Efficacy of extracorporeal shock wave therapy for knee tendinopathies and other soft tissue disorders: a meta-analysis of randomized controlled trials

• Published in: BMC musculoskeletal disorders 2018-08, Vol.19 (1), p.278-278, Article 278
• Main Authors: Liao, Chun-De, Xie, Guo-Min, Tsauo, Jau-Yih, Chen, Hung-Chou, Liou, Tsan-Hon
• Format: Article
• Language: English
• Subjects: Acoustics; Adult; Aged; Aged, 80 and over; Analysis; Biomechanical Phenomena; Care and treatment; Clinical medicine; Clinical trials; Energy; Extracorporeal shock wave therapy; Extracorporeal Shockwave Therapy - adverse effects; Female; Humans; Joint and ligament injuries; Joint surgery; Knee; Knee Injuries - diagnosis; Knee Injuries - physiopathology; Knee Injuries - therapy; Knee Joint - physiopathology; Lithotripsy; Male; Meta-analysis; Middle Aged; Musculoskeletal diseases; Musculoskeletal disorders; Pain; Physical therapy; Randomized Controlled Trials as Topic; Range of Motion, Articular; Recovery of Function; Shock; Sports injuries; Systematic review; Tendinitis; Tendinopathy - diagnosis; Tendinopathy - physiopathology; Tendinopathy - therapy; Tendon injuries; Tissue engineering; Treatment Outcome; Young Adult
• ISSN: 1471-2474; 1471-2474
• DOI: 10.1186/s12891-018-2204-6

Extracorporeal shock-wave therapy (ESWT), which can be divided into radial shock-wave therapy (RaSWT) and focused shock-wave therapy (FoSWT), has been widely used in clinical practice for managing orthopedic conditions. The aim of this study was to determine the clinical efficacy of ESWT for knee soft tissue disorders (KSTDs) and compare the efficacy of different shock-wave types, energy levels, and intervention durations. We performed a comprehensive search of online databases and search engines without restrictions on the publication year or language. We selected randomized controlled trials (RCTs) reporting the efficacy of ESWT for KSTDs and included them in a meta-analysis and risk of bias assessment. The pooled effect sizes of ESWT were estimated by computing odds ratios (ORs) with 95% confidence intervals (CIs) for the treatment success rate (TSR) and standardized mean differences (SMDs) with 95% CIs for pain reduction (i.e., the difference in pain relief, which was the change in pain from baseline to the end of RCTs between treatment and control groups) and for restoration of knee range of motion (ROM). We included 19 RCTs, all of which were of high or medium methodological quality and had a Physiotherapy Evidence Database score of ≥5/10. In general, ESWT had overall significant effects on the TSR (OR: 3.36, 95% CI: 1.84-6.12, P