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Efficacy of Extracorporeal Shockwave Therapy on Pain and Function in Myofascial Pain Syndrome of the Trapezius: A Systematic Review and Meta-Analysis

  • Qing Zhang
    Affiliations
    Department of Rehabilitation Medicine Center, West China Hospital, Sichuan University, Chengdu, Sichuan, PR China

    Key Laboratory of Rehabilitation Medicine in Sichuan Province, Chengdu, Sichuan, PR China
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  • Chenying Fu
    Affiliations
    State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu, Sichuan, China
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  • Liyi Huang
    Affiliations
    Department of Rehabilitation Medicine Center, West China Hospital, Sichuan University, Chengdu, Sichuan, PR China

    Key Laboratory of Rehabilitation Medicine in Sichuan Province, Chengdu, Sichuan, PR China
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  • Feng Xiong
    Affiliations
    Department of Rehabilitation Medicine Center, West China Hospital, Sichuan University, Chengdu, Sichuan, PR China

    Key Laboratory of Rehabilitation Medicine in Sichuan Province, Chengdu, Sichuan, PR China
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  • Lihong Peng
    Affiliations
    Department of Rehabilitation Medicine Center, West China Hospital, Sichuan University, Chengdu, Sichuan, PR China

    Key Laboratory of Rehabilitation Medicine in Sichuan Province, Chengdu, Sichuan, PR China
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  • Zejun Liang
    Affiliations
    Department of Rehabilitation Medicine Center, West China Hospital, Sichuan University, Chengdu, Sichuan, PR China

    Key Laboratory of Rehabilitation Medicine in Sichuan Province, Chengdu, Sichuan, PR China
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  • Li Chen
    Affiliations
    Department of Rehabilitation Medicine Center, West China Hospital, Sichuan University, Chengdu, Sichuan, PR China

    Key Laboratory of Rehabilitation Medicine in Sichuan Province, Chengdu, Sichuan, PR China
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  • Chengqi He
    Affiliations
    Department of Rehabilitation Medicine Center, West China Hospital, Sichuan University, Chengdu, Sichuan, PR China

    Key Laboratory of Rehabilitation Medicine in Sichuan Province, Chengdu, Sichuan, PR China
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  • Quan Wei
    Correspondence
    Corresponding author Quan Wei, MD, Department of Rehabilitation Medicine Center and Key Laboratory of Rehabilitation Medicine, West China Hospital, Sichuan University, No.37 Guo Xue Xiang, Chengdu, Sichuan, 610041, PR China.
    Affiliations
    Department of Rehabilitation Medicine Center, West China Hospital, Sichuan University, Chengdu, Sichuan, PR China

    Key Laboratory of Rehabilitation Medicine in Sichuan Province, Chengdu, Sichuan, PR China
    Search for articles by this author
Published:March 28, 2020DOI:https://doi.org/10.1016/j.apmr.2020.02.013

      Abstract

      Objective

      To evaluate the effect of extracorporeal shockwave therapy (ESWT) on pain and function in myofascial pain syndrome (MPS) of the trapezius.

      Data Sources

      PubMed, EMBASE, Web of Science, Physiotherapy Evidence Database, and The Cochrane Central Register of Controlled Trials were systematically searched from the time of their inception to September 2019.

      Study Selection

      Randomized controlled trials comparing the effects of ESWT on MPS of the trapezius were included in this review.

      Data Extraction

      Data related to study participants, intervention, follow-up period, measure time, and outcomes were extracted. The Physiotherapy Evidence Database scale and the Cochrane Collaboration Tool for Assessing Risk of Bias were used to assess study quality and risk of bias.

      Data Synthesis

      In total, 10 articles (n=477 patients) met our criteria and were included in this study. The overall effectiveness was calculated using a meta-analysis method. The meta-analysis revealed that ESWT exhibited significant improvement in pain reduction compared with sham ESWT or ultrasound treatment, but no significant effect when compared with conventional treatments (dry needling, trigger point injection, laser therapy) as for pain intensity and neck disability index.

      Conclusions

      ESWT appears to benefit patients with MPS of the trapezius by alleviating pain. ESWT may not be an ideal therapeutic method to replace conventional therapies but could serve as an adjunct therapeutic method to those treatments.

      Keywords

      List of abbreviations:

      CI (confidence interval), ESWT (extracorporeal shockwave therapy), MD (mean difference), MPS (myofascial pain syndrome), MTrP (myofascial trigger point), NDI (neck disability index), PEDro (Physiotherapy Evidence Database), RCT (randomized controlled trial), SMD (standard mean difference)
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