Efficacy of Different Energy Levels Used in Focused and Radial Extracorporeal Shockwave Therapy in the Treatment of Plantar Fasciitis: A Meta-Analysis of Randomized Placebo-Controlled Trials
Abstract
:1. Introduction
2. Materials and Methods
2.1. Search Strategy
2.2. Inclusion and Exclusion Criteria
2.3. Type of Outcomes
2.4. Data Extraction
2.5. Quality Assessment
2.6. Statistical Analysis
3. Results
3.1. Study Characteristics
3.2. Quality Assessment
3.3. Meta-Analysis
3.3.1. Different Energy Levels of ESWT regardless of the Types of Shockwave Generators
Success Rate
VAS Score
3.3.2. Radial and Focused ESWTs
Success Rate
VAS Score
3.3.3. Local Anesthesia
Success Rate
VAS Score
4. Discussion
5. Conclusions
Supplementary Materials
Author Contributions
Funding
Conflicts of Interest
Appendix A
Section/Topic | # | Checklist Item | Reported on Page # |
---|---|---|---|
TITLE | |||
Title | 1 | Identify the report as a systematic review, meta-analysis, or both. | 1 |
ABSTRACT | |||
Structured summary | 2 | Provide a structured summary including, as applicable: background; objectives; data sources; study eligibility criteria, participants, and interventions; study appraisal and synthesis methods; results; limitations; conclusions and implications of key findings; systematic review registration number. | 1 |
INTRODUCTION | |||
Rationale | 3 | Describe the rationale for the review in the context of what is already known. | 2 |
Objectives | 4 | Provide an explicit statement of questions being addressed with reference to participants, interventions, comparisons, outcomes, and study design (PICOS). | 2 |
METHODS | |||
Protocol and registration | 5 | Indicate if a review protocol exists, if and where it can be accessed (e.g., Web address), and, if available, provide registration information including registration number. | N/A |
Eligibility criteria | 6 | Specify study characteristics (e.g., PICOS, length of follow-up) and report characteristics (e.g., years considered, language, publication status) used as criteria for eligibility, giving rationale. | 3 |
Information sources | 7 | Describe all information sources (e.g., databases with dates of coverage, contact with study authors to identify additional studies) in the search and date last searched. | 3 |
Search | 8 | Present full electronic search strategy for at least one database, including any limits used, such that it could be repeated. | 3 |
Study selection | 9 | State the process for selecting studies (i.e., screening, eligibility, included in systematic review, and, if applicable, included in the meta-analysis). | 3 |
Data collection process | 10 | Describe method of data extraction from reports (e.g., piloted forms, independently, in duplicate) and any processes for obtaining and confirming data from investigators. | 3 |
Data items | 11 | List and define all variables for which data were sought (e.g., PICOS, funding sources) and any assumptions and simplifications made. | 3 |
Risk of bias in individual studies | 12 | Describe methods used for assessing risk of bias of individual studies (including specification of whether this was done at the study or outcome level), and how this information is to be used in any data synthesis. | 3–4 |
Summary measures | 13 | State the principal summary measures (e.g., risk ratio, difference in means). | 4 |
Synthesis of results | 14 | Describe the methods of handling data and combining results of studies, if done, including measures of consistency (e.g., I2) for each meta-analysis. | 4 |
Risk of bias across studies | 15 | Specify any assessment of risk of bias that may affect the cumulative evidence (e.g., publication bias, selective reporting within studies). | 3-4 |
Additional analyses | 16 | Describe methods of additional analyses (e.g., sensitivity or subgroup analyses, meta-regression), if done, indicating which were pre-specified. | 4 |
RESULTS | |||
Study selection | 17 | Give numbers of studies screened, assessed for eligibility, and included in the review, with reasons for exclusions at each stage, ideally with a flow diagram. | Page 4, Figure 1 |
Study characteristics | 18 | For each study, present characteristics for which data were extracted (e.g., study size, PICOS, follow-up period) and provide the citations. | Page 4, Table 1 |
Risk of bias within studies | 19 | Present data on risk of bias of each study and, if available, any outcome level assessment (see item 12). | Figure 3 |
Results of individual studies | 20 | For all outcomes considered (benefits or harms), present, for each study: (a) simple summary data for each intervention group (b) effect estimates and confidence intervals, ideally with a forest plot. | Pages 9–13, Figure 4, Figure 5, Figure 6, Figure 7, Figure 8 and Figure 9 |
Synthesis of results | 21 | Present results of each meta-analysis done, including confidence intervals and measures of consistency. | 9–13 |
Risk of bias across studies | 22 | Present results of any assessment of risk of bias across studies (see Item 15). | 8 |
Additional analysis | 23 | Give results of additional analyses, if done (e.g., sensitivity or subgroup analyses, meta-regression (see Item [16]). | Table S1 |
DISCUSSION | |||
Summary of evidence | 24 | Summarize the main findings including the strength of evidence for each main outcome; consider their relevance to key groups (e.g., healthcare providers, users, and policy makers). | 13–14 |
Limitations | 25 | Discuss limitations at study and outcome level (e.g., risk of bias), and at review-level (e.g., incomplete retrieval of identified research, reporting bias). | 15 |
Conclusions | 26 | Provide a general interpretation of the results in the context of other evidence, and implications for future research. | 15 |
FUNDING | |||
Funding | 27 | Describe sources of funding for the systematic review and other support (e.g., supply of data); role of funders for the systematic review. | N/A |
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OBS | Study | Study Design | Treatment (Energy) | Use of Local Anesthesia | Number of Patients | Mean Age (Year) | Intensity (mJ/mm2) | Follow-Up Times | Extracted Outcome Data | Definition of Success |
---|---|---|---|---|---|---|---|---|---|---|
1 | Rompe et al. 1996 | NA, RCT | FSW (low) | No | 50 | 44.0 | 0.08 | 3 and 13 months | VAS | |
Placebo | 50 | 49.0 | ||||||||
2 | Rompe et al. 2003 | SB, RCT | FSW (medium) | No | 22 | 43.0 | 0.16 | 6 and 12 months | Success rate and VAS | >50% improvement of pain during the first few minutes of walking scored on VAS |
Placebo | 23 | 40.0 | ||||||||
3 | Speed et al. 2003 | DB, RCT | FSW (medium) | No | 46 | 51.7 | 0.12 | 1, 2, 3, and 6 months | VAS | |
Placebo | 42 | 52.5 | ||||||||
4 | Haake et al. 2003 | DB, RCT | SW (low) | Yes | 129 | NA | 0.08 | 6 weeks, 3 months, and 12 months | Success rate | Roles and Maudsley score 1 or 2 |
Placebo | 132 | NA | ||||||||
5 | Ogden et al. 2004 | DB, RCT | FSW (high) | Yes | 144 | NA | 0.22 | 3 months | Success rate | >50% improvement of pain scored on VAS and VAS of <=4 |
Placebo | 141 | NA | ||||||||
6 | Theodore et al. 2004 | DB, RCT | FSW (high) | Yes | 73 | 50.0 | 0.36 | 6 weeks and 3 months | Success rate and VAS | Roles and Maudsley score 1 or 2 |
Placebo | 73 | 53.0 | ||||||||
7 | Kudo et al. 2006 | DB, RCT | FSW (high) | Yes | 53 | 51.1 | 0.64 | 3 months | Success rate and VAS | >60% improvement of pain during the first few minutes of walking scored on VAS |
Placebo | 52 | 48.8 | ||||||||
8 | Gollwitzer et al. 2007 | DB, RCT | FSW (high) | No | 20 | 53.9 | 0.25 | 3 months | Success rate and VAS | Roles and Maudsley score 1 or 2 |
Placebo | 20 | 58.9 | ||||||||
9 | Gerdesmeyer et al. 2008 | DB, RCT | RSW (medium) | No | 123 | 52.4 | 0.16 | 3 and 12 months | Success rate | >60% from baseline at follow-up after treatment for at least 2 of the 3 heel pain (VAS) measurements |
Placebo | 116 | 52.0 | ||||||||
10 | Marks et al. 2008 | DB, RCT | RSW (medium) | No | 16 | 51.9 | 0.16 | 6 months | Success rate | >50% improvement of pain scored on VAS |
Placebo | 9 | 51.7 | ||||||||
11 | Gollwitzer et al. 2015 | DB, RCT | FSW (high) | No | 125 | 50.0 | 0.25 | 3 months | Success rate | >60% from baseline at follow-up after treatment for at least 2 of the 3 heel pain (VAS) measurements. |
Placebo | 121 | 47.4 | ||||||||
12 | Hawamdeh et al. 2016 | SB, RCT | RSW (high) | No | 12 | NA | 0.25 | 3 weeks | VAS | |
Placebo | 12 | NA | ||||||||
13 | Ibrahim et al. 2017 | DB, RCT | RSW (medium) | No | 25 | 56.6 | 0.16 | 1, 3, 6, and 13 months | VAS | |
Placebo | 25 | 49.1 | ||||||||
14 | Takla et al. 2019 | SB, RCT | FSW (high) | No | 30 | NA | 0.22–0.28 | 3 weeks and 3 months | VAS | |
Placebo | 30 | NA |
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Wang, Y.-C.; Chen, S.-J.; Huang, P.-J.; Huang, H.-T.; Cheng, Y.-M.; Shih, C.-L. Efficacy of Different Energy Levels Used in Focused and Radial Extracorporeal Shockwave Therapy in the Treatment of Plantar Fasciitis: A Meta-Analysis of Randomized Placebo-Controlled Trials. J. Clin. Med. 2019, 8, 1497. https://doi.org/10.3390/jcm8091497
Wang Y-C, Chen S-J, Huang P-J, Huang H-T, Cheng Y-M, Shih C-L. Efficacy of Different Energy Levels Used in Focused and Radial Extracorporeal Shockwave Therapy in the Treatment of Plantar Fasciitis: A Meta-Analysis of Randomized Placebo-Controlled Trials. Journal of Clinical Medicine. 2019; 8(9):1497. https://doi.org/10.3390/jcm8091497
Chicago/Turabian StyleWang, Ying-Chun, Shu-Jung Chen, Peng-Ju Huang, Hsuan-Ti Huang, Yuh-Min Cheng, and Chia-Lung Shih. 2019. "Efficacy of Different Energy Levels Used in Focused and Radial Extracorporeal Shockwave Therapy in the Treatment of Plantar Fasciitis: A Meta-Analysis of Randomized Placebo-Controlled Trials" Journal of Clinical Medicine 8, no. 9: 1497. https://doi.org/10.3390/jcm8091497