| Summary: | 碩士 === 國立陽明大學 === 物理治療暨輔助科技學系 === 96 === Objective: To evaluate the effects on pain and gait improvement after botulinum toxin type A injection under sonographic guidance for plantar fasciitis.
Method: A randomized double-blind control study. 40 patients with chronic unilateral plantar fasciitis were recruited, and divided into experimental group and control group randomly. In experimental group, we injected botulinum toxin type A (Botox; Allergan) 50 unit diluted into 1ml normal saline in each foot under sonographic guidance and followed up effects in 3 weeks and 3 months after injection. In control group, we used 1ml normal saline injection to plantar fascia under sonographic guidance.
Posterior approach injection method was selected for avoiding from fat pad atrophy and lateral planar nerve injury. Effects are measured by plantar fascia and fat pad thickness in ultrasonography, visual analogue pain scale (VAS) and resting foot pressure, maximal center of pressure (COP) velocity during loading response.
Results: VAS and plantar fascia thickness in symptomatic foot reduced significantly 3 weeks and 3 months after botulinum toxin injection respectively (P <0.001). The fat pad thickness kept unchanged. The COP velocity during loading response increased after injection in symptomatic foot (P< 0.05). The rearfoot and forefoot pressure did not show significant changes.
Conclusion:
Injection with botulinum toxin type A for plantar fasciitis is effective for pain treatment and increases of first step velocity during loading response. The injection method under sonographic guidance is more accurate and needs less dose of botulinum toxin without adverse effect of fat pad atrophy.
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