The Experts below are selected from a list of 384 Experts worldwide ranked by ideXlab platform
Elyazid Mouhsine - One of the best experts on this subject based on the ideXlab platform.
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Extracorporeal shock wave therapy in runners with a symptomatic Heel Spur
2006Co-Authors: Biagio Moretti, Raffaele Garofalo, Vittorio Patella, Gian Lorenzo Sisti, Margherita Corrado, Elyazid MouhsineAbstract:The aim of this paper is to assess the benefit to treat plantar fasciitis with low-dose energy extracorporeal shock wave therapy (ESWT) and the efficacy of such treatment to abate the painful symptoms allowing a rapid return to the running activity. Our study included 54 running athletes treated for plantar fasciitis associated with a Heel Spur who received four sessions (once weekly) of low-dose ESWT, and followed prospectively on average 45 days, 6 and 24 months after their last session. The clinical results were excellent in 59% of cases, good in 12%, satisfactory in 21% and distinctly unsatisfactory in 8%. No patient was observed a significant modification of the Heel Spur at the follow-up X-ray. The ultrasound examination at 24 months showed a disappearance of the inflammation signs in 61% of cases. A strong correlation between ultrasound improvement and clinical results were found. Low-energy ESWT seems to be a good mean to treat plantar fasciitis in runners with a 71% of good or excellent results and a persistent improvement lasting 24 months. A randomized multicentric study seems to be necessary to define the type of energy that should be used in the future to treat plantar fasciitis, in particular in the athletic patients, to allow a faster return to sports activities.
Marcus Niewald - One of the best experts on this subject based on the ideXlab platform.
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radiotherapy of painful Heel Spur with two fractionation regimens
2017Co-Authors: Benjamin Prokein, Matthias G Hautmann, Stefan Graeber, Jochen Fleckenstein, Christian Ruebe, Hanspeter Rosler, Henrik Holtmann, Yvonne Dzierma, Marcus NiewaldAbstract:Background In this randomized multicenter trial, we compared the effect of a lower single dose of 0.5 Gy vs. a standard single dose of 1 Gy concerning pain relief and quality of life, while maintaining a uniform total dose of 6 Gy. On the basis of laboratory observations, the lower single dose would be expected to be more effective.
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RESEARCH Open Access Randomized
2016Co-Authors: Marcus Niewald, Matthias G Hautmann, Stefan Graeber, Christian Ruebe, Hanspeter Rosler, Henrik Holtmann, Benjamin Prokein, Yvonne Dzierma, Jochen FleckensteinAbstract:multicenter follow-up trial on the effect of radiotherapy on painful Heel Spur (plantar fasciitis) comparing two fractionation schedules with uniform total dose: first results after three months ’ follow-u
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Randomized multicenter follow-up trial on the effect of radiotherapy on painful Heel Spur (plantar fasciitis) comparing two fractionation schedules with uniform total dose: first results after three months' follow-up.
2015Co-Authors: Marcus Niewald, Matthias G Hautmann, Stefan Graeber, Christian Ruebe, Hanspeter Rosler, Henrik Holtmann, Benjamin Prokein, Yvonne Dzierma, Jochen FleckensteinAbstract:Our first trial on radiotherapy for painful Heel Spur published in 2012 comparing the analgesic effect of a standard dose (6 × 1.0Gy within three weeks) to that of a very low one (6 × 0.1Gy within three weeks) resulted in a highly significant superiority of the standard dose arm. In the meantime, experimental data have shown that lower single doses in the range of 0.5 – 0.7Gy might be even more effective than the current standard dose of 1.0 Gy. Therefore, we conducted a second trial comparing the analgesic effect of standard single doses of 1.0Gy to that of low single doses of 0.5Gy using uniform total doses of 6Gy. One hundred twenty-seven patients were randomized to receive radiation therapy either with a total dose of 6.0Gy applied in 6 fractions of 1.0Gy twice weekly (standard dose) or with the same total dose applied in 12 fractions of 0.5Gy three times weekly (experimental dose). In all patients lateral opposing 6MV photon beams were used. The results were measured using Visual analogue scale (VAS), Calcaneodynia score (CS) and SF-12 health survey. The first phase of this trial ended after a three months’ follow-up; it will be continued up to 48 weeks. Nine patients had to be excluded after randomization either due to the withdrawal of informed consent to radiotherapy by the patients or radiotherapy with an incorrect dosage. The groups were comparable concerning biographical and disease data. The mean calcaneodynia score (CS) was higher in the experimental group (p = 0.002). After three months’ follow-up, we saw a very favorable pain relief in both arms (decline of VAS score: standard arm 42 points, experimental arm 44 points (n.s.), but we did not notice any statistically significant difference between the arms neither concerning the pain parameters nor the quality of life parameters. No relevant acute side effects were recorded. Favorable laboratory results could not be translated into an enhanced pain relief in our patients. This trial was terminated after the interim analysis (127 patients randomized). Further trials will be necessary to explore the best fractionation schedule. This trial has been approved by the expert panel of the DEGRO as well as by the Ethics committee of the Saarland Physicians’ chamber. Current trial registration at German Clinical Trials Register with the number DRKS00004458
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randomized multicenter trial on the effect of radiation therapy on plantar fasciitis painful Heel Spur comparing a standard dose with a very low dose mature results after 12 months follow up
2012Co-Authors: Marcus Niewald, Oliver Micke, Heinrich M Seegenschmiedt, Stefan Graeber, Ralf Muecke, Vera Schaefer, Christine Scheid, Jochen Fleckenstein, Norbert Licht, Christian RuebeAbstract:Purpose To conduct a randomized trial of radiation therapy for painful Heel Spur, comparing a standard dose with a very low dose. Methods and Materials Sixty-six patients were randomized to receive radiation therapy either with a total dose of 6.0 Gy applied in 6 fractions of 1.0 Gy twice weekly (standard dose) or with a total dose of 0.6 Gy applied in 6 fractions of 0.1 Gy twice weekly (low dose). In all patients lateral opposing 4- to 6-MV photon beams were used. The results were measured using a visual analogue scale, the Calcaneodynia score, and the SF12 health survey. The fundamental phase of the study ended after 3 months, and the follow-up was continued up to 1 year. Patients with insufficient pain relief after 3 months were offered reirradiation with the standard dosage at any time afterward. Results Of 66 patients, 4 were excluded because of withdrawal of consent or screening failures. After 3 months the results in the standard arm were highly significantly superior compared with those in the low-dose arm (visual analogue scale, P =.001; Calcaneodynia score, P =.027; SF12, P =.045). The accrual of patients was stopped at this point. Further evaluation after 12 months' follow-up showed the following results: ( 1 ) highly significant fewer patients were reirradiated in the standard arm compared with the low-dose arm ( P 2 ) the results of patients in the low-dose arm who were reirradiated were identical to those in the standard arm not reirradiated (reirradiation as a salvage therapy if the lower dose was ineffective); ( 3 ) patients experiencing a favorable result after 3 months showed this even after 12 months, and some results even improved further between 3 and 12 months. Conclusions This study confirms the superior analgesic effect of radiation therapy with 6-Gy doses on painful Heel Spur even for a longer time period of at least 1 year.
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randomized multicenter trial on the effect of radiotherapy for plantar fasciitis painful Heel Spur using very low doses a study protocol
2008Co-Authors: Marcus Niewald, Oliver Micke, Heinrich M Seegenschmiedt, Stefan GraberAbstract:Background A lot of retrospective data concerning the effect of radiotherapy on the painful Heel Spur (plantar fasciitis) is available in the literature. Nevertheless, a randomized proof of this effect is still missing. Thus, the GCGBD (German cooperative group on radiotherapy for benign diseases) of the DEGRO (German Society for Radiation Oncology) decided to start a randomized multicenter trial in order to find out if the effect of a conventional total dose is superior compared to that of a very low dose.
Biagio Moretti - One of the best experts on this subject based on the ideXlab platform.
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Extracorporeal shock wave therapy in runners with a symptomatic Heel Spur
2006Co-Authors: Biagio Moretti, Raffaele Garofalo, Vittorio Patella, Gian Lorenzo Sisti, Margherita Corrado, Elyazid MouhsineAbstract:The aim of this paper is to assess the benefit to treat plantar fasciitis with low-dose energy extracorporeal shock wave therapy (ESWT) and the efficacy of such treatment to abate the painful symptoms allowing a rapid return to the running activity. Our study included 54 running athletes treated for plantar fasciitis associated with a Heel Spur who received four sessions (once weekly) of low-dose ESWT, and followed prospectively on average 45 days, 6 and 24 months after their last session. The clinical results were excellent in 59% of cases, good in 12%, satisfactory in 21% and distinctly unsatisfactory in 8%. No patient was observed a significant modification of the Heel Spur at the follow-up X-ray. The ultrasound examination at 24 months showed a disappearance of the inflammation signs in 61% of cases. A strong correlation between ultrasound improvement and clinical results were found. Low-energy ESWT seems to be a good mean to treat plantar fasciitis in runners with a 71% of good or excellent results and a persistent improvement lasting 24 months. A randomized multicentric study seems to be necessary to define the type of energy that should be used in the future to treat plantar fasciitis, in particular in the athletic patients, to allow a faster return to sports activities.
Bahar Dirican - One of the best experts on this subject based on the ideXlab platform.
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role of radiotherapy in the management of Heel Spur
2015Co-Authors: Bora Uysal, Murat Beyzadeoglu, Omer Sager, Selcuk Demiral, Hakan Gamsiz, Ferrat Dincoglan, Mustafa Akin, Bahar DiricanAbstract:The purpose of this study is to investigate the use of low-dose radiotherapy (RT) in benign painful Heel Spur management. Between the years of 2009 and 2012, in Gulhane Military Medical Academy Radiation Oncology Department, patients with Heel Spur undergoing radiotherapy for pain relief were analyzed retrospectively. In the evaluation of treatment response, Verbal Numeric Scale (VNS) scoring method was used to compare the pain status before and after radiotherapy. Age, gender, laterality, VNS score before RT, VNS score after RT, RT doses of the patients and patients undergoing second course of radiotherapy were recorded. All patients received 8 Gy RT in two fractions with Co-60 teletherapy machine. Statistical Package for Social Sciences, version 16.0 was used for data analysis with the level of significance set at p < 0.05. The total number of patients receiving RT for Heel Spur pain was 450. Median age was 52 years (range 40–85 years). Two hundred and ninety-two (65 %) of the patients were women and 158 (35 %) were men. Radiologically calcaneal Spurs were bilateral in 432 (96 %) patients, whereas unilateral left in 8 (1.8 %) patients and unilateral right Heel location in 10 (2.2 %) patients. Ten (2.2 %) of the patient group received second course of RT due to refractory pain. Comparative evaluation of VNS scores before and after RT revealed statistically significant pain relief by radiotherapy (p < 0.05). Low-dose radiotherapy is an effective and reliable painkilling treatment method that can be used in the treatment of epin calcanei refractory to medical and surgical treatment.
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Heel Spur radiotherapy and radiation carcinogenesis risk estimation
2006Co-Authors: Serdar Surenkok, Bahar Dirican, Murat Beyzadeoglu, Kaan OysulAbstract:Purpose Radiotherapy is a nonsurgical alternative therapy of painful Heel Spur patients. Nonetheless, cancer induction is the most important somatic effect of ionizing radiation. This study was designed to evaluate the carcinogenesis risk factor in benign painful Heel Spur patients treated by radiotherapy.
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Heel Spur radiotherapy and radiation carcinogenesis risk estimation
2006Co-Authors: Serdar Surenkok, Bahar Dirican, Murat Beyzadeoglu, Kaan OysulAbstract:Radiotherapy is a nonsurgical alternative therapy of painful Heel Spur patients. Nonetheless, cancer induction is the most important somatic effect of ionizing radiation. This study was designed to evaluate the carcinogenesis risk factor in benign painful Heel Spur patients treated by radiotherapy. Between 1974 and 1999, a total of 20 patients received mean 8.16 Gy total irradiation dose in two fractions. Thermoluminescent dosimeters (TLD100) were placed on multiple phantom sites in vivo within the irradiated volume to verify irradiation accuracy and carcinogenesis risk factor calculation. The 20 still-alive patients, who had a minimum 5-year and maximum 29-year follow-up (mean 11.9 years), have been evaluated by carcinogenic radiation risk factor on the basis of tissue weighting factors as defined by the International Commission on Radiological Protection Publication 60. Reasonable pain relief has been obtained in all 20 patients. The calculated mean carcinogenesis risk factor is 1.3% for radiation portals in the whole group, and no secondary cancer has been clinically observed. Radiotherapy is an effective treatment modality for relieving pain in calcaneal Spur patients. The estimated secondary cancer risk factor for irradiation of this benign lesion is not as high as was feared.
Oliver Micke - One of the best experts on this subject based on the ideXlab platform.
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randomized multicenter trial on the effect of radiation therapy on plantar fasciitis painful Heel Spur comparing a standard dose with a very low dose mature results after 12 months follow up
2012Co-Authors: Marcus Niewald, Oliver Micke, Heinrich M Seegenschmiedt, Stefan Graeber, Ralf Muecke, Vera Schaefer, Christine Scheid, Jochen Fleckenstein, Norbert Licht, Christian RuebeAbstract:Purpose To conduct a randomized trial of radiation therapy for painful Heel Spur, comparing a standard dose with a very low dose. Methods and Materials Sixty-six patients were randomized to receive radiation therapy either with a total dose of 6.0 Gy applied in 6 fractions of 1.0 Gy twice weekly (standard dose) or with a total dose of 0.6 Gy applied in 6 fractions of 0.1 Gy twice weekly (low dose). In all patients lateral opposing 4- to 6-MV photon beams were used. The results were measured using a visual analogue scale, the Calcaneodynia score, and the SF12 health survey. The fundamental phase of the study ended after 3 months, and the follow-up was continued up to 1 year. Patients with insufficient pain relief after 3 months were offered reirradiation with the standard dosage at any time afterward. Results Of 66 patients, 4 were excluded because of withdrawal of consent or screening failures. After 3 months the results in the standard arm were highly significantly superior compared with those in the low-dose arm (visual analogue scale, P =.001; Calcaneodynia score, P =.027; SF12, P =.045). The accrual of patients was stopped at this point. Further evaluation after 12 months' follow-up showed the following results: ( 1 ) highly significant fewer patients were reirradiated in the standard arm compared with the low-dose arm ( P 2 ) the results of patients in the low-dose arm who were reirradiated were identical to those in the standard arm not reirradiated (reirradiation as a salvage therapy if the lower dose was ineffective); ( 3 ) patients experiencing a favorable result after 3 months showed this even after 12 months, and some results even improved further between 3 and 12 months. Conclusions This study confirms the superior analgesic effect of radiation therapy with 6-Gy doses on painful Heel Spur even for a longer time period of at least 1 year.
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randomized multicenter trial on the effect of radiotherapy for plantar fasciitis painful Heel Spur using very low doses a study protocol
2008Co-Authors: Marcus Niewald, Oliver Micke, Heinrich M Seegenschmiedt, Stefan GraberAbstract:Background A lot of retrospective data concerning the effect of radiotherapy on the painful Heel Spur (plantar fasciitis) is available in the literature. Nevertheless, a randomized proof of this effect is still missing. Thus, the GCGBD (German cooperative group on radiotherapy for benign diseases) of the DEGRO (German Society for Radiation Oncology) decided to start a randomized multicenter trial in order to find out if the effect of a conventional total dose is superior compared to that of a very low dose.
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calcaneodynia plantar and dorsal Heel Spur Heel Spur syndrome
2008Co-Authors: Oliver Micke, Antje Ernststecken, Ralph Mucke, M H SeegenschmiedtAbstract:Painful Heel Spur (plantar fasciitis) is a major part of the Heel Spur syndrome. It is reportedly the most common cause of pain in the inferior Heel and is estimated to account for 11% to 15% of all foot symptoms requiring professional care among adults [17]. The first description of the clinical picture in the literature came from Wood in 1812, but he incorrectly attributed it to tuberculosis [11, 68]. During the Civil War, another early citing by Zacharie in 1860 discussed a condition affecting the Heel in which patients had “greater pain in the morning than after standing and walking one or two hours” [153].
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low dose radiotherapy for painful Heel Spur retrospective study of 117 patients
2003Co-Authors: Ralph Mucke, Oliver Micke, Heinrich M Seegenschmiedt, K Schonekaes, Dorothee Berning, Rainer HeyderAbstract:Retrospective analysis of 117 patients treated between 1996 and 2000 with low-dose radiotherapy (RT) for painful Heel Spurs. 71 women and 46 men were irradiated on 136 painful Heel Spurs in one (n = 104) or two radiation series (n = 13). The painful Spurs were located either at the plantar (n = 94), dorsal (n = 5) or bilateral Heel (n = 18). 82 patients had prior treatments, in 35 patients RT was the primary treatment. Low-dose RT was performed twice a week with one 6-MV photon field. Ten fractions of 0.5 Gy were applied to a total dose of 5 Gy. Evaluation was done on completion and during follow-up using the four-scale von Pannewitz score. On completion of RT, 27 patients were free of pain, 40 were much improved, 31 reported slight improvement, and 19 experienced no change. After a mean follow-up of 20 months, 75 out of 100 patients were free of pain, twelve had marked and three some improvement. Ten patients reported no change of symptoms. Mean duration of pain before RT was 6 months. RT applied ≤ 6 months after the onset of clinical symptoms resulted in improvement in 94%. By contrast, an interval of > 6 months until the initiation of RT resulted in only 73% of patients with clinical improvement. Low-dose RT reveals a benefit in > 80% of the patients. RT should start during the first 6 months of symptoms. Prospective clinical studies with validated symptom scores should be conducted to assess optimal dose and fractionation scheme of RT.