Extracorporeal Shock Wave Therapy for Chronic Adhesive Capsulitis in Type 2 Diabetics: A Systematic Review With Meta-Analysis.

IF 3.3 4区医学 Q1 ORTHOPEDICS

Physical Therapy Pub Date : 2025-07-01 DOI:10.1093/ptj/pzaf074

Crystal Reno, Paul A Swinton, Lyndsay Alexander

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引用次数: 0

Abstract

Objective: The objective of this study was to assess the effectiveness of extracorporeal shock wave therapy (ESWT) in the treatment of chronic adhesive capsulitis (AC) in the type 2 diabetes population.

Design: This study is a systematic review with meta-analysis. The search was conducted in MEDLINE, EMBASE, CINAHL, PEDro, Cochrane Database of Systematic Reviews, UK Clinical Trial Gateway and gray literature from 2012 to 2023. Two reviewers independently screened and extracted data through Covidence and the quality was evaluated using Cochrane risk-of-bias tool for randomized trials. Meta-analyses were conducted to quantify within-group change and comparative effectiveness. Five hundred and seventy-four studies were identified, and 7 studies included (n = 352 participants).

Participants: This study included type 2 diabetic adults (>18 years) diagnosed with primary or secondary AC.

Interventions: This review and meta-analysis included studies comparing ESWT with conservative management.

Main outcomes: The primary outcome was pain. Secondary outcomes included range of movement (ROM) and disability.

Results: Meta-analysis using Bayesian method of within group change showed consistent improvement for pain (-5.7 [95% credible interval (CrI) = -7 to -4.5] cm), ROM (2.6 [95% CrI = 1.4 - 3.8]), and disability (3.6 [95% CrI = 2.3-4.9]). Consistent evidence of improvements favoring ESWT over conservative management was identified for all outcomes. Study heterogeneity had limited influence on non-controlled effect sizes, whereas limited controlled effect sizes lowered the confidence for outcomes of ROM and disability. Limitations included low number of studies, poor methodological quality, and non-adherence to reporting guidelines.

Conclusions: Extracorporeal shock wave therapy for treatment of AC was shown to reduce pain and improve range of motion and disability in the type 2 diabetes population. These results should be interpreted with caution and high-quality randomized controlled studies are required to establish best-practice ESWT protocols regarding application position, dosage, and duration.

Relevance: Extracorporeal shock wave therapy may improve pain, ROM, and disability in type 2 diabetics with AC.

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体外冲击波治疗2型糖尿病慢性粘连性囊炎：系统回顾与meta分析

目的：本研究的目的是评估体外冲击波治疗2型糖尿病人群慢性粘连性囊炎的有效性。设计：本研究采用meta分析的系统综述。检索在MEDLINE、EMBASE、CINAHL、PEDro、Cochrane系统评价数据库、UK Clinical Trial Gateway和2012 - 2023年的灰色文献中进行。两位审稿人通过covid独立筛选和提取数据，并使用Cochrane随机试验的偏倚风险工具评估质量。进行meta分析以量化组内变化和比较有效性。共确定574项研究，纳入7项研究（n = 352名受试者）。参与者：本研究包括诊断为原发性或继发性粘连性囊炎的2型糖尿病成人（bb0 - 18岁）。干预措施：本综述和荟萃分析包括比较体外冲击波治疗与保守治疗的研究。主要结局：主要结局为疼痛。次要结果包括活动范围和残疾。结果：采用组内变化的贝叶斯方法进行meta分析显示，疼痛（-5.7 [95% CrI = -7至-4.5]cm）、活动范围（2.6 [95% CrI = 1.4至3.8]）和残疾（3.6[95%可信区间= 2.3至4.9]）均有持续改善。所有结果均有一致的证据表明体外冲击波治疗优于保守治疗。研究异质性对非控制效应量的影响有限，而有限的控制效应量降低了对活动范围和残疾结果的信心。局限性包括研究数量少、方法学质量差和不遵守报告指南。结论：体外冲击波治疗粘连性囊炎可减轻2型糖尿病患者的疼痛，改善活动范围和残疾。这些结果应谨慎解释，需要进行高质量的随机对照研究，以建立关于应用位置、剂量和持续时间的最佳体外冲击波治疗方案。相关性：体外冲击波治疗可改善2型糖尿病伴粘连性囊炎患者的疼痛、活动范围和残疾。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Physical Therapy Multiple-

CiteScore

7.10

自引率

0.00%

发文量

187

审稿时长

4-8 weeks

期刊介绍： Physical Therapy (PTJ) engages and inspires an international readership on topics related to physical therapy. As the leading international journal for research in physical therapy and related fields, PTJ publishes innovative and highly relevant content for both clinicians and scientists and uses a variety of interactive approaches to communicate that content, with the expressed purpose of improving patient care. PTJ"s circulation in 2008 is more than 72,000. Its 2007 impact factor was 2.152. The mean time from submission to first decision is 58 days. Time from acceptance to publication online is less than or equal to 3 months and from acceptance to publication in print is less than or equal to 5 months.