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Table 5 Summary of subgroup analysis resultsa

From: Efficacy of extracorporeal shock wave therapy for knee tendinopathies and other soft tissue disorders: a meta-analysis of randomized controlled trials

Subgroups Treatment success rate Pain score reduction Patient-reported functional improvement
Trials (patient), n OR (95% CI) P value I2 (%), LoEd Trials (patient), n SMD (95% CI) P value I2 (%), LoEd Trials (patient), n SMD (95% CI) P value I2 (%), LoEd
Follow-up duration
 Focused ESWT
  Overall 7 (324) 3.28 (1.79, 6.02)b 0.001 25, S 7 (337) −2.01 (−3.31, −0.71)c 0.002 96, M 7 (333) 1.08 (0.19, 1.97)c 0.02 92, M
   > 6 months 2 (99) 0.33 (0.07, 1.45)b 0.14 56, C 1 (46) 0.71 (0.11, 1.31) 0.02 NA, M 2 (99) −0.01 (−1.66, 1.65)c 1.00 94, C
   > 3 months, ≤6 months 2 (87) 0.49 (0.19, 1.29)b 0.15 31, C 4 (220) −2.74 (−4.85, −0.62)c 0.01 97, M 4 (220) 1.81 (−0.14, 3.77)c 0.07 97, C
   > 1 month, ≤3 months 3 (129) 1.02 (0.45, 2.32)b 0.96 0, C 5 (220) −0.31 (−0.78, 0.16)c 0.19 65, C 5 (220) 0.42 (−0.17, 1.00)c 0.16 76, C
   ≤ 1 month 5 (225) 5.53 (2.71, 11.25)b < 0.00001 0, S 6 (291) − 1.39 (−2.37, −0.41)c 0.005 92, M 5 (234) 2.22 (0.51, 3.92)c 0.01 96, M
 Radial ESWT
  Overall 9 (518) 3.11 (1.31, 7.38)c 0.01 73, M 11 (747) −1.36 (−2.02, −0.71)c < 0.0001 93, L 6 (395) 2.56 (0.92, 4.19)c 0.002 97, L
   > 6 months 3 (185) 4.35 (1.96, 9.63)b 0.0003 49, M 2 (165) −2.13 (−2.52, −1.74)b < 0.00001 42, M 2 (165) 4.64 (4.04, 5.25)b < 0.00001 68, M
   > 3 months, ≤6 months 0 NA   NA NA 2 (246) −1.59 (− 1.88, − 1.30)b < 0.00001 20, M 1 (100) 3.79 (3.12, 4.45) < 0.00001 NA, L
   > 1 month, ≤3 months 2 (80) 5.60 (1.97, 15.86)b 0.001 69, M 4 (249) −2.00 (−3.41, −0.58)c 0.006 95, L 4 (261) 2.93 (0.48, 5.37)c 0.02 98, L
   ≤ 1 month 6 (293) 1.88 (0.59, 5.98)c 0.28 75, C 10 (601) −1.07 (−1.67, −0.47)c 0.0005 91, L 6 (395) 2.29 (0.73, 3.84)c 0.004 97, L
Energy level (EFD)
 Focused ESWT
   ≥ 0.2 mJ/mm2 4 (211) 2.25 (1.08, 4.49)b 0.03 8, S 4 (220) −2.94 (−5.05, −0.82)c 0.006 97, M 5 (273) 1.65 (0.21, 3.10)c 0.02 96, M
   < 0.2 mJ/mm2 3 (113) 7.39 (2.52, 21.67)b 0.0003 0, M 3 (117) −1.47 (−2.42, −0.53)c 0.002 77, M 2 (60) 1.99 (−0.82, 4.81)c 0.17 92, C
 Radial ESWT
   ≥ 0.2 mJ/mm2 5 (308) 3.98 (2.18, 7.29)b < 0.00001 40, M 5 (311) −2.17 (−3.23, −1.11)c < 0.0001 92, L 2 (165) 5.49 (4.81, 6.17)b < 0.00001 0, M
   < 0.2 mJ/mm2 4 (210) 2.55 (0.43, 15.17)c 0.30 86, C 6 (436) −0.73 (−1.44, −0.02)c 0.04 91, L 4 (230) 0.80 (0.19, 1.40)c 0.01 79, L
Intervention duration
 Focused ESWT
   ≥ 1 month 2 (73) 7.89 (2.61, 23.88)b 0.0003 0, M 3 (137) −3.13 (−5.70, −0.56)c 0.02 95, M 2 (80) 6.24 (0.86, 11.62)c 0.02 95, M
   < 1 month 5 (251) 1.52 (0.80, 2.87)b 0.20 38, C 4 (200) −0.17 (−0.45, 0.11)b 0.23 61, C 5 (253) 0.51 (−0.17, 1.19)c 0.14 88, C
 Radial ESWT
   ≥ 1 month 6 (375) 5.32 (3.20, 8.83)b < 0.00001 0, M 7 (521) − 1.80 (− 2.52, −1.08)c < 0.00001 91, L 5 (315) 1.99 (1.68, 2.30)c < 0.00001 97, L
   < 1 month 3 (143) 0.78 (0.09, 6.69)c 0.82 81, C 4 (226) −0.58 (−1.64, 0.48)c 0.29 93, C 1 (80) 0.11 (−0.33, 0.54) 0.64 NA, C
Control group type
 Focused ESWT
  Placebo 5 (221) 4.61 (1.92, 11.08)b 0.0006 0, S 5 (234) −3.22 (−5.14, −1.31)c 0.001 97, M 6 (287) 2.03 (0.70, 3.36)c 0.003 95, M
  Noninvasive comparison control 1 (57) 6.40 (1.89, 21.68) 0.003 NA, L 2 (117) −2.07 (−3.73, −0.41)c 0.01 92, M 1 (60) 6.98 (5.59, 8.36) < 0.00001 NA, M
  Invasive comparison control 1 (46) 1.00 (0.31, 3.18) 1.0 NA, C 1 (46) 0.36 (−0.22, 0.95) 0.22 NA, C 1 (46) −0.32 (−0.90, 0.26) 0.28 NA, C
 Radial ESWT
  Placebo 3 (152) 4.41 (2.00, 9.71)b 0.0002 0, M 4 (232) −1.14 (−1.42, −0.86)b < 0.00001 56, M 3 (170) 0.70 (0.02, 1.39)c 0.04 77, L
  Noninvasive comparison control 4 (206) 4.17 (2.23, 7.81)b < 0.00001 61, M 5 (355) −1.81 (−2.83, −0.80)c 0.0005 93, L 2 (125) 3.62 (−0.81, 8.04)c 0.11 98, C
  Invasive comparison control 2 (160) 1.23 (0.02, 63.55)c 0.92 93, C 2 (160) −0.80 (−3.85, 2.24)c 0.61 99, C 1 (100) 5.27 (4.43, 6.12) < 0.00001 NA, L
Treated populations
 Focused ESWT
  Athlete 3 (124) 2.47 (1.16, 5.27)b 0.02 68, M 3 (128) −0.84 (−2.16, 0.47)c 0.21 90, C 3 (128) 0.97 (−0.42, 2.37)c 0.17 91, C
  Nonathlete 4 (200) 5.47 (1.98, 15.11)b 0.001 0, S 4 (209) −3.61 (−5.86, −1.35)c 0.002 97, M 4 (205) 2.35 (0.38, 4.31)c 0.02 97, M
 Radial ESWT
  Athlete 4 (285) 3.10 (0.50, 19.30)c 0.23 87, C 4 (285) −1.79 (−3.73, 0.15)c 0.07 98, C 3 (225) 4.16 (1.09, 7.24)c 0.008 98, L
  Nonathlete 5 (233) 3.22 (1.75, 5.94)b 0.0002 32, M 7 (462) −1.24 (−1.57, −0.91)c < 0.00001 60, L 3 (170) 0.59 (0.01, 1.18)c 0.05 72, L
Treated disease
 Focused ESWT
  Tendinopathy 5 (214) 3.62 (1.28, 5.36)b 0.008 38, S 6 (280) −2.29 (−3.84, −0.75)c 0.004 96, M 6 (280) 1.14 (0.06, 2.21)c 0.04 94, M
  Other KSTDs 2 (110) 5.83 (1.86, 18.26)b 0.002 0, M 1 (57) −1.24 (−1.81, −0.67) < 0.0001 NA, L 1 (53) 0.84 (0.27, 1.40) 0.004 NA, M
 Radial ESWT
  Tendinopathy 5 (306) 4.67 (2.61, 8.36)b < 0.00001 54, M 7 (535) −1.70 (−2.48, − 0.92)c < 0.0001 93, L 4 (305) 3.47 (0.78, 6.16)c 0.01 98, L
  Other KSTDs 4 (212) 2.13 (0.40, 11.43)c 0.38 83, C 4 (212) −0.77 (−1.92, 0.38)c 0.19 93, C 2 (90) 0.91 (0.47, 1.34)b < 0.0001 0, M
Cointervention design
 Focused ESWT
  Monotherapy 1 (16) 45.00 (1.83, 1104.64) 0.0002 NA, L 2 (80) −5.17 (−6.43, −3.91)c < 0.0001 98, M 2 (80) 6.24 (0.86, 11.62)c 0.02 95, M
  Cointervention 6 (308) 2.98 (1.61, 5.52)b 0.0005 6, S 5 (257) −0.26 (−0.87, 0.35)c 0.41 83, C 5 (253) 0.29 (−0.12, 0.71)c 0.17 63, C
 Radial ESWT
  Monotherapy 3 (185) 2.18 (0.21, 22.89)c 0.52 91, C 4 (331) −1.62 (−3.32, 0.08)c 0.06 97, C 2 (125) 3.99 (0.31, 7.68)c 0.03 97, L
  Cointervention 6 (333) 3.72 (2.11, 6.57)b < 0.00001 33, M 7 (416) −1.26 (−1.78, −0.75)c < 0.00001 82, L 4 (270) 2.11 (0.02, 4.21)c 0.05 98, L
  1. aOR odds ratio, I2 heterogeneity, LoE level of evidence, SMD standard mean difference, NA not applicable, EFD energy flux density, ESWT extracorporeal shock wave therapy, KSTDs knee soft tissue disorders
  2. bFixed-effects model
  3. cRandom-effects model
  4. dLevel of evidence: Strong (S), Moderate (M), Limited (L), Very limited (V), Conflicting (C)