling
Micro-damaging disorganisatie verlaagde cell-viability
Toegenomen cel-metabolisme (calcium resorptie)
Proliferatie en Remodulatie = Regeneratie
Pijnvermindering en functieverbetering = Herstel
Werking ndash regeneratieve prikkel + pijndemping
14-6-2019
6
Evidentie
- Veel onderzoeken
van varieumlrende
kwaliteit
- 2018 systematic
review in BR J
Sports Med
bull Werking
bull Evidentie
Percutane electrolyse
14-6-2019
7
bull Chemische reactie agv de elektrolyse door alkalische reactie bij kathode
bull Beiumlnvloeden PH waarde ndash basisch
bull Lokale fysiologische ontstekingsreactie door oa VEGFVEGF 2 factoren
bull Fibroblasten stimuleren door mechanotransuctie (naaldrotatie)
bull Vrijkomen van PPAR-Y na 10-14 dagen (pro-inflammatoire cytokines naar
beneden brengen)
bull MMPrsquos en TIMPrsquos in balans krijgen
Werking regeneratieve prikkel + pijndemping
Prospective Randomized Trial of Electrolysis for
Chronic Plantar Heel Pain
Foot Ankle Int 2018 May 1
Fernaacutendez-Rodriacuteguez T12 Fernaacutendez-Rolle Aacute1 Truyols-Domiacutenguez
S1 Beniacutetez-Martiacutenez JC3 Casantildea-Granell J3
BACKGROUND
Chronic plantar heel pain (CPHP) is a common condition with high prevalence rates and a projected cost of treatment of US$192 to US$376 million There are several
therapeutic approaches and there is increased interest in treatments aimed at the regeneration of tissues with poor healing potential Our purpose was to investigate the
effectiveness of ultrasound-guided percutaneous needle electrolysis in chronic plantar heel pain
METHODS
A total of 73 patients with a clinical and ultrasonographic diagnosis of plantar heel pain unrelated to systemic inflammatory disease who had not received any other treatment in
the previous 6 months on the affected foot were randomly allocated to receive either ultrasound-guided percutaneous needle electrolysis of the fascia (experimental group n
= 39) or placebo puncture (control group n = 34) The primary outcome was pain scored with an 11-point numeric pain rating scale (0 = no pain 10 = maximum pain)
Secondary outcomes were function and disability measured by the 21-item activities of daily living subscale of the Foot and Ankle Ability Measure questionnaire and fascia
thickness measured by ultrasound Outcomes were measured at 1 12 and 24 weeks
RESULTS
The mixed-model analysis of covariance observed significant group x time interactions from all variables pain in numeric pain rating scale ( P lt 001) FAAM Activities of Daily
Living Subscale scale ( P lt 002) and ultrasonographic measures of the plantar heel ( P lt 002) Patients in the experimental group had better results posttreatment at 12 and
24 weeks compared with the control group
CONCLUSION
With chronic plantar heel pain ultrasound-guided percutaneous needle electrolysis
improved pain and function This treatment may also decrease fascia thickness
14-6-2019
8
Kom je een keer vrijblijvend kennismaken
bull Gratis kennismakingsbijeenkomst echografiebull 25 september 0900 ndash 1200u
bull Gratis kennismakingsbijeenkomst shockwave therapiebull 25 september 1300 ndash 1600u
bull Update tendinopathieeumln en andere spier-peesproblemenbull 1400 ndash 2030u
15
Basisopleiding echografie voor podotherapeuten en podologen
Lisette de Graauw16
14-6-2019
6
Evidentie
- Veel onderzoeken
van varieumlrende
kwaliteit
- 2018 systematic
review in BR J
Sports Med
bull Werking
bull Evidentie
Percutane electrolyse
14-6-2019
7
bull Chemische reactie agv de elektrolyse door alkalische reactie bij kathode
bull Beiumlnvloeden PH waarde ndash basisch
bull Lokale fysiologische ontstekingsreactie door oa VEGFVEGF 2 factoren
bull Fibroblasten stimuleren door mechanotransuctie (naaldrotatie)
bull Vrijkomen van PPAR-Y na 10-14 dagen (pro-inflammatoire cytokines naar
beneden brengen)
bull MMPrsquos en TIMPrsquos in balans krijgen
Werking regeneratieve prikkel + pijndemping
Prospective Randomized Trial of Electrolysis for
Chronic Plantar Heel Pain
Foot Ankle Int 2018 May 1
Fernaacutendez-Rodriacuteguez T12 Fernaacutendez-Rolle Aacute1 Truyols-Domiacutenguez
S1 Beniacutetez-Martiacutenez JC3 Casantildea-Granell J3
BACKGROUND
Chronic plantar heel pain (CPHP) is a common condition with high prevalence rates and a projected cost of treatment of US$192 to US$376 million There are several
therapeutic approaches and there is increased interest in treatments aimed at the regeneration of tissues with poor healing potential Our purpose was to investigate the
effectiveness of ultrasound-guided percutaneous needle electrolysis in chronic plantar heel pain
METHODS
A total of 73 patients with a clinical and ultrasonographic diagnosis of plantar heel pain unrelated to systemic inflammatory disease who had not received any other treatment in
the previous 6 months on the affected foot were randomly allocated to receive either ultrasound-guided percutaneous needle electrolysis of the fascia (experimental group n
= 39) or placebo puncture (control group n = 34) The primary outcome was pain scored with an 11-point numeric pain rating scale (0 = no pain 10 = maximum pain)
Secondary outcomes were function and disability measured by the 21-item activities of daily living subscale of the Foot and Ankle Ability Measure questionnaire and fascia
thickness measured by ultrasound Outcomes were measured at 1 12 and 24 weeks
RESULTS
The mixed-model analysis of covariance observed significant group x time interactions from all variables pain in numeric pain rating scale ( P lt 001) FAAM Activities of Daily
Living Subscale scale ( P lt 002) and ultrasonographic measures of the plantar heel ( P lt 002) Patients in the experimental group had better results posttreatment at 12 and
24 weeks compared with the control group
CONCLUSION
With chronic plantar heel pain ultrasound-guided percutaneous needle electrolysis
improved pain and function This treatment may also decrease fascia thickness
14-6-2019
8
Kom je een keer vrijblijvend kennismaken
bull Gratis kennismakingsbijeenkomst echografiebull 25 september 0900 ndash 1200u
bull Gratis kennismakingsbijeenkomst shockwave therapiebull 25 september 1300 ndash 1600u
bull Update tendinopathieeumln en andere spier-peesproblemenbull 1400 ndash 2030u
15
Basisopleiding echografie voor podotherapeuten en podologen
Lisette de Graauw16
14-6-2019
7
bull Chemische reactie agv de elektrolyse door alkalische reactie bij kathode
bull Beiumlnvloeden PH waarde ndash basisch
bull Lokale fysiologische ontstekingsreactie door oa VEGFVEGF 2 factoren
bull Fibroblasten stimuleren door mechanotransuctie (naaldrotatie)
bull Vrijkomen van PPAR-Y na 10-14 dagen (pro-inflammatoire cytokines naar
beneden brengen)
bull MMPrsquos en TIMPrsquos in balans krijgen
Werking regeneratieve prikkel + pijndemping
Prospective Randomized Trial of Electrolysis for
Chronic Plantar Heel Pain
Foot Ankle Int 2018 May 1
Fernaacutendez-Rodriacuteguez T12 Fernaacutendez-Rolle Aacute1 Truyols-Domiacutenguez
S1 Beniacutetez-Martiacutenez JC3 Casantildea-Granell J3
BACKGROUND
Chronic plantar heel pain (CPHP) is a common condition with high prevalence rates and a projected cost of treatment of US$192 to US$376 million There are several
therapeutic approaches and there is increased interest in treatments aimed at the regeneration of tissues with poor healing potential Our purpose was to investigate the
effectiveness of ultrasound-guided percutaneous needle electrolysis in chronic plantar heel pain
METHODS
A total of 73 patients with a clinical and ultrasonographic diagnosis of plantar heel pain unrelated to systemic inflammatory disease who had not received any other treatment in
the previous 6 months on the affected foot were randomly allocated to receive either ultrasound-guided percutaneous needle electrolysis of the fascia (experimental group n
= 39) or placebo puncture (control group n = 34) The primary outcome was pain scored with an 11-point numeric pain rating scale (0 = no pain 10 = maximum pain)
Secondary outcomes were function and disability measured by the 21-item activities of daily living subscale of the Foot and Ankle Ability Measure questionnaire and fascia
thickness measured by ultrasound Outcomes were measured at 1 12 and 24 weeks
RESULTS
The mixed-model analysis of covariance observed significant group x time interactions from all variables pain in numeric pain rating scale ( P lt 001) FAAM Activities of Daily
Living Subscale scale ( P lt 002) and ultrasonographic measures of the plantar heel ( P lt 002) Patients in the experimental group had better results posttreatment at 12 and
24 weeks compared with the control group
CONCLUSION
With chronic plantar heel pain ultrasound-guided percutaneous needle electrolysis
improved pain and function This treatment may also decrease fascia thickness
14-6-2019
8
Kom je een keer vrijblijvend kennismaken
bull Gratis kennismakingsbijeenkomst echografiebull 25 september 0900 ndash 1200u
bull Gratis kennismakingsbijeenkomst shockwave therapiebull 25 september 1300 ndash 1600u
bull Update tendinopathieeumln en andere spier-peesproblemenbull 1400 ndash 2030u
15
Basisopleiding echografie voor podotherapeuten en podologen
Lisette de Graauw16
14-6-2019
8
Kom je een keer vrijblijvend kennismaken
bull Gratis kennismakingsbijeenkomst echografiebull 25 september 0900 ndash 1200u
bull Gratis kennismakingsbijeenkomst shockwave therapiebull 25 september 1300 ndash 1600u
bull Update tendinopathieeumln en andere spier-peesproblemenbull 1400 ndash 2030u
15
Basisopleiding echografie voor podotherapeuten en podologen
Lisette de Graauw16