British Medical Bulletin Advance Access originally published online on April 24, 2007
British Medical Bulletin 2007 81-82(1):183-208; doi:10.1093/bmb/ldm005
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Shock wave therapy for chronic plantar fasciopathy
OrthoTrauma Evaluation Center, Hans-Zoeller-Str. 83, D-55130 Mainz, Germany
Sun Orthopaedics Group, 900 Buffalo Road, Lewisburg, PA 17837, USA
¶ Weil Foot and Ankle Institute, 1455 Golf Road, Des Plaines, IL 60016, USA
Department of Trauma and Orthopaedic Surgery, Keele University School of Medicine, Thornburrow Drive, Hartshill, Stoke on Trent, Staffordshire, UK
* Correspondence to: E-mail: profrompe{at}web.de
Introduction: Relevant data of randomized-controlled studies on shock wave treatment for chronic plantar fasciopathy are statistically and clinically heterogeneous.
Methods: Randomized trials were identified form a current search of the Cochrane Bone, Joint and Muscle Trauma Group specialized register of trials, the Cochrane Central Register of Controlled Trials, MEDLINE and reference lists of articles and dissertations. We identified and retrieved a total of 17 articles. Methodological quality criterial included appropriate randomization, allocation concealment, blinding, number lost of follow-up and intention to treat analysis. Significant heterogeneity between studies precluded pooled analyses. Instead, individual trial results were described in the text.
Results: We identified conflicting results in the 17 studies, involving more than 2100 participants. There was considerable heterogeneity in terms of methodological quality, treatment regimen, patient selection and follow-up period.
Conclusions: With current studies heterogenous in terms of the duration of the disorder; type, frequency and total dose of shock wave therapy (SWT); period of time between SWT; type of management and control group; timing of follow-up and outcomes assessed, a pooled meta-analysis of SWT for chronic plantar fasciopathy was considered inappropriate. Neverhteless, there was a preponderance of well-designed studies showing favourable results. It appears that one should only consider SWT for plantar fasciopathy after more common, accepted and proven non-invasive treatments have failed.
Keywords: plantar fasciopathy • plantar fasciitis • shock wave therapy
Accepted for publication February 13, 2007.