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Comparison of efficacy of eight treatments for plantar fasciitis: A network meta‐analysis
Author(s) -
Li Haibo,
Lv Hao,
Lin Ting
Publication year - 2019
Publication title -
journal of cellular physiology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.529
H-Index - 174
eISSN - 1097-4652
pISSN - 0021-9541
DOI - 10.1002/jcp.26907
Subject(s) - medicine , plantar fasciitis , placebo , extracorporeal shockwave therapy , meta analysis , visual analogue scale , randomized controlled trial , cochrane library , dry needling , tendinopathy , surgery , tendon , acupuncture , alternative medicine , pathology
The objective of this network meta‐analysis (NMA) was to assess the pain relief performance of eight different plantar fasciitis therapies, including nonsteroidal anti‐inflammatory medications, corticosteroid injections (CSs), autologous whole blood, platelet‐rich plasma (PRP), extracorporeal shockwave therapy (ESWT), ultrasound therapy (US), botulinum toxin A (BTX‐A), and dry needling (DN). Published prospective or randomized controlled trials (RCTs) as for the above eight therapies were identified by searching CNKI, PubMed, and Embase. Mean difference (MD) and 95% credible intervals (CrIs) of visual analogue scale (VAS) were used to evaluate multiaspect comparisons. The ranking result was obtained by utilizing surface under cumulative ranking curve (SUCRA). Node‐splitting plots were conducted to assess the consistency between direct and indirect evidence. Egger’s test and funnel plots were performed to examine publication bias. Forty‐one trials with a total of 2,889 cases were involved in this NMA. In terms of 1‐month VAS, only ESWT turned out to be of better efficacy than placebo (MD = −3.3; CrI: [−5.3, −1.1]). No statistically significant difference was found between pair‐wise comparisons concerning 2‐month VAS. ESWT also demonstrated better efficacy as for 3‐month results (MD = −2.7; CrI: [−4.2, −1.3]). Besides, CSs was significantly better than placebo as well in 3‐month results (MD = −2.1; CrI: [−4.1, −0.19]). With regard to 6‐month VAS results, ESWT performed better than placebo (MD = −3.0; CrI: [−5.0, −0.51]). According to the SUCRA, ESWT ranked the first as for all seven outcomes. ESWT might be the optimal treatment. In addition, BTX‐A and PRP were considered as suboptimal.