title: Focused extracorporeal shock wave therapy in calcifying tendinitis of the shoulder: a meta-analysis.
abstract: BACKGROUND
  The objective of this study is to assess the effectiveness of extracorporeal shock wave therapy in the management of calcifying tendinitis of the shoulder. Furthermore, a dose-response relationship was sought as a secondary confirmation of effectiveness.
  
  
  OBJECTIVE
  Focused extracorporeal shock wave therapy has a high, dose-responsive effectiveness in the management of calcifying tendinitis of the shoulder.
  
  
  METHODS
  Meta-analysis.
  
  
  METHODS
  Studies were identified from online databases (MEDLINE, EMBASE, and Cochrane Controlled Trials Register), manual searches, and personal communication with experts in the field. After assessment of heterogeneity, a random effects model was generated. The primary end points were identified as pain and function by using the visual analog scale and the Constant-Murley Score, respectively. These end points were pooled and the weighted mean differences and 95% confidence intervals were estimated. Odds ratios of the secondary end point deposit resorption were pooled.
  
  
  RESULTS
  In 14 studies, shock wave therapy led to a significantly higher reduction of pain (weighted mean difference, -2.8 points; 95% confidence interval, -4.2 to -1.5 points) and improvement of function (weighted mean difference, 19.8 points; 95% confidence interval, 13.4-26.3 points), compared to other treatments and placebo. High-energy treatment produced significantly better results than low-energy treatment for pain reduction (weighted mean difference, 1.7 points; 95% confidence interval, 0.7-2.6 points) and improvement of function (weighted mean difference, 10.7 points; 95% confidence interval, 7.2-14.1 points). These results are consistent with a dose-response relationship supporting the effectiveness of shock wave therapy.
  
  
  CONCLUSIONS
  Shock wave therapy for calcifying tendinitis of the shoulder is effective in pain relief, function restoration, and deposit resorption; however, these conclusions are susceptible to bias arising from the limitations of the included studies.
authors.affiliation: Children's Hospital Boston, Harvard Medical School, Boston, Massachusetts.
authors.forename: Patrick
authors.initials: P
authors.lastname: Vavken
authors.forename: Johannes
authors.initials: J
authors.lastname: Holinka
authors.forename: Jan Dirk
authors.initials: JD
authors.lastname: Rompe
authors.forename: Ronald
authors.initials: R
authors.lastname: Dorotka