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      Efficacy and safety of extracorporeal shock wave therapy for upper limb tendonitis: a systematic review and meta-analysis of randomized controlled trials

      systematic-review

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          Abstract

          Objective

          This study synthesized the highest level of evidence to analyse the effectiveness and safety of using extracorporeal shock wave therapy (ESWT) to treat upper limb tendonitis, which was unknown.

          Design

          We conducted a systematic review and meta-analysis of 18 randomized controlled trials (RCTs) in PubMed, Embase, Web of Science, Medline, and the Cochrane Library.

          Methods

          Two researchers performed the screening, data extraction, literature quality assessment, and heterogeneity analysis of the searched RCTs.

          Results

          The main types of morbidity included rotator cuff tendonitis, lateral epicondylitis, finger tendonitis, and long bicipital tendonitis. The results of the meta-analysis showed that ESWT was effective in relieving pain in all four types of tendonitis. In addition, ESWT was more effective in relieving pain in patients with upper limb tendonitis than placebo at the 3- and 6-month follow-ups, especially with radial ESWT (RESWT). Data analysis of the forest plot showed that the experimental group with ESWT as an intervention had a significant improvement in function in patients with rotator cuff tendonitis at the 3-month follow-up. However, subgroup analysis showed that low-energy ESWT was effective in improving function in patients with calcified and non-calcified rotator cuff tendonitis, whereas it was not effective in relieving pain.

          Conclusion

          ESWT can effectively improve the functional activity in patients with rotator cuff tendonitis and may produce positive analgesic effects in patients with upper limb tendonitis. The incidence of adverse effects is low.

          Systematic Review Registration

          https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42023403594, identifier: PROSPERO, CRD42023403594.

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          Most cited references59

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          Measuring inconsistency in meta-analyses.

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            RoB 2: a revised tool for assessing risk of bias in randomised trials

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              The PRISMA statement for reporting systematic reviews and meta-analyses of studies that evaluate healthcare interventions: explanation and elaboration

              Systematic reviews and meta-analyses are essential to summarise evidence relating to efficacy and safety of healthcare interventions accurately and reliably. The clarity and transparency of these reports, however, are not optimal. Poor reporting of systematic reviews diminishes their value to clinicians, policy makers, and other users. Since the development of the QUOROM (quality of reporting of meta-analysis) statement—a reporting guideline published in 1999—there have been several conceptual, methodological, and practical advances regarding the conduct and reporting of systematic reviews and meta-analyses. Also, reviews of published systematic reviews have found that key information about these studies is often poorly reported. Realising these issues, an international group that included experienced authors and methodologists developed PRISMA (preferred reporting items for systematic reviews and meta-analyses) as an evolution of the original QUOROM guideline for systematic reviews and meta-analyses of evaluations of health care interventions. The PRISMA statement consists of a 27-item checklist and a four-phase flow diagram. The checklist includes items deemed essential for transparent reporting of a systematic review. In this explanation and elaboration document, we explain the meaning and rationale for each checklist item. For each item, we include an example of good reporting and, where possible, references to relevant empirical studies and methodological literature. The PRISMA statement, this document, and the associated website (www.prisma-statement.org/) should be helpful resources to improve reporting of systematic reviews and meta-analyses.
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                Author and article information

                Contributors
                URI : http://loop.frontiersin.org/people/2278239/overviewRole: Role: Role: Role: Role:
                URI : http://loop.frontiersin.org/people/1586623/overviewRole: Role:
                Role: Role: Role: Role:
                Role: Role: Role: Role:
                Role: Role: Role:
                Role: Role: Role:
                URI : http://loop.frontiersin.org/people/2710660/overviewRole: Role: Role:
                Role: Role: Role:
                Journal
                Front Med (Lausanne)
                Front Med (Lausanne)
                Front. Med.
                Frontiers in Medicine
                Frontiers Media S.A.
                2296-858X
                30 July 2024
                2024
                : 11
                : 1394268
                Affiliations
                Gannan Medical University, Ganzhou , Jiangxi, China
                Author notes

                Edited by: Ching-Mao Chang, Taipei Veterans General Hospital, Taiwan

                Reviewed by: Domiziano Tarantino, University of Naples Federico II, Italy

                Madhan Jeyaraman, Dr MGR Educational and Research Institute, India

                Jia-Chi Wang, Taipei Veterans General Hospital, Taiwan

                *Correspondence: Wei Li 282788183@ 123456qq.com
                Article
                10.3389/fmed.2024.1394268
                11319137
                39139789
                95a7666b-83e9-431f-b975-989010ff3906
                Copyright © 2024 Xiong, Wen, Jin, Lin, Shao, Peng, Zheng and Li.

                This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

                History
                : 01 March 2024
                : 29 April 2024
                Page count
                Figures: 12, Tables: 2, Equations: 0, References: 60, Pages: 15, Words: 7515
                Funding
                The author(s) declare financial support was received for the research, authorship, and/or publication of this article. This study was supported by the Science and Technology Research Project of Jiangxi Provincial Education (GJJ190801) to WL.
                Categories
                Medicine
                Systematic Review
                Custom metadata
                Rheumatology

                extracorporeal shock wave,upper limb tendonitis,rotator cuff tendonitis,lateral epicondylitis,randomized controlled trials

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