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Shock-wave therapy improved outcome with plantar fasciitis: a meta-analysis of randomized controlled trials

Archives of Orthopaedic and Trauma Surgery volume 139, pages 1763–1770 (2019)Cite this article

Abstract

Background

Shock-wave therapy (SWT) has been widely applied and proven to be an effective treatment in ameliorating symptoms of plantar fasciitis (PF). Ultrasound therapy (UT) is another common treatment of PF, and several researches have documented its advantages when compared to corticosteroid injection. Despite this, few studies have focused on comparing the use of SWT and UT in the treatment of PF. The purpose of our meta-analysis is to evaluate whether SWT is better than UT in managing PF, both in terms of ameliorating pain and improving functionality.

Methods

A systematic search of the literature was conducted to identify relevant articles that were published in Pubmed, Medline, Embase, the Cochrane Library, SpringerLink, Clinical Trials.gov and OVID from the databases’ inception to October 2018. All studies comparing the efficacy of SWT and UT in terms of pain levels and functionality improvement were included. Data on the two primary outcomes were collected and analyzed using the Review Manager 5.3.

Results

Five studies were included in the current meta-analysis. A significant difference in VAS score (MD = − 13.14, Cl − 14.07 to − 12.75 P < 0.00001, I2 = 100%) was noted between the SWT group and the UT group. No significant difference was seen in the AOFAS (MD = 3.19, Cl − 1.72 to 8.10 P = 0.20, I2 = 100%); FFI or PFPS score was not found significant difference either (SMD = − 1.17, Cl − 4.45 to 2.10 P = 0.48, I2 = 96%).

Conclusions

The results from this meta-analysis highlight the effectiveness of both SWT and UT in the treatment of PF. Although inter-group differences were not significant, the VAS score was better improved in the SWT group, suggesting that SWT may be a superior alternative for the treatment of PF.

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Data availability

Please contact author for data requests.

Abbreviations

SWT:

Shock-wave therapy

UT:

Ultrasound therapy

PF:

Plantar fasciitis

VAS:

Visual analog scale

HTI:

Heel tenderness index

FFI:

Foot function index

LQ:

Laitinen questionnaire

PFPS:

Plantar fasciitis pain and disability scale

AOFAS:

American orthopaedic foot and ankle society

RMS:

Roles-maudsley score

RCT:

Randomized controlled trial

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Acknowledgements

This work was accomplished with the help of the library of Huazhong University of Science and Technology.

Funding

This study was supported by grants from the National Natural Science Foundation of China (No. 81772345). The funder had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.

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Author notes

  1. Hui Li and Yuan Xiong contributed equally to this work.

Authors and Affiliations

  1. Department of Orthopedics, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China

    Hui Li, Yuan Xiong, Wu Zhou, Yi Liu, Jing Liu, Hang Xue, Liangcong Hu, Bobin Mi & Guohui Liu

  2. The Division of Plastic Surgery, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, USA

    Adriana C. Panayi

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  1. Hui Li
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Contributions

YX and HX participated in the design of the study; BM and YL carried out data curation; JL and QW performed the statistical analysis; LC and QW carried out investigation; BM and CY carried out project administration; YS and WZ operated software; YX carried out supervision; LH and WZ carried out validation; YX and HX conceived the study, and participated in its design and coordination and helped to draft the manuscript; GL. YX and AP participated in the sequence alignment and drafted the manuscript. All authors read and approved the final manuscript.

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Correspondence to Bobin Mi or Guohui Liu.

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Li, H., Xiong, Y., Zhou, W. et al. Shock-wave therapy improved outcome with plantar fasciitis: a meta-analysis of randomized controlled trials. Arch Orthop Trauma Surg 139, 1763–1770 (2019). https://doi.org/10.1007/s00402-019-03262-z

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Keywords

  • Plantar fasciitis
  • Shock wave
  • Ultrasound
  • Therapy