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 |