Hi Dieter,
I am afraid I believe your colleague is confusing publications. I quoted
from a Buchbinder "review" article, I think his arguments are aimed at an
ESWT trial that Buchbinder published in the Journal of the American Medical
Association (2002).
My quote was regarding the six randomized, double-blind, placebo-controlled
trials that have been published evaluating this intervention. These trials
are the highest quality of evidence available and should be the research
that we hang our hats on, not anecdotal evidence coming from clinical
experience. Five of these trials showed either very small or no benefit.
Only one, the smallest trial, reported a large reduction in pain.
Five out of six trials with similar results is enough to convince me and I'd
be interested to know if your colleague believes a subtherapeutic dose of
shockwave was used in every trial.
Less than 6 months duration is not a necessary requirement for participants
in plantar fasciitis trials. Four weeks is commonly used as inclusion
criteria in such trials.
And for what it counts, Rachelle Buchbinder is a rheumatologist as well as a
clinical epidemiologist. And as seronegative arthropathies may present with
heel pain, I believe she would be very aware of plantar fasciitis as a
differential diagnosis and have seen a case or two in her time. More info
available on her here:
http://www.med.monash.edu.au/epidemiology/people/academic/buchbinder.html
Her article on plantar fasciitis that I quoted from used research to back up
every statement and is possibly the best review article I have seen on
plantar fasciitis. And as it is in the New England Journal of Medicine
should be readily available at almost at every large hospital in the world.
I urge all interested to find a copy of it.
Cheers,
Joel.
-----Original Message-----
From: A group for the academic discussion of current issues in podiatry
[mailto:[log in to unmask]] On Behalf Of Dieter
Sent: Thursday, October 07, 2004 10:25 PM
To: [log in to unmask]
Subject: Re: ESWT
I do not have access to a library resources to evaluate the article, but I
received this response from an American Podiatrist who is stronlgy pro-
active in this field:
"Rachel Buchbinder is an epidemiologist (in other words, never treated a
case of plantar fasciitis in her life). The population used in the study
included 50% whom had PF less than 6 months, ie. not meeting the minimum
duration for inclusion in most PF studies. Also, technique was questionable
in that a subtherapeutic dose of shockwave was delivered."
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