Recommendations for use of extracorporeal shockwave therapy in sports medicine: an international modified Delphi study.
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Rhim Hye Chang, Singh Mani, Maffulli Nicola, Saxena Amol, Leal Carlos, Gerdesmeyer Ludger, Quirolgico Kristina, Furia John P, Zwerver Johannes, Liao Chun-De, Moya Daniel, Huang Shih-Wei, Robinson David M, Jarnagin Johnny, Ruiz Joseph, Noble-Taylor Kayle E, Alkhawashki Hazem, Blatz Brice W, Borg-Stein Joanne, Borowski Lauren, Bowen Jay, Chin Michael, Conenello Robert M, Fredericson Michael, Fullem Brian W, Gravare Silbernagel Karin, Hollander Karsten, Jelsing Elena J, Langer Paul, Mautner Kenneth, Meron Adele, Monaco Robert, Paul Rowan V, Raiser Sara, Ratcliff James W, Sampson Steven, Schaden Wolfgang, Spector Jay, Sun Wei, Syrop Isaac P, Takahashi Kenji, Tan Benedict, Wyss James F, Zin Dan, Soo Hoo Jennifer, Tenforde Adam S
Аннотация
METHODS: A systematic literature search was performed on the use of ESWT for musculoskeletal and sports medicine injuries to identify potential panellists, followed by the development of a steering committee-led questionnaire. A three-stage, modified Delphi questionnaire was provided to a panel of 41 international clinical and research experts across 13 countries. Panellists had the opportunity to suggest edits to existing statements or recommend additional statements in Round 1. Consensus was defined as≥75% agreement.
RESULTS: All 41 panellists completed Rounds 1, 2 and 3. Consensus was reached on 69/118 statements (58.5%), including recommendations on terminology and fundamental concepts, indications for use, procedural aspects for tendinopathy and bone pathologies, treatment correlations with imaging, periprocedural and postprocedural considerations, absolute and relative contraindications and potential side effects. Of the 49 statements that did not reach consensus, 17/49 (34.7%) were related to procedural aspects of bone pathology.
CONCLUSION: This international panel presents recommendations on ESWT terminology, indications and treatment considerations to guide ESWT use and decision-making by sports medicine clinicians. While our panel supported the use of ESWT in the treatment of bone pathologies, certain procedural aspects of ESWT specific to these injuries did not reach consensus and require further investigation.