Article

Extracorporeal shock wave therapy, including radial shock wave and
focused shock wave types, is widely used for managing tendinopathies. The
difference in efficacy between the 2 shock wave characteristics with different
dosage levels remains controversial, and the purpose of this meta-analysis was to
examine it for patients with lower-limb tendinopathy. DESIGN:
A comprehensive
search of online databases and search engines was performed. This study included
randomized controlled trials reporting the efficacy of extracorporeal shock wave
therapy in treating lower-limb tendinopathy. The included randomized controlled
trials were subjected to a meta-analysis and risk of bias assessment. RESULTS: In
total, 29 randomized controlled trials were included, all of which had a good
methodological quality, with a PEDro score of >/=6/10. General extracorporeal
shock wave therapy showed significant effects at the immediate follow-up [pain
score: standardized mean difference = -1.41, 95% confidence interval = -2.01 to
-0.82, P < 0.00001; function: standardized mean difference = 2.59, 95% confidence
interval = 1.54 to 3.64, P < 0.00001] as well as at 3, 6, and >/=12 months. In
sequence, high-dosage focused shock wave, high-dosage radial shock wave, and
low-dosage radial shock wave had superior pooled effects on overall clinical
outcomes. CONCLUSIONS: Extracorporeal shock wave therapy exerted a positive
overall effect on pain and function for lower-limb tendinopathy. Shock wave types
and dosage levels may have different contributions to treatment efficacy. TO
CLAIM CME CREDITS: Complete the self-assessment activity and evaluation online at
http://www.physiatry.org/JournalCME CME OBJECTIVES: Upon completion of this
article, the reader should be able to: (1) Describe benefits of extracorporeal
shock wave therapy for individuals with lower-limb tendinopathy; (2) Understand
the impact of dosing and type of extracorporeal shock wave therapy has on
treatment efficacy; and (3) Identify appropriate indications for incorporating
extracorporeal shock wave therapy into the treatment plan for patients with
lower-limb tendinopathy. LEVEL: Advanced ACCREDITATION: The Association of
Academic Physiatrists is accredited by the Accreditation Council for Continuing
Medical Education to provide continuing medical education for physicians.The
Association of Academic Physiatrists designates this Journal-based CME activity
for a maximum of 1.0 AMA PRA Category 1 Credit(s). Physicians should only claim
credit commensurate with the extent of their participation in the activity.

Langue : ANGLAIS