4. The Procedure
orthosis, Shock, shock
SHOCKS, SHOCK, SHOCK
The shock wave therapy machine used was the Masterpuls MP 200, serial No: BS 2058, manufactured in 2011 by STORZ MEDICAL, Switzerland. Shock wave therapy was applied locally, on the heel of the foot, at the site of the calcar calcanei. The application was performed with a focused probe with the following parameters: 16 Hz frequency, 1,600 shocks, and a pressure of 1.6 bars. The patients lay prone, and a cylinder was placed under their lower leg so the heel would be completely relaxed and more accessible to the doctor performing the therapy. The f-ESWT was applied once a week for ten weeks.The patients in the control group underwent a series of ten physical ultrasound therapy treatments continuously every day. The machine applied was the SONOPULS 492 Enraf-Nonius. The application of standard ultrasound therapy was performed using the stable method, directly on the heel of the foot and the plantar fascia, for five minutes at an intensity ranging between 0.5 and 0.8 W/cm2. The patients were positioned in the same way as for shock wave therapy application. A licensed physician administered shock wave therapy. A licensed physical therapist administered standard ultrasound treatment to the patients in the control group according to the protocol defined by a physiatrist. None of the patients treated in either of the groups took any medication belonging to the group of analgesics or non-steroid antirheumatics, nor were they treated with corticosteroid drugs during the study. Additionally, none used an orthosis for their heel or applied any gels locally.