Mixed/non-specified 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 | |||||
| FIL and AOFAS scores Follow-up: 3 months | ESWT: The mean standardised disability score was 91.5 (range 88.0–95.0) | Placebo ESWT: the mean standardised disability score was 52.2 (range 24.0–81.0) | SMD* 0.77 (0.25 to 1.30) The difference was clinically and statistically significant | 97/2 | ⊕ Very low1,2 | Very low level of evidence in favour of ESWT compared with placebo ESWT in non-condition specific functional outcome measures |
| Self-perceived recovery Defined by EQ-5D Follow-up: 3 months | ESWT: mean±SD was 0.11±0.24 | Placebo ESWT: mean±SD was 0.07±0.24 | MD 0.04 (−0.10 to 0.18) The difference was not statistically significant | 49/1 | ⊕ Very low3 | Very low level of evidence of no difference between focused ESWT compared with placebo ESWT in activities of daily living |
| VAS pain score* Follow-up: 3 months | ESWT: mean±SD was 4.78±3.14 | Placebo ESWT: mean±SD was 5.80±3.8 | MD −1.02 (−2.96 to 0.92) The difference was not statistically significant | 49/1 | ⊕ Very low3 | Very low level of evidence of no difference between focused ESWT compared with placebo ESWT in VAS scores |
| Patient-rated pain reduction*, ** 3 months | ESWT: MD from baseline was 2.0 points | Eccentric load: MD from baseline was 0.4 points | Not estimable | 49/1 | N/A | ESWT: much improved Placebo ESWT: minimally improved |
*Pain scores refer to sports participation, were converted from 0 to 100 into 0–10 scale and cut-off points adjusted from Farrar et al. 44
**SMD calculated due to outcome measures were not directly comparable.
1 Inconsistent results between studies and reporting bias.
2 Indirect comparison.
3 Reporting bias.
AOFAS, American Orthopedic Foot and Ankle Society; ESWT, extracorporeal shockwave therapy; FIL, functional index of lower limb activity; GRADE, Grading of Recommendations Assessment, Development and Evaluation; MD, mean difference; N/A, not available; SMD, standardised mean difference; VAS, visual analogue scale.