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Dr. Rompe reports on ESWT placebo effects

Posted by BrianG on 2/22/03 at 20:08 (110424)

Dr. Jan Rompe has reported the results of a placebo controlled double blind ESWT trial, using a low energy machine. He reports 75% of the people who had the real ESWT treatment, were able to jog again. He also reports that 25% of the placebo group were able to return to jogging. Something to think about....

BrianG

Title: AAOS: Lithotripsy Leads to Quick Recovery for Runners with Plantar Fasciitis
URL: http://www.pslgroup.com/dg/22B6BA.htm
Doctor's Guide
February 7, 2003
By Cameron Johnston
Special to DG News
NEW ORLEANS, LA -- February 7, 2003 -- Extra-corporeal shock wave lithotripsy allows runners with chronic fasciitis to return to their former regimens in fairly short order, and curtails their reliance on pain-killers and non-steroidal anti-inflammatory drugs, German researchers report.
In a presentation here on February 6th at the 70th Annual Meeting of the American Academy of Orthopaedic Surgeons, Dr. Jan Rompe of the University of Mainz, in Germany, described what he said was the first placebo controlled double blind study to evaluate this procedure for plantar fasciitis.
The study enrolled 45 runners who had plantar fasciitis for 1 to 6 years despite conventional therapies such as corticosteroid injections and physiotherapy. Treatment consisted of 3 applications of 2,100 impulses of low-energy shock waves. Sixteen of 22 subjects treated with lithotripsy and 19 of 23 treated with a sham procedure were followed for 1 year.
The subjects were considered treatment failures if they took any medications for their fasciitis within 3 months of the initial treatment.
At the end of 6 months, mean pain scores on first walking for the lithotripsy group fell from 7 to 2 on the 10-point Visual Analogue Scale. Mean pain scores fell from 7 to 5 in the placebo group (p=0.0004). Three-quarters of the treated group were able to resume regular running within 6 months, while only one-quarter of the placebo group had begun running again.
Dr. Rompe noted that there was a 'considerable placebo effect' among this series of patients

Re: Dr. Rompe reports on ESWT placebo effects

Ed Davis, DPM on 2/23/03 at 21:19 (110559)

Brian:

A timely post. The numbers here are not very big but I am confident that the statistics will continue to roll in on this.

Ed

Re: Dr. Rompe reports on ESWT placebo effects

Don Scott on 2/26/03 at 03:49 (110794)

To All,
Very interesting, could someone check my figures?
6 of the original group were not tested (successful) 100% or did they take drugs therefore classified as failures??????????
16 of the original 22 were retested that is 72%
75% of this group were then treated successfully that means 12 in the group
So is it 6+12=18/22 =81.3% success rate or 16/22=75%

Of the placebo/sham group 19/23 were retested but only 25% can now run

4 of the sham group were not retested. Were they able to run or not. Did they take drugs or not??????????

The results are vague. Did the persons being treated have follow up injuries during the year i.e. fall, sprain an ankle, twist a knee during the year. What happens after the treatment happens! As a practioner you can only treat the here and now. A patient could have a treatment, leave your office, get hit by a car!!!! Was the treatment a success or a failure?????????????? It is all semantics
Good luck with playing with stats.

Don Scott
Australia

Re: Dr. Rompe reports on ESWT placebo effects

Bill on 2/26/03 at 07:04 (110797)

If the patient was hit by a car while running then I would consider the treatment a success.

Re: Dr. Rompe reports on ESWT placebo effects

Jan rompe on 2/26/03 at 07:05 (110798)

You should not discuss the results of the study before you have read its details in the upcoming March 2003 issue in the American Journal of Sports Medicine.
Then, I will be happy to answer your questions.

Re: Dr. Rompe reports on ESWT placebo effects

Ed Davis, DPM on 2/26/03 at 15:57 (110890)

Dr. Rompe:
Thank you for coming to this board. It is great to get first hand info. from you and hope you come back to visit often.
Ed

Re: Dr. Rompe reports on ESWT placebo effects

Dr. Z on 2/26/03 at 16:01 (110892)

Hello,

I would very much like to read this article. How would like find journal of Sports Medicine.??

Re: Dr. Rompe reports on ESWT placebo effects

Pauline on 2/26/03 at 19:16 (110919)

Dr. Ed,
Do you also believe in Peter Pan? Tell me your not serious. I hate to be the doubting Thomas, but with the entire scientific world available to Dr. Rompe this just doesn't seem to be his style.

I've got a bridge for sale. Interested?

Re: Dr. Rompe reports on ESWT placebo effects

Ed Davis, DPM on 2/26/03 at 21:36 (110936)

Pauline:
I am not sure I understand your question. Rompe is a major researcher in this area. What aspect of Dr. Rompe's research are you questioning or are in disagreement with?

I am not getting too excited over the placebo effect issue, assuming that is what you are questioning. Take a look at the aggregate of information presented and read his upcoming article ( I have not seen it yet either) before coming to any conclusions.
Ed

Re: Dr. Rompe reports on ESWT placebo effects

Dr. Z on 2/26/03 at 21:59 (110937)

I think I know what she may be talking about. I think that Pauline thinks that this is not the true man in person. I could be wrong but that is my guess.

Re: Dr. Rompe reports on ESWT placebo effects

Pauline on 2/26/03 at 22:48 (110940)

Right on Dr. Z. As the foremost expert in the field of ESWT I just don't picture him gathering his information in these type of forums.

Re: Dr. Rompe reports on ESWT placebo effects

Dr. Z on 2/27/03 at 07:11 (110959)

I think he postered in the past, on this board directed at Dr. Z. I have to take a look in the archives to try and pull this up. You thoughs were the same as mine at first but you never know. I will check the archives. I have seen his picture but never met him. His picture give the appearance of a very low keyed, down to earth physician that just might post. Who knows

Re: Dr. Rompe reports on ESWT placebo effects

Pauline on 2/27/03 at 08:24 (110966)

Dr. Z,
The man is 'THE' expert in ESWT and in 10 years he never once had to ask an opinion from anyone what 'HE' should consider including in his next research study. This man already has the rest of the scientific world a phone call away.

Re: Dr. Rompe reports on ESWT placebo effects

Dr. Z on 2/27/03 at 09:52 (110975)

You are 99.9% right about this but you never know, this is heelspurs.com and I have seen some strange things in my life. I sure am leaning toward toward that 100%. Ok sorry he is a fake. Go home Mr. fake Hey wait a minute heelspurs.com is the largest platform in the WORLD on heel pain
so back to 99.99%. Dam this is a tough one. If I was a betting man well I would bet that the Fake is a Fake. Any odds for this bet?. Hey lets open up a betting post. The money will go to one ESWT treament for the needy one. Pauline will determine the winner by contacting Dr. Rompe. Dr.Rompe will present the ESWT winner. with a ESWT treatment IF the patient is from Europe he will do it if East Coast I will do it and if West Coast Dr. Ed.
Sorry Dr. Ed you are in this one. Shall we ask the rest of the board to help us determine will the real Dr. Rompe stand up .

Re: Dr. Rompe reports on ESWT placebo effects

Pauline on 2/27/03 at 10:43 (110981)

Dr. Z,
No raffles necessary. If you want to give a free treatment just do it. No need for all the fanfare.

Re: imposters?? Suggestions from Scott R. needed!

Ed Davis, DPM on 2/27/03 at 12:40 (110997)

Pauline and Dr. Z:

That is a hard call to make. Hopefully, Dr. Rompe will respond.
I do not know how one can verify the identity of a poster but would like to hear from Scott R. on this.

I am not sure I would use the presence of a post on this board alone to determine whether such post are originating from the source in question. Researchers are curious individuals just like the rest of us and may ask for feedback.
ed

Re: The man...

Ed Davis, DPM on 2/27/03 at 12:43 (110999)

If this poster is indeed Rompe, then we should try to encourage him to stay.
Ed

Re: imposters?? Suggestions from Scott R. needed!

Pauline on 2/27/03 at 14:33 (111016)

Dr. Ed,
Did you see where his presentation was made? This is from Brian's post.

In a presentation on February 6th at the 70th Annual Meeting of the American Academy of Orthopaedic Surgeons, Dr. Jan Rompe of the University of Mainz, in Germany, described what he said was the first placebo controlled double blind study to evaluate this procedure for plantar fasciitis.

He presented at 'The 70th Annual Meeting of the American Academy of Orthopaedic Surgeons'. He couldn't get any feed back from this prestigious group so instead he turns to 3 nuns in Hoboken:*)

Re: Dr. Rompe reports on ESWT placebo effects

Jan Rompe on 2/28/03 at 05:53 (111124)

Pauline:

Anybody who is interested in contacting me about the experiences of our study group can do so at

(email removed)

or

http://www.uni-mainz.de/FB/Medizin/Orthopaedie/rompe.htm

or

Jan D. Rompe, MD
Professor
Dept. of Orthopaedic Surgery
Johannes Gutenberg University
School of Medicine
Langenbeckstr. 1
D-55131 Mainz
Germany

Fax +49-6131-176612

Any professional comments are welcome and should be sent directly to me (rather not via this website).

JAMA trial:
You are right, the entire scientific world is available to me.
However,if you are no native speaker it is quite difficult to work yourself through the incredible amount of data provided by R. Buchbinder. It is even more difficult get an idea what could be the key point for her negative results?

patient selection?

device?

way of shock wave application?

short period of follow-up?

ongoing pain medication?

lack of validated rating scores?

Some critical brain storming may be helpful before designing further trials.
I am not interested in emotional or preconceived opinions: There are too many on this website.

Yours sincerely,

Jan D. Rompe

Re: The real Dr. Rompe

Ed Davis, DPM on 2/28/03 at 12:15 (111173)

Dr. Rompe:

Thank you. I need to assume you are the real Dr. Rompe since concern was expressed that we actually had you on this board. Your concerns about Buchbinder are duly noted and are consistent, I believe with the concerns of many.

It appears that the trend in Europe has been toward smaller machines and low energy. Is that a correct impression and if so, what is your opinion of why that trend is occurring?
Ed

Re: The real Dr. Rompe

Pauline on 2/28/03 at 13:48 (111181)

Dr. Ed,
This last post is certainly more in keeping with the professionalism of the real Dr. Rompe and yes indeed he is more than willing to answer anyone's questions. He has answered mine when ever I've contacted him directly as requested in his post.