title: Meta-analysis of high-energy extracorporeal shock wave therapy in recalcitrant plantar fasciitis.
abstract: BACKGROUND
  Randomised controlled trials (RCTs) have reported conflicting results on whether extracorporeal shock wave therapy alleviates the pain of recalcitrant plantar fasciitis patients. We focused on high-energy extracorporeal shock wave therapy (HESWT) and aimed to assess the effectiveness and feasibility of HESWT versus placebo in the treatment of recalcitrant plantar fasciitis.
  
  
  METHODS
  We reviewed all RCTs comparing HESWT and placebo from PubMed, EMBASE, Cochrane Central Register of Controlled Trials and also the reference lists of articles. We used a fixed-effects model or a random model depending on heterogeneity and estimated the odds radio (OR) and 95% confidence interval (95% CI). Study quality was assessed using the Jadad scale.
  
  
  RESULTS
  Five placebo-controlled and double-blinded clinical trials including 716 patients were included. Overall, the quality of the trials was good, and a test for heterogeneity confirmed the presence of little heterogeneity (p = 0.31, I2 = 16%). The pooled OR from the five trials was estimated to be 2.25 (95% CI, 1.66-3.06; p <0.00001) at 12 weeks after active treatment.
  
  
  CONCLUSIONS
  The results of the meta-analysis provide strong evidence that HESWT was effective in the treatment of recalcitrant plantar fasciitis when compared with placebo. We recommend HESWT as a remedial measure after failure of traditional conservative treatment and ahead of surgical intervention.
authors.affiliation: Department of orthopedics, First Affiliated Hospital of Nanchng University, China. lzyiloveyou@163.com
authors.forename: Li
authors.initials: L
authors.lastname: Zhiyun
authors.forename: Jin
authors.initials: J
authors.lastname: Tao
authors.forename: Shao
authors.initials: S
authors.lastname: Zengwu
mesh_terms: D036981:Fasciitis, Plantar / Q000628:therapy*; D019220:High-Energy Shock Waves / Q000627:therapeutic use*; D006801:Humans; D010147:Pain Measurement; D016032:Randomized Controlled Trials as Topic; D016896:Treatment Outcome