{Reference Type}: Journal Article
{Title}: Is shockwave therapy effective in the management of greater trochanteric pain syndrome? A systematic review and meta-analysis.
{Author}: Harding D;Cameron L;Monga A;Winter S;
{Journal}: Musculoskeletal Care
{Volume}: 22
{Issue}: 2
{Year}: 2024 Jun
暂无{DOI}: 10.1002/msc.1892
{Abstract}: <B>BACKGROUND: </B>Evidence is lacking for the efficacy of shockwave therapy (SWT) in the treatment of greater trochanteric pain syndrome (GTPS).<BR><B>OBJECTIVE: </B>To investigate the efficacy of SWT on pain and function in the management of GTPS.<BR><B>METHODS: </B>A systematic search of electronic databases and grey literature was conducted up to May 2023. Studies utilising SWT on adults for GTPS, providing measures of pain and/or function at baseline and at follow-up were considered for inclusion. Meta-analysis was undertaken using converted pain and functional outcomes. Studies were assessed for quality and risk of bias, and assigned a level of evidence as per the Grading of Recommendations, Assessment, Development and Evaluations criteria.<BR><B>RESULTS: </B>Twelve articles (n = 1121 subjects) were included, including five randomised controlled trials (RCTs) and seven non-RCTs. No statistical differences were observed for pain over time f(1,5) = 1.349 (p = 0.298) or between SWT and control f(1,5) = 1.782 (p = 0.238). No significant differences in functional outcomes in short- (H = 2.591, p = 0.181) and medium-term follow-up (H = 0.189, p = 0.664) were identified between SWT and control. Moderate magnitude treatment effects for pain (Hedges-G [HG] 0.71) favouring SWT groups over control was identified, decreasing to low for function (HG 0.20). Further pain and functional treatment effects were identified at higher magnitudes across follow-up time-points in SWT groups compared to control.<BR><B>CONCLUSIONS: </B>Moderate-quality evidence demonstrated no statistically significant improvements in pain and function post-SWT compared to control. Low-quality evidence established clinical improvements throughout all included studies favouring SWT over control. Consequently, owing to relatively low incidence of side effects, SWT should be considered a viable option for the management of GTPS. Issues with both clinical and statistical heterogeneity of studies and during meta-analysis require consideration, and more robust RCTs are recommended if the efficacy of SWT for the management of GTPS is to be comprehensively determined.