Systematic Review and Meta-analysis Assessing the Effects of Focal and Radial Extracorporeal Shockwave Therapy on Pain and Function in Patellar Tendinopathy.
Adam Friedman, Seth Spicer, Jared Garfinkle and 1 others
PMID 42769704WHAT IT FOUND
For patellar tendinopathy, shockwave therapy, sometimes with eccentric training or other exercise, reduced pain and improved function more than control.
Many participants were athletes, so this is an option when usual care has not helped.
Key findings
01Pooled pain scores decreased after shockwave therapy and after control, with a significant difference between groups.
02Pooled function scores increased after shockwave therapy and after control, with a significant difference between groups.
03Focused and radial shockwave were not pooled head-to-head; a randomized trial that directly compared them found no difference when each was combined with eccentric training.
STILL TO COME
How it was doneWhat they foundWhat it means for PTs
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What it does not show
The pooled pain and function results varied a lot between studies, so the average numbers should not be treated as a precise prediction for one patient. Some included studies were nonrandomized and had serious or moderate risk of bias, especially because they lacked control groups or used unblinded outcome assessment. The review could not determine whether focused or radial shockwave is better, because direct randomized comparison was limited. Treatment dose and follow-up timing were not standardized, so the review does not identify an optimal protocol. Some studies combined shockwave therapy with eccentric training or other exercise, so the pooled effect cannot be attributed to shockwave alone in those studies.
Declared interests
The investigators reported no financial or nonfinancial disclosures.
The easy way to misread this
Do not conclude that shockwave therapy alone caused the pooled improvement. Some studies gave shockwave together with eccentric training or other exercise, and the review did not separate those contributions.