Rompe Jan D, Furia John, Weil Lowell, Maffulli Nicola
OrthoTrauma Evaluation Center, Mainz, Germany.
Br Med Bull. 2007;81-82:183-208. doi: 10.1093/bmb/ldm005. Epub 2007 Apr 24.
Relevant data of randomized-controlled studies on shock wave treatment for chronic plantar fasciopathy are statistically and clinically heterogeneous.
Randomized trials were identified form a current search of the Cochrane Bone, Joint and Muscle Trauma Group specialized register of trials, the Cochrane Central Register of Controlled Trials, MEDLINE and reference lists of articles and dissertations. We identified and retrieved a total of 17 articles. Methodological quality criterial included appropriate randomization, allocation concealment, blinding, number lost of follow-up and intention to treat analysis. Significant heterogeneity between studies precluded pooled analyses. Instead, individual trial results were described in the text.
We identified conflicting results in the 17 studies, involving more than 2100 participants. There was considerable heterogeneity in terms of methodological quality, treatment regimen, patient selection and follow-up period.
With current studies heterogenous in terms of the duration of the disorder; type, frequency and total dose of shock wave therapy (SWT); period of time between SWT; type of management and control group; timing of follow-up and outcomes assessed, a pooled meta-analysis of SWT for chronic plantar fasciopathy was considered inappropriate. Neverhteless, there was a preponderance of well-designed studies showing favourable results. It appears that one should only consider SWT for plantar fasciopathy after more common, accepted and proven non-invasive treatments have failed.
关于冲击波治疗慢性足底筋膜炎的随机对照研究的相关数据在统计学和临床上存在异质性。
通过检索Cochrane骨、关节和肌肉创伤组专门的试验注册库、Cochrane对照试验中央注册库、MEDLINE以及文章和论文的参考文献列表来识别随机试验。我们共识别并检索出17篇文章。方法学质量标准包括适当的随机化、分配隐藏、盲法、失访人数以及意向性分析。研究之间的显著异质性排除了汇总分析。相反，在正文中描述了各个试验的结果。
我们在17项研究中发现了相互矛盾的结果，涉及超过2100名参与者。在方法学质量、治疗方案、患者选择和随访期方面存在相当大的异质性。
鉴于目前的研究在疾病持续时间、冲击波治疗（SWT）的类型、频率和总剂量；SWT之间的时间间隔；管理和对照组的类型；随访时间和评估的结果等方面存在异质性，对慢性足底筋膜炎进行SWT的汇总荟萃分析被认为是不合适的。然而，有大量设计良好的研究显示出有利的结果。似乎只有在更常见、被接受且经过验证的非侵入性治疗失败后，才应考虑对足底筋膜炎进行SWT。
