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Extracorporeal shock wave therapy is effective in treating chronic plantar fasciitis: A meta-analysis of RCTs

BACKGROUND: Plantar fasciitis (PF) is the most common reason for heel pain. The efficacy of extracorporeal shock wave therapy (ESWT) as an ideal alternative to conservative treatments and surgery is controversial, and almost all previous articles compared general ESWT with placebo without indicating...

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Detalles Bibliográficos
Autores principales: Sun, Jiale, Gao, Fuqiang, Wang, Yanhua, Sun, Wei, Jiang, Baoguo, Li, Zirong
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Wolters Kluwer Health 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5403108/
https://www.ncbi.nlm.nih.gov/pubmed/28403111
http://dx.doi.org/10.1097/MD.0000000000006621
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author Sun, Jiale
Gao, Fuqiang
Wang, Yanhua
Sun, Wei
Jiang, Baoguo
Li, Zirong
author_facet Sun, Jiale
Gao, Fuqiang
Wang, Yanhua
Sun, Wei
Jiang, Baoguo
Li, Zirong
author_sort Sun, Jiale
collection PubMed
description BACKGROUND: Plantar fasciitis (PF) is the most common reason for heel pain. The efficacy of extracorporeal shock wave therapy (ESWT) as an ideal alternative to conservative treatments and surgery is controversial, and almost all previous articles compared general ESWT with placebo without indicating the kind of shock wave. We undertook a meta-analysis to compare the efficacy of general ESWT, focused shock wave (FSW), and radial shock wave (RSW) with placebo, to assess their effectiveness in chronic PF. METHODS: The PubMed, Medline, EmBase, Web of Science, and Cochrane library databases were searched for studies comparing FSW or RSW therapy with placebo in chronic PF. Clinical outcomes included the odds ratios (ORs) of pain relief, pain reduction, and complications. Relevant data were analyzed using RevMan v5.3. RESULTS: Nine studies involving 935 patients were included. ESWT had higher improvement rates than the placebo group (OR 2.58, 95% confidence interval [CI] 1.97–3.39, P < .00001). ESWT had markedly lower standardized mean difference than placebo, with heterogeneity observed (standardized mean difference 1.01, 95% CI −0.01 to 2.03, P = .05, I(2) = 96%, P < .00001). FSW and RSW therapies had greater therapeutic success in pain relief than the placebo group (OR 2.17, 95% CI 1.49–3.16, P < .0001; OR 4.63, 95% CI 1.30–16.46, P = .02), but significant heterogeneity was observed in RSW therapy versus placebo (I(2) = 81%, P = .005). CONCLUSION: This meta-analysis suggested that FSW therapy can relieve pain in chronic PF as an ideal alternative option; meanwhile, no firm conclusions of general ESWT and RSW effectiveness can be drawn. Due to variations in the included studies, additional trials are needed to validate these conclusions.
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spelling pubmed-54031082017-04-28 Extracorporeal shock wave therapy is effective in treating chronic plantar fasciitis: A meta-analysis of RCTs Sun, Jiale Gao, Fuqiang Wang, Yanhua Sun, Wei Jiang, Baoguo Li, Zirong Medicine (Baltimore) 3700 BACKGROUND: Plantar fasciitis (PF) is the most common reason for heel pain. The efficacy of extracorporeal shock wave therapy (ESWT) as an ideal alternative to conservative treatments and surgery is controversial, and almost all previous articles compared general ESWT with placebo without indicating the kind of shock wave. We undertook a meta-analysis to compare the efficacy of general ESWT, focused shock wave (FSW), and radial shock wave (RSW) with placebo, to assess their effectiveness in chronic PF. METHODS: The PubMed, Medline, EmBase, Web of Science, and Cochrane library databases were searched for studies comparing FSW or RSW therapy with placebo in chronic PF. Clinical outcomes included the odds ratios (ORs) of pain relief, pain reduction, and complications. Relevant data were analyzed using RevMan v5.3. RESULTS: Nine studies involving 935 patients were included. ESWT had higher improvement rates than the placebo group (OR 2.58, 95% confidence interval [CI] 1.97–3.39, P < .00001). ESWT had markedly lower standardized mean difference than placebo, with heterogeneity observed (standardized mean difference 1.01, 95% CI −0.01 to 2.03, P = .05, I(2) = 96%, P < .00001). FSW and RSW therapies had greater therapeutic success in pain relief than the placebo group (OR 2.17, 95% CI 1.49–3.16, P < .0001; OR 4.63, 95% CI 1.30–16.46, P = .02), but significant heterogeneity was observed in RSW therapy versus placebo (I(2) = 81%, P = .005). CONCLUSION: This meta-analysis suggested that FSW therapy can relieve pain in chronic PF as an ideal alternative option; meanwhile, no firm conclusions of general ESWT and RSW effectiveness can be drawn. Due to variations in the included studies, additional trials are needed to validate these conclusions. Wolters Kluwer Health 2017-04-14 /pmc/articles/PMC5403108/ /pubmed/28403111 http://dx.doi.org/10.1097/MD.0000000000006621 Text en Copyright © 2017 the Author(s). Published by Wolters Kluwer Health, Inc. http://creativecommons.org/licenses/by-nd/4.0 This is an open access article distributed under the Creative Commons Attribution-NoDerivatives License 4.0, which allows for redistribution, commercial and non-commercial, as long as it is passed along unchanged and in whole, with credit to the author. http://creativecommons.org/licenses/by-nd/4.0
spellingShingle 3700
Sun, Jiale
Gao, Fuqiang
Wang, Yanhua
Sun, Wei
Jiang, Baoguo
Li, Zirong
Extracorporeal shock wave therapy is effective in treating chronic plantar fasciitis: A meta-analysis of RCTs
title Extracorporeal shock wave therapy is effective in treating chronic plantar fasciitis: A meta-analysis of RCTs
title_full Extracorporeal shock wave therapy is effective in treating chronic plantar fasciitis: A meta-analysis of RCTs
title_fullStr Extracorporeal shock wave therapy is effective in treating chronic plantar fasciitis: A meta-analysis of RCTs
title_full_unstemmed Extracorporeal shock wave therapy is effective in treating chronic plantar fasciitis: A meta-analysis of RCTs
title_short Extracorporeal shock wave therapy is effective in treating chronic plantar fasciitis: A meta-analysis of RCTs
title_sort extracorporeal shock wave therapy is effective in treating chronic plantar fasciitis: a meta-analysis of rcts
topic 3700
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5403108/
https://www.ncbi.nlm.nih.gov/pubmed/28403111
http://dx.doi.org/10.1097/MD.0000000000006621
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