Short term effectiveness of extra corporeal shock wave therapy for plantar fasciitis: A systematic review and meta-analysis

Abstract

Background: The argument on whether extracorporeal shock-wave therapy (ESWT) is benefi cial in short- term intervention in adults with plantar fasciitis. It is important and necessary to conduct a meta-analysis to make a comparatively more reliable and overall assessment of the outcomes of ESWT in the less than 6 months. Methods: We conducted a systematic review and meta-analysis of randomized control trials from MEDLINE, EMBASE and CINAHL databases from 2000 to 2020. Randomized trials that evaluated extracorporeal shock wave therapy used to treat plantar heel pain were included. Trials comparing an extra corporeal shock wave therapy with control/placebo were considered for inclusion in the review. We independently applied the inclusion and exclusion criteria to each identifi ed randomized controlled trial, extracted data and assessed the methodological quality of each trial. Results: Four studies involving 645 patients were included. 3 RCTs (n = 605) permitted a pooled estimate of eff ectiveness based on overall success rate and composite score of visual analogue scales for pain at follow-up 1 (12 weeks) .The pooled data showed no signifi cant heterogeneity at the three-month follow-up (p - value of chi-square = 0.61, p = 0.74 and I2 = 0%). The shock wave group had a better success rate than the control group at the three-month followup (OR = 2.26, 95% CI = 1.62-3.15, p < 0.00001). For reduction of pain the pooled data showed no signifi cant heterogeneity (p value of chi-Square 0.28 and I2 22%).There were signifi cant diff erences between the ESWT and control groups for all follow-up visits (random-eff ect model, three trials, MD = 15.14, 95% CI = 13.86 to 16.42, < 0.00001 at three-month). Conclusion: A meta-analysis of data from three randomized-controlled trials that included a total of 605 patients was statistically signifi cant in favor of extracorporeal shock wave therapy at follow-up 1(12 weeks).