Insertional Achilles tendinopathy summary of evidence
| Outcomes | Comparisons | Relative effect (95% CI) | Patients /studies (n) | Quality of evidence (GRADE) | Clinical significance | |
| Average estimate/assumed risk in the ESWT group | Average estimate/assumed risk in the control group | |||||
| VISA-A score Follow-up: 4 months | ESWT: mean±SD was 79.4±10.4 | Eccentric load: mean±SD was 63.4±12.0 | MD 16.00 (9.78 to 22.22) The difference was clinically and statistically significant | 50/1 | ⊕⊕ Low1 | Low level of evidence in favour of radial ESWT compared with eccentric training in VISA-A score |
| Self-perceived recovery Defined as completely recovered and much improved Follow-up: 4 months | ESWT: 16 of 25 (66%) participants reported satisfactory recovery | Eccentric load: 7 of 25 (28%) participants reported satisfactory recovery | OR 4.57, (1.38 to 15.11) The difference was statistically significant | 50/1 | ⊕⊕ Low1 | Low level of evidence in favour of radial ESWT compared with eccentric training in patient-rated recovery |
| NRS pain score* Follow-up: 4 months | ESWT: mean±SD was 3.0±2.3 | Eccentric load: mean±SD was 5.0±2.3 | MD −2.00 (−3.28 to 0.72) The difference was clinically and statistically significant | 50/1 | ⊕⊕ Low1 | Low level of evidence in favour of radial ESWT compared with eccentric training in NRS pain reduction scores |
| Patient-rated pain reduction** Follow-up: 4 months | ESWT: MD from baseline was 4.0 points | Eccentric load: MD from baseline was 1.8 points | Not estimable | 50/1 | N/A | ESWT: much improved Eccentric load: minimally improved |
*Load-induced pain.
**Cut-off points adjusted from Farrar et al. 44
1 Only one high-quality randomised controlled trial was available for analysis.
ESWT, extracorporeal shockwave therapy; GRADE, Grading of Recommendations Assessment, Development and Evaluation; MD, mean difference; N/A, not available; NRS, numeric rating scale.