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Br Med Bull. 2015;116:115-38. doi: 10.1093/bmb/ldv047. Epub 2015 Nov 18.

Efficacy and safety of extracorporeal shock wave therapy for orthopedic conditions: a systematic review on studies listed in the PEDro database.

Author information

1
Extracorporeal Shock Wave Research Unit, Department of Anatomy II, Ludwig-Maximilians-University of Munich, Pettenkoferstr. 11, Munich 80336, Germany christoph_schmitz@med.uni-muenchen.de.
2
Extracorporeal Shock Wave Research Unit, Department of Anatomy II, Ludwig-Maximilians-University of Munich, Pettenkoferstr. 11, Munich 80336, Germany.
3
Department of Surgery, Experimental Surgery and Regenerative Medicine, Ludwig-Maximilians-University of Munich, Nussbaumstr. 20, Munich 80336, Germany.
4
Department of Musculoskeletal Disorders, University of Salerno School of Medicine, Salerno, Italy Queen Mary University of London, Centre for Sports and Excercise Medicine, Mile End Hospital, Mann Ward, 275 Bancroft Road, London E1 4DG, UK.
5
OrthoTrauma Evaluation Institute, Oppenheimer Str. 70, Mainz 55130, Germany.
6
SUN Orthopaedics and Sports Medicine, Division of Evangelical Community Hospital, 900 Buffalo Road, Lewisburg, PA 17837, USA.

Abstract

BACKGROUND:

Extracorporeal shock wave therapy (ESWT) is an effective and safe non-invasive treatment option for tendon and other pathologies of the musculoskeletal system.

SOURCES OF DATA:

This systematic review used data derived from the Physiotherapy Evidence Database (PEDro; www.pedro.org.au, 23 October 2015, date last accessed).

AREAS OF AGREEMENT:

ESWT is effective and safe. An optimum treatment protocol for ESWT appears to be three treatment sessions at 1-week intervals, with 2000 impulses per session and the highest energy flux density the patient can tolerate.

AREAS OF CONTROVERSY:

The distinction between radial ESWT as 'low-energy ESWT' and focused ESWT as 'high-energy ESWT' is not correct and should be abandoned.

GROWING POINTS:

There is no scientific evidence in favour of either radial ESWT or focused ESWT with respect to treatment outcome.

AREAS TIMELY FOR DEVELOPING RESEARCH:

Future randomized controlled trials should primarily address systematic tests of the aforementioned optimum treatment protocol and direct comparisons between radial and focused ESWT.

KEYWORDS:

ESWT; PEDRo; RSWT; musculoskeletal system

PMID:
26585999
PMCID:
PMC4674007
DOI:
10.1093/bmb/ldv047
[Indexed for MEDLINE]
Free PMC Article

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