scholarly journals 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

2019 ◽  
Vol 8 (9) ◽  
pp. 1497 ◽  
Author(s):  
Wang ◽  
Chen ◽  
Huang ◽  
Huang ◽  
Cheng ◽  
...  
Keyword(s):  
Plantar Fasciitis ◽  
Meta Analysis ◽  
Energy Levels ◽  
High Energy ◽  
Control Group ◽  
Medium Energy ◽  
Extracorporeal Shockwave Therapy ◽  
Shockwave Therapy ◽  
Vas Scores

The objective of this study was to assess the efficacy of different energy levels used in extracorporeal shockwave therapy (ESWT) in the treatment of plantar fasciitis using a systematic review and meta-analysis. We searched PubMed, Embase, and Cochrane library, from inception to March 2019 for randomized controlled trials that compared ESWT with placebo in patients with plantar fasciitis. The risk of bias for selected articles was assessed based on the Cochrane Handbook Systematic Review of Interventions. The pooled data were estimated by the mean difference or odds ratio. The meta-analysis showed that the high-energy ESWT group had a better success rate than the control group only at a three-month follow-up, but no significant difference between groups was observed for the other follow-up visits (1 and 12 months). In addition, no significant differences in visual analog scale (VAS) scores between groups were observed for all the follow-up visits (one-month and three-month). On the contrary, the medium-energy ESWT group had significantly better success rates than the control group for all the follow-up visits (3, 6, and 12 months). In addition, the medium-energy ESWT group had significant improvement in VAS scores compared with the control group for all the follow-up visits (1, 3, 6, and 12 months) after removing the extreme values. The low-energy ESWT group had significant improvement in VAS scores compared with the control group for all the follow-up visits (3 and 12 months). Otherwise, focused ESWT seems to be more effective than radial ESWT when compared with the control group. Use of local anesthesia can reduce the efficacy of low- and high-energy ESWTs. Our meta-analysis suggested that medium-energy ESWT in the treatment of plantar fasciitis was more effective than the control group. A limited number of trials related to low- and high-energy ESWTs were included in our meta-analysis. More research is required to confirm the efficacy of low- and high-energy ESWTs in future studies.

Efficacy and Safety of Extracorporeal Shockwave Therapy for Treatment of Knee Osteoarthritis: A Systematic Review and Meta-analysis

Pain Medicine ◽  
2019 ◽  
Vol 21 (4) ◽  
pp. 822-835 ◽  
Author(s):  
Ying-Chun Wang ◽  
Hsuan-Ti Huang ◽  
Peng-Ju Huang ◽  
Zi-Miao Liu ◽  
Chia-Lung Shih
Keyword(s):  
Pain Relief ◽  
Knee Osteoarthritis ◽  
Baseline Level ◽  
Meta Analysis ◽  
Control Group ◽  
Efficacy And Safety ◽  
Extracorporeal Shockwave Therapy ◽  
Shockwave Therapy ◽  
Vas Scores

Abstract Objective The objective of this study was to assess the efficacy and safety of extracorporeal shockwave therapy (ESWT) for treatment of knee osteoarthritis (OA) using a systemic review and meta-analysis. Methods An extensive search of relevant articles from electronic databases Pubmed, Embase, and Cochrane Library from inception to March 2019 was conducted. The treatment outcomes (visual analog scale [VAS] and the Western Ontario and McMaster Universities Arthritis Index [WOMAC]) of the included articles were pooled to calculate effect sizes. The assessment of heterogeneity among articles was evaluated using I2. Statistical analyses were conducted using RevMan software. Results The results showed that the ESWT group had significant improvement in pain relief compared with the control group through 12 months based on WOMAC and VAS scores. Compared with the baseline level, the patients had significant improvement in pain relief at most follow-up points (one week to 12 months) based on WOMAC and VAS scores. The patients showed significant improvement in physical function at six- and 12-month follow-up when compared with the control group and for all follow-up (one to 12 months) when compared with the baseline level. Additionally, only minor complications were observed after ESWT treatment. Conclusions The use of ESWT for treatment of knee OA had a beneficial effect on pain relief and physical function improvement for up to 12 months, and only minor complications occurred after ESWT treatment. However, there remains a lack of clarity regarding the frequency and dosage levels of ESWT required to achieve the maximum improvement.

scholarly journals Extracorporeal shockwave therapy versus musculoskeletal mesotherapy for Achilles tendinopathy in athlete

2020 ◽  
Vol 47 (1) ◽  
Author(s):  
Reem EL-Mallah ◽  
Enas A. Elattar
Keyword(s):  
Treatment Options ◽  
Visual Analogue Score ◽  
Achilles Tendinopathy ◽  
Extracorporeal Shockwave Therapy ◽  
Extracorporeal Shockwave ◽  
Shockwave Therapy ◽  
Tendon Thickness ◽  
Vas Scores ◽  
Tendon Pathology

Abstract Background Achilles tendinopathy (AT) is considered the commonest tendon pathology, occurring mainly in athletes. Different conservative treatment options have been introduced but with short-term effects; however, extracorporeal shockwave therapy (ESWT) and mesotherapy (MT) injections were claimed to provide longer effects and could be used in cases failure of response to conservative treatments. The objective of our prospective 12-week study was to compare the effect of ESWT and MT on chronic Achilles tendinopathy in athletes by both clinical and ultrasonographical assessment. Results Forty patients with chronic AT diagnosed clinically and with high-resolution ultrasound (US) randomly allocated in two groups first received weekly ESWT session, and the other group underwent weekly MT sessions for 4 consecutive weeks. Both groups improved during the treatment and follow-up period. The mean visual analogue score (VAS) decreased in both the ESWT group and the MT group. Mean American Orthopedic Foot and Ankle Society (AOFAS) hindfoot score and VAS scores were not significantly different between ESWT and MT groups at the 4th and the 12th week of follow-up. However, US assessment significantly improved after 12 weeks in the ESWT group (as regards tendon thickness, calcifications, and Doppler signal), and for the mesotherapy group, there was the only improvement of tendon thickness. Conclusion ESWT showed improvement of pain and inflammation and calcifications of AT than MT injections, which was documented by US improved findings at week 12 follow up.

scholarly journals Effects of Adjuvant Low-Dye Kinesio Taping, Adjuvant Sham Taping, or Extracorporeal Shockwave Therapy Alone in Plantar Fasciitis: A Randomized Double-Blind Controlled Trial

2020 ◽  
Author(s):  
Yeliz Bahar-Ozdemir ◽  
TUĞBA ATAN
Keyword(s):  
Plantar Fasciitis ◽  
Activity Limitation ◽  
Double Blind ◽  
Extracorporeal Shockwave Therapy ◽  
Extracorporeal Shockwave ◽  
Shockwave Therapy ◽  
Kinesio Taping ◽  
Foot Function ◽  
Group 1

Aim Extracorporeal shockwave therapy (ESWT) is known as one of the most effective treatment methods in plantar fasciitis (PF). Low-dye taping, which is the most preferred method of banding treatments, provides an analgesic effect by correcting biomechanics. It was aimed to compare the efficacy of adjuvant low-dye kinesio-taping (KT), sham-taping, or extracorporeal shockwave therapy (ESWT) alone in plantar fasciitis (PF). Methods In this double-blind, sham-controlled study, forty-five patients with PF were randomized to 3-group (Group 1: ESWT plus low-dye KT, n=15; Group 2: ESWT plus Sham-taping, n=15; and Group 3: ESWT only, n=15) five-session ESWT were administrated. KT was performed and changed every 1-week for the ESWT sessions in Groups 1 and 2. The main outcome measures were the visual analog scale (VAS) change, the heel tenderness index (HTI), foot function index (FFI). The patients were evaluated at the beginning and end of the treatment and the 4-week follow-up. Results The demographic characteristics and baseline outcomes between groups were similar (p>0.05). VAS and HTI changes were observed in all three groups, there was no difference between groups. Repeated-measures ANOVA showed a significant interaction between the time and the groups in FFI-total (F3.919= 2.607; p=.043). At the 4-week follow-up, when Groups 1 and 2 were evaluated, the lower FFI-total, FFI-disability, and FFI-activity limitation were statistically significant in Group 1 (p=0.027; p=0.026; p=0.029, respectively). When Group 1 and 3 were compared, the decrease in FFI-pain and FFI-activity limitation were significant in Group 1 (p=0.042; p=0.035, respectively). Conclusions Low-dye KT, in addition to ESWT, is more effective than sham-taping and ESWT in pain relief and foot function improvement due to PF at a 4-week follow-up.

scholarly journals Extracorporeal Shockwave Therapy Versus Ultrasound Therapy for Plantar Fasciitis: Systematic Review and Meta-Analysis

2020 ◽  
Author(s):  
Zeyana Ali Al-Siyabi ◽  
Mohammad Karam ◽  
Ethar Al-Hajri ◽  
Abdulmalik Alsaif
Keyword(s):  
Success Rate ◽  
Plantar Fasciitis ◽  
Meta Analysis ◽  
Ultrasound Therapy ◽  
Activity Limitations ◽  
Primary Efficacy ◽  
Extracorporeal Shockwave Therapy ◽  
Shockwave Therapy ◽  
Significant Difference ◽  
Secondary Outcomes

Objective To compare the outcomes of Extracorporeal Shockwave Therapy (ESWT) versus Ultrasound Therapy (UST) in plantar fasciitis. Methods A systematic review and meta-analysis were performed. An electronic search identifying studies comparing ESWT and UST for plantar fasciitis was conducted. Primary outcomes were morning and activity pain, functional impairment and the American Orthopaedic Foot and Ankle Society (AOFAS) scale score. Secondary outcomes included fascial thickness, primary efficacy success rate, activity limitations, pain intensity and satisfaction. Results Seven studies enrolling 369 patients were identified. No significant difference was found between ESWT and UST for functional impairment (Mean Difference [MD]= -2.90, P= 0.22), AOFAS scale score (MD= 35, P= 0.20) and pain in the first steps in the morning (MD= -4.72, P= 0.39). However, there was a significant improvement in pain during activity for the ESWT group (MD= -1.36, P= 0.005). For secondary outcomes, ESWT had improved results in terms of primary efficacy success rate, activity limitations and patient satisfaction. Reduction of planter fascia thickness showed no significant difference. Pain intensity after treatment had varied results amongst included studies. Conclusion ESWT is superior to UST for plantar fasciitis as it improves pain activity and intensity, primary efficacy success rate and activity limitations.

Extracorporeal shockwave therapy in spinal cord injury, early to advance to clinical trials? A systematic review and meta-analysis on animal studies

2021 ◽  
pp. 197140092110268
Author(s):  
Seyedeh Niloufar Rafiei Alavi ◽  
Arian Madani Neishaboori ◽  
Mahmoud Yousefifard
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Clinical Trials ◽  
Animal Models ◽  
Meta Analysis ◽  
Mean Difference ◽  
Extracorporeal Shockwave Therapy ◽  
Extracorporeal Shockwave ◽  
Shockwave Therapy ◽  
Cord Injury

Background As there is no consensus over the efficacy of extracorporeal shockwave therapy in the management of spinal cord injury complications, the current meta-analysis aims to investigate preclinical evidence on the matter. Methods The search strategy was developed based on keywords related to ‘spinal cord injury’ and ‘extracorporeal shockwave therapy’. A primary search was conducted in Medline, Embase, Scopus and Web of Science until the end of 2020. Studies which administered extracorporeal shockwave therapy on spinal cord injury animal models and evaluated motor function and/or histological findings were included. The standardised mean difference with a 95% confidence interval (CI) were calculated. Results Seven articles were included. Locomotion was significantly improved in the extracorporeal shockwave therapy treated group (standardised mean difference 1.68, 95% CI 1.05–2.31, P=0.032). It seems that the efficacy of extracorporeal shockwave therapy with an energy flux density of 0.1 mJ/mm2 is higher than 0.04 mJ/mm2 ( P=0.044). Shockwave therapy was found to increase axonal sprouting (standardised mean difference 1.31, 95% CI 0.65, 1.96), vascular endothelial growth factor tissue levels (standardised mean difference 1.36, 95% CI 0.54, 2.18) and cell survival (standardised mean difference 2.49, 95% CI 0.93, 4.04). It also significantly prevents axonal degeneration (standardised mean difference 2.25, 95% CI 1.47, 3.02). Conclusion Extracorporeal shockwave therapy significantly improves locomotor recovery in spinal cord injury animal models through neural tissue regeneration. Nonetheless, in spite of the promising results and clinical application of extracorporeal shockwave therapy in various conditions, current evidence implies that designing clinical trials on extracorporeal shockwave therapy in the management of spinal cord injury may not be soon. Hence, further preclinical studies with the effort to reach the safest and the most efficient treatment protocol are needed.

scholarly journals Effectiveness of the Internet-based Versus Face-to-Face Interaction on Reduction of Tobacco use among Adults: A Systematic Review and Meta-Analysis

2021 ◽  
Author(s):  
Rajesh Kumar ◽  
Ravi Kant ◽  
Poonam Yadav ◽  
Tamar Rodney ◽  
Mukesh Bairwa
Keyword(s):  
Developing Countries ◽  
Tobacco Use ◽  
Meta Analysis ◽  
Intervention Group ◽  
The Internet ◽  
Control Group ◽  
Forest Plot ◽  
Cochrane Central Register ◽  
Face To Face

Abstract BackgroundThe burden of tobacco-associated disorders is prevalent worldwide. Over the years, many innovative internet-based approaches have been utilized with variable success to quit tobacco. Though the effectiveness of internet-based and face-to-face interventions on quitting smoking are very well reported in the literature, due to limitation in methodology and limited sample size, it is required to integrate and analyze these studies' findings to reach a single conclusion. The study evaluated the effectiveness of the internet as an intervention approach versus face-to-face interaction on reducing tobacco use as control among adults.MethodsA systematic search was performed through various electronic databases such as Medline, PsychInfo, PubMed, Embase, Cochrane Central Register of Controlled Trials (CENTRAL), ResearchGate, Google Scholar, and Academia. Reference lists of the eligible articles were also screened. Full-text articles were included as per eligibility criteria (PICO framework). No ethnicity restriction was applied.ResultsA total of 13 studies were selected for meta-analysis, with 3852 and 3908 participants in intervention and control groups respectively. Forest plot favours the intervention group at one month follow up for tobacco quitting (OR: 2.37, CI: 1.86-3.02, P-0.00001, I2 =0%), at three months (OR: 1.88, CI: 1.48-2.40, P-0.00001, I2 =42%) at six months (OR: 2.02, CI: 1.64-2.50, P-0.00001, I2 =38%) and at 1 year of follow-up (OR: 1.43, CI: 1.18-1.74, P-0.00001, I2 = 36%) comparing to control group. ConclusionInternet and web-based interventions are highly useful in tobacco quitting at one month, three months, six months, and one year of follow-up compared to face-to-face interaction or no intervention, although the level of evidence was moderate. Additionally, limited availability of trials in developing countries, arising need for research of internet use in developing countries to quit tobacco. Prospero Registration number- PROSPERO 2020 CRD42020214306

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