Efficacy of Extracorporeal Shock Wave Therapy for Lower Extremity Tendinopathy: A Meta-analysis of Randomised Controlled Trials

Chun-De Liao, Jau-Yih Tsauo, Hung-Chou Chen, Tsan-Hon Liou

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Abstract

OBJECTIVE: Extracorporeal shock wave therapy (ESWT), including radial shock wave (RaSW) and focused shock wave (FoSW) types, is widely used for managing tendinopathies. The difference in efficacy between the 2 shock wave characteristics with different dosage levels remains controversial, and the purpose of this meta-analysis was to examine it for patients with lower extremity (LE) tendinopathy.

DESIGN: A comprehensive search of online databases and search engines was performed. This study included randomized controlled trials (RCTs) reporting the efficacy of ESWT in treating LE tendinopathy. The included RCTs were subjected to a meta-analysis and risk of bias assessment.

RESULTS: In total, 29 RCTs were included, all of which had a good methodological quality, with a PEDro score of ≥6/10. General ESWT showed significant effects at the immediate follow-up [pain score: standardized mean difference (SMD) = -1.41, 95% confidence interval (CI) = -2.01 to -0.82, P < .00001; function: SMD = 2.59, 95% CI = 1.54-3.64, P < .00001] as well as at 3, 6, and ≥12 months. In sequence, HD-FoSW, HD-RaSW, and LD-RaSW had superior pooled effects on overall clinical outcomes.

CONCLUSION: ESWT exerted a positive overall effect on pain and function for LE tendinopathy. Shock wave types and dosage levels may have different contributions to treatment efficacy.

LanguageEnglish
JournalAmerican Journal of Physical Medicine and Rehabilitation
DOIs
StateE-pub ahead of print - Mar 19 2018

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Convulsive Therapy
Tendinopathy
Meta-Analysis
Lower Extremity
Randomized Controlled Trials
Confidence Intervals
Pain
Search Engine
Databases

Cite this

@article{99c88869a1804b94a16caa04bbd839f8,
title = "Efficacy of Extracorporeal Shock Wave Therapy for Lower Extremity Tendinopathy: A Meta-analysis of Randomised Controlled Trials",
abstract = "OBJECTIVE: Extracorporeal shock wave therapy (ESWT), including radial shock wave (RaSW) and focused shock wave (FoSW) types, is widely used for managing tendinopathies. The difference in efficacy between the 2 shock wave characteristics with different dosage levels remains controversial, and the purpose of this meta-analysis was to examine it for patients with lower extremity (LE) tendinopathy.DESIGN: A comprehensive search of online databases and search engines was performed. This study included randomized controlled trials (RCTs) reporting the efficacy of ESWT in treating LE tendinopathy. The included RCTs were subjected to a meta-analysis and risk of bias assessment.RESULTS: In total, 29 RCTs were included, all of which had a good methodological quality, with a PEDro score of ≥6/10. General ESWT showed significant effects at the immediate follow-up [pain score: standardized mean difference (SMD) = -1.41, 95{\%} confidence interval (CI) = -2.01 to -0.82, P < .00001; function: SMD = 2.59, 95{\%} CI = 1.54-3.64, P < .00001] as well as at 3, 6, and ≥12 months. In sequence, HD-FoSW, HD-RaSW, and LD-RaSW had superior pooled effects on overall clinical outcomes.CONCLUSION: ESWT exerted a positive overall effect on pain and function for LE tendinopathy. Shock wave types and dosage levels may have different contributions to treatment efficacy.",
author = "Chun-De Liao and Jau-Yih Tsauo and Hung-Chou Chen and Tsan-Hon Liou",
year = "2018",
month = "3",
day = "19",
doi = "10.1097/PHM.0000000000000925",
language = "English",
journal = "American Journal of Physical Medicine and Rehabilitation",
issn = "0894-9115",
publisher = "Lippincott Williams and Wilkins",

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T2 - American Journal of Physical Medicine and Rehabilitation

AU - Liao,Chun-De

AU - Tsauo,Jau-Yih

AU - Chen,Hung-Chou

AU - Liou,Tsan-Hon

PY - 2018/3/19

Y1 - 2018/3/19

N2 - OBJECTIVE: Extracorporeal shock wave therapy (ESWT), including radial shock wave (RaSW) and focused shock wave (FoSW) types, is widely used for managing tendinopathies. The difference in efficacy between the 2 shock wave characteristics with different dosage levels remains controversial, and the purpose of this meta-analysis was to examine it for patients with lower extremity (LE) tendinopathy.DESIGN: A comprehensive search of online databases and search engines was performed. This study included randomized controlled trials (RCTs) reporting the efficacy of ESWT in treating LE tendinopathy. The included RCTs were subjected to a meta-analysis and risk of bias assessment.RESULTS: In total, 29 RCTs were included, all of which had a good methodological quality, with a PEDro score of ≥6/10. General ESWT showed significant effects at the immediate follow-up [pain score: standardized mean difference (SMD) = -1.41, 95% confidence interval (CI) = -2.01 to -0.82, P < .00001; function: SMD = 2.59, 95% CI = 1.54-3.64, P < .00001] as well as at 3, 6, and ≥12 months. In sequence, HD-FoSW, HD-RaSW, and LD-RaSW had superior pooled effects on overall clinical outcomes.CONCLUSION: ESWT exerted a positive overall effect on pain and function for LE tendinopathy. Shock wave types and dosage levels may have different contributions to treatment efficacy.

AB - OBJECTIVE: Extracorporeal shock wave therapy (ESWT), including radial shock wave (RaSW) and focused shock wave (FoSW) types, is widely used for managing tendinopathies. The difference in efficacy between the 2 shock wave characteristics with different dosage levels remains controversial, and the purpose of this meta-analysis was to examine it for patients with lower extremity (LE) tendinopathy.DESIGN: A comprehensive search of online databases and search engines was performed. This study included randomized controlled trials (RCTs) reporting the efficacy of ESWT in treating LE tendinopathy. The included RCTs were subjected to a meta-analysis and risk of bias assessment.RESULTS: In total, 29 RCTs were included, all of which had a good methodological quality, with a PEDro score of ≥6/10. General ESWT showed significant effects at the immediate follow-up [pain score: standardized mean difference (SMD) = -1.41, 95% confidence interval (CI) = -2.01 to -0.82, P < .00001; function: SMD = 2.59, 95% CI = 1.54-3.64, P < .00001] as well as at 3, 6, and ≥12 months. In sequence, HD-FoSW, HD-RaSW, and LD-RaSW had superior pooled effects on overall clinical outcomes.CONCLUSION: ESWT exerted a positive overall effect on pain and function for LE tendinopathy. Shock wave types and dosage levels may have different contributions to treatment efficacy.

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JF - American Journal of Physical Medicine and Rehabilitation

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