Extracorporeal Shock Wave Therapy for Treating Foot Ulcers in Adults With Type 1 and Type 2 Diabetes: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

AbstractExtracorporeal shock wave therapy (ESWT) as a new adjuvant therapy has shown a potential capability to promote diabetic foot ulcer (DFU) healing. The purpose of this study was to assess the efficacy and safety of ESWT on the healing of DFUs. The Cochrane Library, PubMed, Embase, Web of Scien...

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Veröffentlicht in:Canadian journal of diabetes 2020-03, Vol.44 (2), p.196-204.e3
Hauptverfasser: Huang, Qiangru, MM, Yan, Peijing, MM, Xiong, Huaiyu, MM, Shuai, Tiankui, MM, Liu, Jingjing, MM, Zhu, Lei, MM, Lu, Jiaju, MM, Shi, Xiue, MM, Yang, Kehu, MM, Liu, Jian, PhD
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container_end_page 204.e3
container_issue 2
container_start_page 196
container_title Canadian journal of diabetes
container_volume 44
creator Huang, Qiangru, MM
Yan, Peijing, MM
Xiong, Huaiyu, MM
Shuai, Tiankui, MM
Liu, Jingjing, MM
Zhu, Lei, MM
Lu, Jiaju, MM
Shi, Xiue, MM
Yang, Kehu, MM
Liu, Jian, PhD
description AbstractExtracorporeal shock wave therapy (ESWT) as a new adjuvant therapy has shown a potential capability to promote diabetic foot ulcer (DFU) healing. The purpose of this study was to assess the efficacy and safety of ESWT on the healing of DFUs. The Cochrane Library, PubMed, Embase, Web of Science, China Biology Medicine and reference lists were searched for studies published up to December 2018. Randomized controlled trials of any design, including ESWT for patients with DFU, were included. Two reviewers extracted data, including the wound surface area (WSA), percentage of re-epithelialization, population of complete cure and unchanged and other related outcomes. Eight randomized controlled trials (N=339) were included. ESWT was found to be associated with a greater reduction of WSA by 1.54 cm 2, and increase of re-epithelialization by 26.31%. A greater population with complete cure was found at the end of treatment (risk ratio [RR] = 2.22; 95% confidence interval [CI], 1.46 to 3.40); however, there was no statistically significant difference at the end of follow up (p=0.052). It can also reduce treatment inefficiency by 4.8-fold (95% CI, 0.12 to 0.37). In addition, ESWT also showed a higher superiority than hyperbaric oxygen therapy in the population for complete cure and unchanged ulcer (RR=1.83; 95% CI, 1.14 to 2.94 and RR=0.25; 95% CI, 0.13 to 0.48, respectively). ESWT is a feasible adjuvant treatment for DFUs. It can effectively improve the complete cure rate, shorten the healing period of DFUs and significantly reduce treatment ineffectiveness. This can provide new therapeutic ideas for clinical practice of intractable and recurrent DFUs.
doi_str_mv 10.1016/j.jcjd.2019.05.006
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The purpose of this study was to assess the efficacy and safety of ESWT on the healing of DFUs. The Cochrane Library, PubMed, Embase, Web of Science, China Biology Medicine and reference lists were searched for studies published up to December 2018. Randomized controlled trials of any design, including ESWT for patients with DFU, were included. Two reviewers extracted data, including the wound surface area (WSA), percentage of re-epithelialization, population of complete cure and unchanged and other related outcomes. Eight randomized controlled trials (N=339) were included. ESWT was found to be associated with a greater reduction of WSA by 1.54 cm 2, and increase of re-epithelialization by 26.31%. A greater population with complete cure was found at the end of treatment (risk ratio [RR] = 2.22; 95% confidence interval [CI], 1.46 to 3.40); however, there was no statistically significant difference at the end of follow up (p=0.052). It can also reduce treatment inefficiency by 4.8-fold (95% CI, 0.12 to 0.37). In addition, ESWT also showed a higher superiority than hyperbaric oxygen therapy in the population for complete cure and unchanged ulcer (RR=1.83; 95% CI, 1.14 to 2.94 and RR=0.25; 95% CI, 0.13 to 0.48, respectively). ESWT is a feasible adjuvant treatment for DFUs. It can effectively improve the complete cure rate, shorten the healing period of DFUs and significantly reduce treatment ineffectiveness. 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It can also reduce treatment inefficiency by 4.8-fold (95% CI, 0.12 to 0.37). In addition, ESWT also showed a higher superiority than hyperbaric oxygen therapy in the population for complete cure and unchanged ulcer (RR=1.83; 95% CI, 1.14 to 2.94 and RR=0.25; 95% CI, 0.13 to 0.48, respectively). ESWT is a feasible adjuvant treatment for DFUs. It can effectively improve the complete cure rate, shorten the healing period of DFUs and significantly reduce treatment ineffectiveness. This can provide new therapeutic ideas for clinical practice of intractable and recurrent DFUs.</abstract><cop>Canada</cop><pub>Elsevier Inc</pub><pmid>31515158</pmid><doi>10.1016/j.jcjd.2019.05.006</doi></addata></record>
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subjects Aged
Diabetes Mellitus, Type 1 - complications
Diabetes Mellitus, Type 2 - complications
Diabetic Foot - therapy
diabetic foot ulcer
Endocrinology and Metabolism
extracorporeal shock wave therapy
Extracorporeal Shockwave Therapy
Humans
meta-analysis
Middle Aged
méta-analyse
Other
physiotherapy
physiothérapie
Randomized Controlled Trials as Topic
revue systématique
systematic review
traitement par ondes de choc extracorporelles
Treatment Outcome
ulcère du pied diabétique
title Extracorporeal Shock Wave Therapy for Treating Foot Ulcers in Adults With Type 1 and Type 2 Diabetes: A Systematic Review and Meta-Analysis of Randomized Controlled Trials
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