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To investigate which modality of ESWT brings the greatest clinical improvements between High (HE)\u2010SWT and Low Energy (LE)\u2010SWT and between Focal (F)\u2010SWT and Radial (R)\u2010SWT.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>MEDLINE, EMBASE, CENTRAL Database, and PEDro databases until February 2024 were searched. Study registers were further investigated. The Risk of Bias (RoB) was assessed with the Revised Cochrane RoB Tool (RoB 2). The certainty of evidence was rated with GRADE.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Twenty\u2010one randomized controlled trials were included. None was judged as overall low RoB. Comparing ESWT and Ultrasound Guided Needling Procedures (USGNP), the pooled results reported a significant difference favoring USGNP in pain at &lt;24 and\u00a0&lt;48\u00a0weeks (MD\u00a0=\u00a01.17,\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u00a00.004,\n                      <jats:italic>I<\/jats:italic>\n                      <jats:sup>2<\/jats:sup>\n                      \u00a0=\u00a059%; MD\u00a0=\u00a01.31,\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u00a00.004,\n                      <jats:italic>I<\/jats:italic>\n                      <jats:sup>2<\/jats:sup>\n                      \u00a0=\u00a042%, respectively). Comparing ESWT and sham\u2010ESWT, the pooled results reported a clinically significant difference favoring ESWT in pain and function at 24\u00a0weeks (MD\u00a0=\u00a0\u22125.72,\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0&lt;\u00a00.00001,\n                      <jats:italic>I<\/jats:italic>\n                      <jats:sup>2<\/jats:sup>\n                      \u00a0=\u00a00%; Standardized Mean Difference\u00a0=\u00a02.94,\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u00a00.02\n                      <jats:italic>I<\/jats:italic>\n                      <jats:sup>2<\/jats:sup>\n                      \u00a0=\u00a098%, respectively). Comparing HE\u2010SWT and LE\u2010SWT, HE\u2010SWT was statistically and clinically superior in pain and function at &lt;24\u00a0weeks (MD\u00a0=\u00a0\u22121.83,\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u00a00.03,\n                      <jats:italic>I<\/jats:italic>\n                      <jats:sup>2<\/jats:sup>\n                      \u00a0=\u00a087%; MD\u00a0=\u00a014.60,\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u00a00.002,\n                      <jats:italic>I<\/jats:italic>\n                      <jats:sup>2<\/jats:sup>\n                      \u00a0=\u00a077%, respectively) and showed a significantly higher complete resorption rate of calcification at 12\u00a0weeks (Risk Ratio\u00a0=\u00a02.53,\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u00a00.001,\n                      <jats:italic>I<\/jats:italic>\n                      <jats:sup>2<\/jats:sup>\n                      \u00a0=\u00a00%). F\u2010SWT and R\u2010SWT appear equally effective in reducing pain, improving disability and resorption rate. The certainty of evidence was rated as very low through GRADE approach.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>USGNP was statistically superior to ESWT in pain reduction at &lt;24 and\u00a0&lt;48\u00a0weeks. ESWT was clinically better to sham\u2010ESWT in pain reduction and function improvement at 24\u00a0weeks. HE\u2010SWT was clinically more effective than LE\u2010SWT in reducing pain, improving function at &lt;24\u00a0weeks, and resolving calcific deposits at 12\u00a0weeks, while no differences between F\u2010SWT and R\u2010SWT were reported.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/pri.2106","type":"journal-article","created":{"date-parts":[[2024,6,15]],"date-time":"2024-06-15T13:34:28Z","timestamp":1718458468000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":18,"title":["The effectiveness of extracorporeal shock wave therapy for rotator cuff calcific tendinopathy. 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