Extracorporeal Shock Wave Therapy in Acute Injury Care: A Systematic Review

OBJECTIVES: We provide a systematic review of the literature to identify clinical studies assessing the effects of extracorporeal shock wave therapy (ESWT) on acutely injured tissues of human subjects, also highlighting the biological mechanisms by which the technique is proposed to promote the processes of early tissue repair. Special attention is also paid to the progress of research in animal models. METHOD: A systematic review of the literature on ESWT of acute injuries of bone and soft tissue as available in the PubMed/MEDLINE, Cochrane CENTRAL, SPORTDiscus, and CINAHL databases up to December 2017 was conducted. RESULTS: A total of 10 studies were included. There is some evidence for the application of ESWT in an early postacute injury phase. Most studies report benefits with no or minimal side effects. However, different types of treated tissues and wounds (varying cause and severity) and resulting heterogeneity in study design and outcome measurement make it difficult to compare studies. The picture of knowledge remains limited by an apparent lack of data on optimal treatment timing and on tissue- and injury-specific parameters. CONCLUSIONS: Although the amount of studies to date is still limited, recent clinical research has presented first successful steps to introduce ESWT as a means of treatment in acute injury care. Therefore, on the basis of the analyzed data, further testing is encouraged to validate optimal timing, physical settings, and possible long-term effects to exclude potential risks.