Review article (meta-analysis)Is Extracorporeal Shock Wave Therapy Clinical Efficacy for Relief of Chronic, Recalcitrant Plantar Fasciitis? A Systematic Review and Meta-Analysis of Randomized Placebo or Active-Treatment Controlled Trials
Section snippets
Search strategy
We followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) recommendations for this meta-analysis.42 With the assistance of a medical research librarian, we performed serial literature searches for English and non-English articles. The following electronic databases were searched from their inception dates to April 2013: PubMed, MEDLINE, Embase, Cochrane Central Register of Controlled Trials, and Evidence-Based Medicine Reviews. We used Boolean logic with search
Study description
From an initial search yield of 108 articles, 53 potentially relevant articles were identified. After reading the titles and abstracts, 23 studies were identified as RCTs. Among these, 11 lacked a clear definition of successful treatment standards. Two studies compared local ESWT with radial ESWT for the treatment of plantar fasciitis, and 3 studies used a local anesthetic in the ESWT group. After exclusion of these studies, the 7 remaining studies with adequate methodology were incorporated in
Summary of the main findings
We used 5 levels of evidence to assess whether treatment was beneficial: strong evidence (consistent findings in several high-quality RCTs), moderate evidence (findings from 1 high-quality RCT or consistent findings in several low-quality trials), limited evidence (1 low-quality RCT), unclear evidence (inconsistent or contradictory results in several randomized trials), and no evidence (no studies identified).
The results of the present review showed strong statistical evidence for the efficacy
Conclusions
This meta-analysis provides substantive clinical evidence for clinicians in the treatment of chronic, recalcitrant plantar fasciitis. The results show that the efficacy of low-intensity ESWT is worthy of recognition. The short-term pain relief and functional outcomes of this treatment are satisfactory. However, owing to the lack of a long-term follow-up, its long-term efficacy remains unknown.
Supplier
- a.
The Nordic Cochrane Centre, The Cochrane Collaboration. Available at: http://tech.cochrane.org/revman/about-revman-5.
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Supported by the Project of Shanghai City Health System Excellent Discipline Leader Training (grant no. XBR2013104) and the Construction of The National Five Years' Major Drug Discovery Projects-Chinese Medicine (malignant tumor disease) Clinical Evaluation (grant no. 2011ZX09302-006-04).
Disclosures: none.