{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,14]],"date-time":"2026-06-14T17:55:36Z","timestamp":1781459736098,"version":"3.54.1"},"reference-count":61,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2026,6,10]],"date-time":"2026-06-10T00:00:00Z","timestamp":1781049600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Foot &amp; Ankle Specialist"],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Plantar fasciitis (PF) is the leading cause of chronic heel pain in adults, impairing mobility and quality of life. Radial extracorporeal shockwave therapy (rESWT) is widely used in physiotherapy for its practicality and cost-effectiveness. However, heterogeneity in study designs and protocols limits conclusions regarding its efficacy compared with other electrophysical modalities (EPMs). This systematic review and meta-analysis aimed to synthesize the immediate effects of rESWT, alone or combined with conventional physiotherapy, versus other EPMs, focusing on pain and functional outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A systematic search of PubMed, CINAHL, Scopus, Web of Science, and PEDro was conducted up to April 2025 to identify randomized controlled trials (RCTs) comparing rESWT, alone or combined with non-electrophysical interventions, versus other EPMs in adults with PF. Pain intensity and functional disability were the primary outcomes. Meta-analyses were performed using random-effects models, with sensitivity analyses conducted according to outcome type and comparator. Certainty of evidence was assessed using the Grading of Recommendations Assessment, Development and Evaluation approach.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Fourteen RCTs (n = 797) were included, of which 12 contributed to the meta-analysis. Radial extracorporeal shockwave therapy did not demonstrate superiority over other EPMs for pain reduction (standardized mean difference [SMD] = \u22120.03; 95% confidence interval [CI]: \u22120.39 to 0.33) or functional improvement (SMD = \u22120.11; 95% CI: \u22120.47 to 0.25). Low-level laser therapy showed small but statistically significant advantages over rESWT for functional outcomes. Overall risk of bias (RoB) was high across most studies.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Radial extracorporeal shockwave therapy, alone or combined with physical therapy, does not appear superior to other EPMs for PF. The high heterogeneity and overall elevated RoB limit the certainty of these findings, highlighting the need for high-quality trials to guide clinical recommendations.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Level of Evidence:<\/jats:title>\n                    <jats:p>Level I: Systematic Review<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/19386400261449323","type":"journal-article","created":{"date-parts":[[2026,6,10]],"date-time":"2026-06-10T10:05:11Z","timestamp":1781085911000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Effectiveness of Radial Extracorporeal Shockwave Therapy Versus Other Electrophysical Modalities on Pain and Functionality in Patients With Plantar Fasciitis: A Systematic Review and Meta-Analysis"],"prefix":"10.1177","author":[{"given":"Francisco","family":"Guede-Rojas","sequence":"first","affiliation":[{"name":"Exercise and Rehabilitation Sciences Institute, School of Physical Therapy, Faculty of Rehabilitation Sciences, Universidad Andres Bello, Santiago, Chile"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4599-0039","authenticated-orcid":false,"given":"Leonardo","family":"Rodriguez-Lagos","sequence":"additional","affiliation":[{"name":"Cognitive Neuroscience, Pain and Rehabilitation Research Group (NECODOR), Faculty of Health Sciences, Rey Juan Carlos University, Alcorc\u00f3n, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4271-9657","authenticated-orcid":false,"given":"Claudio","family":"Carvajal-Parodi","sequence":"additional","affiliation":[{"name":"Escuela de Kinesiolog\u00eda, Facultad de Ciencias de la Rehabilitaci\u00f3n y Calidad de Vida, Universidad San Sebasti\u00e1n, Concepci\u00f3n, Chile"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,6,10]]},"reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1038\/s41598-022-19588-5"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.3399\/bjgp19X706061"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.2519\/jospt.2014.0303"},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpain.2018.03.003"},{"key":"e_1_3_2_6_2","first-page":"676","article-title":"Diagnosis and treatment of plantar fasciitis","volume":"84","author":"Goff JD","year":"2011","unstructured":"Goff JD, Crawford R. Diagnosis and treatment of plantar fasciitis. Am Fam Physician. 2011;84:676-682.","journal-title":"Am Fam Physician"},{"key":"e_1_3_2_7_2","doi-asserted-by":"publisher","DOI":"10.4103\/jmu.jmu_2_23"},{"key":"e_1_3_2_8_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.cpm.2004.08.001"},{"key":"e_1_3_2_9_2","doi-asserted-by":"publisher","DOI":"10.7547\/87507315-93-3-234"},{"key":"e_1_3_2_10_2","doi-asserted-by":"publisher","DOI":"10.1007\/s40477-022-00712-0"},{"key":"e_1_3_2_11_2","doi-asserted-by":"publisher","DOI":"10.5535\/arm.2019.43.6.662"},{"key":"e_1_3_2_12_2","doi-asserted-by":"publisher","DOI":"10.1682\/JRRD.2011.09.0181"},{"key":"e_1_3_2_13_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.apmr.2020.10.124"},{"key":"e_1_3_2_14_2","doi-asserted-by":"publisher","DOI":"10.3113\/FAI.2007.0004"},{"key":"e_1_3_2_15_2","doi-asserted-by":"publisher","DOI":"10.1038\/s41598-018-22402-w"},{"key":"e_1_3_2_16_2","doi-asserted-by":"publisher","DOI":"10.1136\/bjsports-2019-101970"},{"key":"e_1_3_2_17_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12891-023-06407-9"},{"key":"e_1_3_2_18_2","doi-asserted-by":"publisher","DOI":"10.1302\/2058-5241.5.190067"},{"key":"e_1_3_2_19_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijsu.2015.06.059"},{"key":"e_1_3_2_20_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcot.2020.02.004"},{"key":"e_1_3_2_21_2","doi-asserted-by":"publisher","DOI":"10.3389\/fimmu.2023.1193835"},{"key":"e_1_3_2_22_2","doi-asserted-by":"publisher","DOI":"10.1177\/02692155241253779"},{"key":"e_1_3_2_23_2","doi-asserted-by":"publisher","DOI":"10.1177\/10711007241231959"},{"key":"e_1_3_2_24_2","doi-asserted-by":"publisher","DOI":"10.23736\/S1973-9087.24.08136-X"},{"key":"e_1_3_2_25_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00402-024-05464-6"},{"key":"e_1_3_2_26_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.fas.2024.11.005"},{"key":"e_1_3_2_27_2","unstructured":"Chang KV Chen SY Chen WS et al. Comparative Effectiveness of Focused Shock Wave Therapy of Different Intensity Levels and Radial Shock Wave Therapy for Treating Plantar Fasciitis: A Systematic Review and Network Meta-Analysis. Centre for Reviews and Dissemination; 2012. Accessed November 5 2022. https:\/\/www.ncbi.nlm.nih.gov\/books\/NBK109267\/"},{"key":"e_1_3_2_28_2","article-title":"The PRISMA 2020 statement: an updated guideline for reporting systematic reviews","volume":"372","author":"Page MJ","year":"2021","unstructured":"Page MJ, McKenzie JE, Bossuyt PM, et al. The PRISMA 2020 statement: an updated guideline for reporting systematic reviews. BMJ. 2021;372:n71.","journal-title":"BMJ"},{"key":"e_1_3_2_29_2","doi-asserted-by":"publisher","DOI":"10.1186\/s13643-016-0384-4"},{"key":"e_1_3_2_30_2","article-title":"RoB 2: a revised tool for assessing risk of bias in randomised trials","volume":"366","author":"Sterne JAC","year":"2019","unstructured":"Sterne JAC, Savovi\u0107 J, Page MJ, et al. RoB 2: a revised tool for assessing risk of bias in randomised trials. BMJ. 2019;366:l4898.","journal-title":"BMJ"},{"key":"e_1_3_2_31_2","doi-asserted-by":"publisher","DOI":"10.1002\/jrsm.1411"},{"key":"e_1_3_2_32_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.cegh.2023.101484"},{"key":"e_1_3_2_33_2","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2288-5-13"},{"key":"e_1_3_2_34_2","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2288-14-135"},{"key":"e_1_3_2_35_2","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.d5928"},{"key":"e_1_3_2_36_2","doi-asserted-by":"publisher","DOI":"10.1093\/pm\/pnx113"},{"key":"e_1_3_2_37_2","doi-asserted-by":"publisher","DOI":"10.12965\/jer.1836048.024"},{"key":"e_1_3_2_38_2","doi-asserted-by":"publisher","DOI":"10.1177\/1071100717747590"},{"key":"e_1_3_2_39_2","doi-asserted-by":"publisher","DOI":"10.5455\/msm.2018.30.141-146"},{"key":"e_1_3_2_40_2","first-page":"3823","article-title":"Effect of radial shock wave and ultrasound therapy combined with traditional physical therapy exercises on foot function and dorsiflexion range in plantar fasciitis: a prospective randomized clinical trial","volume":"27","author":"Fouda KZ","year":"2023","unstructured":"Fouda KZ, Ali ZA, Elshorbagy RT, et al. Effect of radial shock wave and ultrasound therapy combined with traditional physical therapy exercises on foot function and dorsiflexion range in plantar fasciitis: a prospective randomized clinical trial. Eur Rev Med Pharmacol Sci. 2023;27:3823-3832.","journal-title":"Eur Rev Med Pharmacol Sci"},{"key":"e_1_3_2_41_2","doi-asserted-by":"publisher","DOI":"10.6061\/clinics\/2013(08)05"},{"key":"e_1_3_2_42_2","doi-asserted-by":"publisher","DOI":"10.1590\/S1807-59322009000200006"},{"key":"e_1_3_2_43_2","first-page":"834","article-title":"Comparison between shockwave and ultrasound therapy in patients with plantar fasciitis","volume":"45","author":"Hashmi R","year":"2020","unstructured":"Hashmi R, Yousaf MS, Arshad N, et al. Comparison between shockwave and ultrasound therapy in patients with plantar fasciitis. Rawal Med J. 2020;45:834-834.","journal-title":"Rawal Med J"},{"key":"e_1_3_2_44_2","article-title":"A comparison of the effectiveness of radial extracorporeal shock wave therapy and ultrasound therapy in the treatment of chronic plantar fasciitis: a randomized controlled trial","author":"Konjen N","year":"2015","unstructured":"Konjen N, Napnark T, Janchai S. A comparison of the effectiveness of radial extracorporeal shock wave therapy and ultrasound therapy in the treatment of chronic plantar fasciitis: a randomized controlled trial. J Med Assoc Thai. 2015;98 suppl 1:S49-S56.","journal-title":"J Med Assoc Thai"},{"key":"e_1_3_2_45_2","doi-asserted-by":"publisher","DOI":"10.1007\/s10103-023-03791-5"},{"key":"e_1_3_2_46_2","doi-asserted-by":"publisher","DOI":"10.7547\/22-095"},{"key":"e_1_3_2_47_2","doi-asserted-by":"publisher","DOI":"10.1053\/j.jfas.2017.02.013"},{"key":"e_1_3_2_48_2","doi-asserted-by":"publisher","DOI":"10.5606\/tftrd.2019.3528"},{"key":"e_1_3_2_49_2","first-page":"147","article-title":"Comparison of high-intensity laser therapy with extracorporeal shock wave therapy in the treatment of patients with plantar fasciitis: a double-blind randomized clinical trial","volume":"49","author":"Zare Bidoki M","year":"2024","unstructured":"Zare Bidoki M, Vafaeei Nasab MR, Khatibi Aghda A. Comparison of high-intensity laser therapy with extracorporeal shock wave therapy in the treatment of patients with plantar fasciitis: a double-blind randomized clinical trial. Iran J Med Sci. 2024;49:147-155.","journal-title":"Iran J Med Sci"},{"key":"e_1_3_2_50_2","doi-asserted-by":"publisher","DOI":"10.1097\/MD.0000000000012819"},{"key":"e_1_3_2_51_2","doi-asserted-by":"publisher","DOI":"10.1177\/02692155221143865"},{"key":"e_1_3_2_52_2","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2021-059479"},{"key":"e_1_3_2_53_2","doi-asserted-by":"publisher","DOI":"10.1177\/0269215506069244"},{"key":"e_1_3_2_54_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00482-003-0308-9"},{"key":"e_1_3_2_55_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.neuroscience.2008.03.062"},{"key":"e_1_3_2_56_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0304-3940(01)02320-5"},{"key":"e_1_3_2_57_2","doi-asserted-by":"publisher","DOI":"10.1302\/0301-620X.78B2.0780233"},{"key":"e_1_3_2_58_2","doi-asserted-by":"publisher","DOI":"10.1097\/01.blo.0000188064.56091.a7"},{"key":"e_1_3_2_59_2","unstructured":"Mokhtar M Singh P. Neuroanatomy Periaqueductal Gray. StatPearls Publishing; 2025. Accessed August 28 2025. http:\/\/www.ncbi.nlm.nih.gov\/books\/NBK554391\/"},{"key":"e_1_3_2_60_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijsu.2015.08.083"},{"key":"e_1_3_2_61_2","doi-asserted-by":"publisher","DOI":"10.1097\/MD.0000000000019085"},{"key":"e_1_3_2_62_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijsu.2017.08.587"}],"container-title":["Foot &amp; Ankle Specialist"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/19386400261449323","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/19386400261449323","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/19386400261449323","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,14]],"date-time":"2026-06-14T17:05:42Z","timestamp":1781456742000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/19386400261449323"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,6,10]]},"references-count":61,"alternative-id":["10.1177\/19386400261449323"],"URL":"https:\/\/doi.org\/10.1177\/19386400261449323","relation":{},"ISSN":["1938-6400","1938-7636"],"issn-type":[{"value":"1938-6400","type":"print"},{"value":"1938-7636","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,6,10]]},"article-number":"19386400261449323"}}