What You Should Know About Shockwave Therapy

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Continuing Education Course #125 — November 2004

I am very pleased to introduce the latest article, “What You Should Know About Shockwave Therapy,” in our CE series. This series, brought to you by the North American Center for Continuing Medical Education (NACCME), consists of regular CE activities that qualify for one continuing education contact hour (.1 CEU). Readers will not be required to pay a processing fee for this course.

Extracorporeal shockwave therapy (ESWT) has been a subject of controversy as various experts have debated its efficacy in treating chronic plantar fasciitis. With this in mind, Lowell Scott Weil Jr., DPM, explores the various types of shockwave therapy and provides a thorough analysis of the literature on ESWT.

At the end of this article, you’ll find a nine-question exam. Please mark your responses on the enclosed postcard and return it to NACCME. This course will be posted on Podiatry Today’s Web site (www.podiatrytoday.com) roughly one month after the publication date. I hope this CE series contributes to your clinical skills.

Sincerely,

Jeff A. Hall
Editor-In-Chief
Podiatry Today

INSTRUCTIONS: Physicians may receive one continuing education contact hour (.1 CEU) by reading the article on pg. 61 and successfully answering the questions on pg. 66. Use the enclosed card provided to submit your answers or fax the form to the NACCME at (610) 560-0502.
ACCREDITATION: NACCME is approved by the Council on Podiatric Medical Education as a sponsor of continuing education in podiatric medicine.
DESIGNATION: This activity is approved for 1 continuing education contact hour or .1 CEU.
DISCLOSURE POLICY: All faculty participating in Continuing Education programs sponsored by the NACCME are expected to disclose to the audience any real or apparent conflicts of interest related to the content of their presentation.
DISCLOSURE STATEMENTS: Dr. Weil has disclosed that he has received grant and/or research support from Healthtronics, EMS DolorClast, UMS Wolf and Orthometrix.
This article contains discussion of published and/or investigational uses of agents that are not indicated by the FDA. Neither NACCME nor HMP Communications recommends the use of any agent or device outside of the labeled indications. Please refer to the official prescribing information for each product for discussion of approved indications, contraindications and warnings.
GRADING: Answers to the CE exam will be graded by the NACCME. Within 60 days, you will be advised that you have passed or failed the exam. A score of 70 percent or above will comprise a passing grade.
TARGET AUDIENCE: Podiatrists.
RELEASE DATE: November 2004.
EXPIRATION DATE: November 30, 2005.
LEARNING OBJECTIVES: At the conclusion of this activity, participants should be able to:
• discuss the different types of technology used to create medical shockwave;
• cite the potential benefits of ESWT for patients with chronic plantar fasciitis; and
• discuss the recent literature on electrohydraulic, piezoelectric and radial shockwave therapy.
Sponsored by the North American Center for Continuing Medical Education.

What One Randomized Study Revealed About Electrohydraulic Shockwave
What One Randomized Study Revealed About Piezoelectric Shockwave
What One Randomized Study Revealed About Radial Shockwave
66
Author(s): 
By Lowell Scott Weil, Jr., DPM, MBA

1. Tomczak RL, Haverstock BD. A Retrospective Comparison of Endoscopic Plantar Fasciotomy to Open Plantar Fasciotomy with Heel Spur Resection for Chronic Plantar Fasciitis/Heel Spur Syndrome. J. Foot Ankle Surg. 34(3): 305-311, 1995.
2. Gill L, Kiebzak G. Outcome of Non-surgical Treatment for Plantar Fasciitis. Foot Ankle Int. 1996; 17: 527-532.
3. Weil LS, Golding PB, Nutbrown NJ. Heel Spur Syndrome. A Retrospective Study of 250 Patients Undergoing a Standardized Method of Treatment. J. Foot Ankle Surg. 4: 69-78, 1994.
4. Benton-Weil, Borelli AB, Weil Jr. LS, Weil Sr. LS. Percutaneous Plantar Fasciiotomy: A Minimally Invasive Procedure for Recalcitrant Plantar Fasciitis. J. Foot Ankle Surg. 37(4): 269-272, 1998.
5. Jerosch JU. Endoscopic Release of Plantar Fasciitis - A Benign Procedure? Foot Ankle, 21: 511-513, 2000.
6. Alvarez R. Preliminary Results on the Safety and Efficacy of the Ossatron for Treatment of Plantar Fasciitiis. Foot Ankle Int. 2002; 23: 197-203.
7. Weil Jr. LS, et al. Extracorporeal Shock Wave Therapy for the Treatment of Chronic Plantar Fasciitis: Indications, Protocol, Intermediate Results, and a Comparison of Results to Fasciotomy. JFAS 41(3), 2002.
8. Chen HS, et al. Shockwave Therapy for Patients with Plantar Fasciitis: A One-Year Follow-Up Study. Clinical Orthopedics and Related Research 387: 41-46, 2001.
9. Wang CJ, et al. Shockwave Therapy for Patients with Plantar Fasciitis: A One-Year Follow-up Study. Foot and Ankle International, 23(3), 2002.
10. Ogden JA, et al. Shockwave Therapy for Chronic Proximal Plantar Fasciitis: A Meta-Analysis. Foot and Ankle International 23(4), 2002.
11. Hammer DS, et al. Extracorporeal Shockwave Therapy (ESWT) in Patients with Chronic Proximal Plantar Fasciitis. Foot and Ankle International 23(4), 2002.
12. Buchbinder R, et. al. Ultrasound-Guided Extracorporeal Shock Wave Therapy for Plantar Fasciitis: A Randomized Controlled Trial. JAMA 288(11), 2002.
13. Rompe JD, et. al. Shock Wave Application for Chronic Plantar Fasciitis in Running Athletes: A Prospective, Randomized, Placebo-Controlled Trial. The American Journal of Sports Medicine 31(2), 2003.
14. Dalay PJ, et al. Plantar Fasciotomy for Intractable Plantar Fasciitis: Clinical Results and Biomechanical Evaluation. Foot and Ankle, 13(41), 1992.
15. Vohra PK, et al. Long-term Follow-up of Heel Spur Surgery: A 10-Year Retrospective Study. JAPMA, 89(2), 1999.
16. Lundeen RO, et al. Endoscopic Plantar Fasciotomy: A Retrospective Analysis of Results in 53 Patients. JFAS, 39(4), 2000.














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