The effects of shockwave therapy on musculoskeletal conditions based on changes in imaging: a systematic review and meta-analysis with meta-regression.
Adult
Aged
Aged, 80 and over
Calcinosis
/ diagnostic imaging
Clinical Trials as Topic
Diagnostic Imaging
/ methods
Extracorporeal Shockwave Therapy
/ methods
Fasciitis, Plantar
/ therapy
Female
Femur Head Necrosis
/ therapy
Humans
Male
Middle Aged
Musculoskeletal Diseases
/ diagnostic imaging
Outcome Assessment, Health Care
Prospective Studies
Rotator Cuff Injuries
/ pathology
Extracorporeal shockwave therapy
Imaging
Meta-analysis
Systematic review
Journal
BMC musculoskeletal disorders
ISSN: 1471-2474
Titre abrégé: BMC Musculoskelet Disord
Pays: England
ID NLM: 100968565
Informations de publication
Date de publication:
28 Apr 2020
28 Apr 2020
Historique:
received:
06
01
2020
accepted:
06
04
2020
entrez:
30
4
2020
pubmed:
30
4
2020
medline:
20
1
2021
Statut:
epublish
Résumé
Shockwave therapy (SWT) is a commonly used intervention for a number of musculoskeletal conditions with varying clinical outcomes. However, the capacity of SWT to influence pathophysiological processes and the morphology of affected tissues remains unclear. The objective of the current review is to evaluate changes in imaging outcomes of musculoskeletal conditions following SWT. A comprehensive search of Medline, Embase, Cochrane Controlled Trials Register, CINAHL and SportDiscus was conducted from inception to October 2018. Prospective clinical trials evaluating the effectiveness of SWT based on changes in imaging outcomes were eligible for inclusion. Articles were evaluated independently for risk of bias using the Cochrane Risk of Bias list and the Methodological Index for Non-Randomized Studies. Random-effects meta-analysis and meta-regression with a priori determined covariates was conducted for each condition to determine potential predictors of SWT effects. Sixty-three studies were included, with data from 27 studies available for effect size pooling. Meta-analyses and meta-regression on imaging outcomes were performed for rotator cuff calcific tendinitis (n = 11), plantar fasciitis (n = 7) and osteonecrosis of the femoral head (n = 9). There was an overall reduction in the size of measured lesion following SWT (MD 8.44 mm (95%CI -4.30, 12.57), p < 0.001) for calcium deposit diameter, (MD 0.92 mm (95%CI -0.03, 1.81), p = 0.04) for plantar fascia thickness and (MD 4.84% (95%CI -0.06, 9.75), p = 0.05) for lesion size in femoral head osteonecrosis. Meta-regression showed no influence of SWT dosage parameters, however, baseline lesion size was an independent predictor for changes in imaging outcomes. SWT altered the morphology of musculoskeletal conditions, potentially reflecting changes in underlying pathophysiological processes. The parameters of SWT dosage are not significant predictors of changes in imaging outcomes. Lack of adequate reporting of imaging outcomes limited the conclusions that could be drawn from the current review. Registration number: PROSPERO CRD42018091140.
Sections du résumé
BACKGROUND
BACKGROUND
Shockwave therapy (SWT) is a commonly used intervention for a number of musculoskeletal conditions with varying clinical outcomes. However, the capacity of SWT to influence pathophysiological processes and the morphology of affected tissues remains unclear. The objective of the current review is to evaluate changes in imaging outcomes of musculoskeletal conditions following SWT.
METHODS
METHODS
A comprehensive search of Medline, Embase, Cochrane Controlled Trials Register, CINAHL and SportDiscus was conducted from inception to October 2018. Prospective clinical trials evaluating the effectiveness of SWT based on changes in imaging outcomes were eligible for inclusion. Articles were evaluated independently for risk of bias using the Cochrane Risk of Bias list and the Methodological Index for Non-Randomized Studies. Random-effects meta-analysis and meta-regression with a priori determined covariates was conducted for each condition to determine potential predictors of SWT effects.
RESULTS
RESULTS
Sixty-three studies were included, with data from 27 studies available for effect size pooling. Meta-analyses and meta-regression on imaging outcomes were performed for rotator cuff calcific tendinitis (n = 11), plantar fasciitis (n = 7) and osteonecrosis of the femoral head (n = 9). There was an overall reduction in the size of measured lesion following SWT (MD 8.44 mm (95%CI -4.30, 12.57), p < 0.001) for calcium deposit diameter, (MD 0.92 mm (95%CI -0.03, 1.81), p = 0.04) for plantar fascia thickness and (MD 4.84% (95%CI -0.06, 9.75), p = 0.05) for lesion size in femoral head osteonecrosis. Meta-regression showed no influence of SWT dosage parameters, however, baseline lesion size was an independent predictor for changes in imaging outcomes.
CONCLUSIONS
CONCLUSIONS
SWT altered the morphology of musculoskeletal conditions, potentially reflecting changes in underlying pathophysiological processes. The parameters of SWT dosage are not significant predictors of changes in imaging outcomes. Lack of adequate reporting of imaging outcomes limited the conclusions that could be drawn from the current review. Registration number: PROSPERO CRD42018091140.
Identifiants
pubmed: 32345281
doi: 10.1186/s12891-020-03270-w
pii: 10.1186/s12891-020-03270-w
pmc: PMC7189454
doi:
Types de publication
Journal Article
Meta-Analysis
Systematic Review
Langues
eng
Sous-ensembles de citation
IM
Pagination
275Références
Knee Surg Sports Traumatol Arthrosc. 2005 Jul;13(5):405-10
pubmed: 15800753
Radiol Med. 2008 Jun;113(4):486-95
pubmed: 18523846
Foot Ankle Int. 2003 Dec;24(12):927-30
pubmed: 14733349
PM R. 2013 Dec;5(12):1035-43
pubmed: 23973504
Arch Orthop Trauma Surg. 2008 Sep;128(9):901-8
pubmed: 18060419
Clin Orthop Relat Res. 2014 Sep;472(9):2816-25
pubmed: 24872197
Knee Surg Sports Traumatol Arthrosc. 2006 Oct;14(10):1029-32
pubmed: 16362358
Eur J Phys Rehabil Med. 2016 Apr;52(2):145-51
pubmed: 26365144
Biomed J. 2012 Nov-Dec;35(6):481-5
pubmed: 23442361
Clin Orthop Relat Res. 2001 Jun;(387):119-26
pubmed: 11400872
J Musculoskelet Neuronal Interact. 2018 Mar 1;18(1):47-54
pubmed: 29504578
J Shoulder Elbow Surg. 1995 Mar-Apr;4(2):101-6
pubmed: 7600159
Clin Rehabil. 2011 Aug;25(8):731-9
pubmed: 21508083
Clin Orthop Relat Res. 1990 May;(254):111-20
pubmed: 2157572
J Orthop. 2017 Aug 01;14(4):466-469
pubmed: 28831234
Rheumatol Int. 2011 Jul;31(7):871-7
pubmed: 20232068
Knee Surg Sports Traumatol Arthrosc. 2013 Jun;21(6):1451-8
pubmed: 22547246
Arch Orthop Trauma Surg. 2012 Apr;132(4):499-508
pubmed: 22228278
Inflammation. 2014 Feb;37(1):65-70
pubmed: 23948864
ANZ J Surg. 2003 Sep;73(9):712-6
pubmed: 12956787
J Bone Joint Surg Br. 1999 Sep;81(5):863-7
pubmed: 10530851
Am J Sports Med. 2005 Sep;33(9):1365-8
pubmed: 16002492
Rheumatol Int. 2012 Feb;32(2):343-7
pubmed: 21110027
Ann Rheum Dis. 2003 Mar;62(3):248-50
pubmed: 12594112
Radiology. 2005 Jan;234(1):206-10
pubmed: 15564391
J Orthop Surg Res. 2012 Mar 20;7:11
pubmed: 22433113
Arch Phys Med Rehabil. 2003 Jul;84(7):988-93
pubmed: 12881822
Am J Orthop (Belle Mead NJ). 2012 Sep;41(9):E122-7
pubmed: 23365814
Joint Bone Spine. 2001 May;68(3):241-4
pubmed: 11394624
Clin Rehabil. 2019 Sep;33(9):1419-1430
pubmed: 31066293
Phys Ther. 2006 May;86(5):672-82
pubmed: 16649891
J Shoulder Elbow Surg. 2002 Sep-Oct;11(5):476-80
pubmed: 12378167
J Bone Joint Surg Am. 2018 Feb 7;100(3):251-263
pubmed: 29406349
Ultrasound Med Biol. 2012 Oct;38(10):1673-80
pubmed: 22920552
Br J Sports Med. 2014 Nov;48(21):1538-42
pubmed: 23918444
Med Princ Pract. 2017;26(1):23-29
pubmed: 27784022
J Bone Joint Surg Am. 2005 Nov;87(11):2380-7
pubmed: 16264111
Clin Orthop Relat Res. 2001 Jun;(387):72-82
pubmed: 11400897
J Foot Ankle Surg. 2017 Jul - Aug;56(4):762-767
pubmed: 28633773
Clin Orthop Relat Res. 2001 Jun;(387):102-11
pubmed: 11400870
Int J Surg. 2016 Nov;35:179-186
pubmed: 27664561
Lupus. 2009 Oct;18(12):1082-6
pubmed: 19762382
J Am Podiatr Med Assoc. 2017 May;107(3):192-199
pubmed: 28650749
Orthopedics. 2015 Apr;38(4):e263-70
pubmed: 25901618
J Sports Med Phys Fitness. 2000 Dec;40(4):356-61
pubmed: 11297007
Arch Orthop Trauma Surg. 2009 Jun;129(6):837-41
pubmed: 19165494
Knee Surg Sports Traumatol Arthrosc. 2012 Dec;20(12):2567-72
pubmed: 22349603
J Bone Joint Surg Br. 2005 Apr;87(4):501-7
pubmed: 15795200
Knee Surg Sports Traumatol Arthrosc. 2011 Dec;19(12):2085-9
pubmed: 21431373
Arch Orthop Trauma Surg. 2010 Jan;130(1):23-9
pubmed: 19557424
Adv Orthop. 2018 Aug 19;2018:7410246
pubmed: 30210874
Arch Orthop Trauma Surg. 2005 Feb;125(1):6-9
pubmed: 14530990
J Shoulder Elbow Surg. 2008 Jan-Feb;17(1):55-9
pubmed: 18069011
Foot (Edinb). 2017 Dec;33:25-28
pubmed: 29126038
Clin Rheumatol. 2012 May;31(5):807-12
pubmed: 22278162
J Bone Joint Surg Am. 2011 Jan 19;93(2):187-94
pubmed: 21248216
Int J Surg. 2015 Dec;24(Pt B):115-9
pubmed: 26455534
BMJ. 2011 Oct 18;343:d5928
pubmed: 22008217
J Orthop Surg Res. 2018 Jul 3;13(1):166
pubmed: 29970103
Wien Klin Wochenschr. 2004 Aug 31;116(15-16):536-41
pubmed: 15471181
J Am Podiatr Med Assoc. 2018 Mar;108(2):100-105
pubmed: 29634309
Foot Ankle Int. 2013 Jan;34(1):33-41
pubmed: 23386759
Am J Sports Med. 2015 Mar;43(3):752-61
pubmed: 24817008
Rheumatol Int. 2014 Nov;34(11):1513-8
pubmed: 24658812
J Bone Joint Surg Br. 2007 Mar;89(3):335-41
pubmed: 17356145
Biomed Res Int. 2016;2016:2580969
pubmed: 28004000
Ultrasound Med Biol. 2010 Mar;36(3):397-409
pubmed: 20133043
Ultrasound Med Biol. 2011 Sep;37(9):1452-6
pubmed: 21767905
Am J Phys Med Rehabil. 2017 Aug;96(8):529-534
pubmed: 27977431
ANZ J Surg. 2002 Jul;72(7):496-500
pubmed: 12123512
Br J Sports Med. 2018 Mar;52(6):387-407
pubmed: 28954794
J Res Med Sci. 2012 Sep;17(9):834-8
pubmed: 23826009
Clin Orthop Relat Res. 2001 Jun;(387):95-101
pubmed: 11400901
J Shoulder Elbow Surg. 2014 Nov;23(11):1640-6
pubmed: 25219475
Clin Orthop Relat Res. 1995 Dec;(321):196-201
pubmed: 7497669
J Evid Based Med. 2015 Feb;8(1):2-10
pubmed: 25594108
JAMA. 2003 Nov 19;290(19):2573-80
pubmed: 14625334