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Background: Published trials reported that high-energy extracorporeal shock wave therapy (HEEPSWT) can effectively treat early stage femoral head osteonecrosis (ESFHO). However, their results are still inconsistent. Thus, this study will systematically and comprehensively explore the effectiveness and safety of HEEPSWT for ESFHO. Methods: We will retrieve the electronic databases of Cochrane Library, EMBASE, PubMed, Web of Science, Cumulative Index to Nursing and Allied Health Literature, VIP database, and China National Knowledge Infrastructure from inception to the present. All randomized controlled trials that focusing on the effectiveness and safety of HEEPSWT for ESFHO will be considered. Two researchers will undertake literature selection, information collection, and risk of bias evaluation separately. If disagreements occur, we will invite a third researcher for consultation and a final decision will be made. Cochrane risk of bias tool, and Grades of Recommendation, Assessment, Development and Evaluation will be utilized to assess the risk of bias and quality of evidence, respectively. We will perform statistical analysis using RevMan 5.3 software. Results: This study will provide a detailed summary of exist evidence related to the effectiveness and safety of HEEPSWT for ESFHO. Conclusion: The results of this study synthesize the evidence regarding the HEEPSWT for ESFHO, which may help to guide clinical management in the future. Systematic review registration: INPLASY202060055.

Background: Post-stroke shoulder-hand syndrome (PSSHS) is one of the most common sequelae in patients with stroke. Previous studies have reported that extracorporeal shock wave (EPSW) has been used to treat this condition effectively. However, its conclusions are still inconsistent. Therefore, this study will provide evidence to systematically assess the effectiveness and safety of EPSW for the treatment of PSSHS. Methods: We will comprehensively search relevant randomized controlled trials (RCTs) assessing the effectiveness and safety of EPSW for the treatment of PSSHS in the following databases from their start to February 1, 2020 without language and publication date limitations: Cochrane Library, MEDLINE, EMBASE, CINAHL, Web of Science, PsycINFO, Chinese Biomedical Literature Database, and China National Knowledge Infrastructure. For trials that meet all inclusion criteria, 2 researchers will independently extract the data from them and appraise study quality by Cochrane risk of bias. Any differences will be solved by discussion with the help of another researcher. All data will be performed and analyzed using RevMan 5.3 software. Results: We will summarize up-to-date high quality RCTs to evaluate the effectiveness and safety of EPSW for the treatment of PSSHS. Conclusions: This study will provide a comprehensive evidence summary to determine whether EPSW is effective and safety for the treatment of PSSHS or not. PROSPERO registration number: PROSPERO CRD42020175630.

Background: Previous studies have reported that extracorporeal shock wave (EPSW) combined spinal core decompression (SCD) has been used for the treatment of patients with femoral head necrosis (FHN) effectively. However, their results are still inconsistent. Therefore, this study will systematically assess the efficacy and safety of EPSW and SCD for the treatment of patients with FHN. Methods: This study will systematically search the following databases from inception through March 1, 2020: MEDLINE, Web of Science, Scopus, EMBASE, Cochrane Library, Cumulative Index to Nursing and Allied Health Literature, and China National Knowledge Infrastructure. All searches will be performed without language and publication date restrictions. This study will only include randomized controlled trials investigating the efficacy and safety of EPSW and SCD for the treatment of patients with FHN. Two authors will independently assess all literatures, extract data, and appraise risk of bias. Any confusion between 2 authors will be cleared up by a third author through discussion. RevMan 5.3 software will be utilized to analyze the data and to perform a meta-analysis if necessary. Results: This study will summarize up-to-date evidence and provide a detailed summary related to the efficacy and safety of EPSW and SCD for the treatment of patients with FHN. Conclusion: This study may provide helpful evidence to determine whether or not EPSW combined SCD is effective and safety for the treatment of patients with FHN. Systematic review registration: INPLASY202040092.

Background: Previous clinical studies have reported that extracorporeal shock wave (EPSW) monotherapy can effectively treat avascular necrosis of femoral head (ANFH). However, no systematic review has been conducted to assess its effectiveness and safety for patients with ANFH. Therefore, this study will systematically assess the effectiveness and safety of EPSW monotherapy for patients with ANFH. Methods: In this study, the following electronic databases will be searched from their inceptions to the present: Cochrane Library, EMBASE, PUBMED, Cumulative Index to Nursing and Allied Health Literature, China National Knowledge Infrastructure, and Chinese Biomedical Literature Database. This study will include randomized controlled trials for assessing the effectiveness and safety of EPSW monotherapy for patients with ANFH. Two independent authors will perform study selection, data extraction, and methodology assessment. RevMan 5.3 software will be used for statistical analysis. Results: This systematic review will provide latest summary evidence of EPSW monotherapy for patients with ANFH through assessing the outcome measurements. The primary outcome is pain intensity, which can be measured by visual analog scale or relevant measurement tools. The secondary outcomes are functional status of attacked femoral head, as assessed by Western Ontario and McMaster Universities Osteoarthritis Index, or other relevant scales; quality of life, as evaluated by The 36-Item Short Form Health Survey, or related instruments; and adverse events. Conclusion: The results of this study may provide the latest evidence for assessing the effectiveness and safety of EPSW for the treatment of ANFH. Dissemination and ethics: This study does not require ethical approval, because no individual data will be involved in this systematic review. The findings of this study will be published through a peer-reviewed journal. Systematic review registration: PROSPERO CRD42019124665.

Background: Previous clinical trials have reported that extracorporeal shock wave (EPSW) can be used to treat low back pain (LBP), and have achieved satisfied effect. However, its effectiveness is still inconclusive. Thus, this systematic review will aim to assess the effectiveness and safety of EPSW for patients with LBP. Methods: In this systematic review, the electronic databases of Cochrane Central Register of Controlled Trials, EMBASE, PUBMED, Cumulative Index to Nursing and Allied Health Literature, China National Knowledge Infrastructure, Chinese Biomedical Literature Database, Chinese Scientific Journal Database, and Wanfang Data will be searched from inception to January 1, 2019. Randomized controlled trials and case-control studies that assessed the effectiveness and safety of EPSW for LBP will be included. The primary outcome is pain intensity. The secondary outcomes are functional status, quality of life, psychological outcomes, as well as the adverse events. All process of the study selection, data extraction, and methodology evaluation will be carried out by two authors independently. RevMan 5.3 software will be utilized for statistical analysis. Results: This study will provide a detailed summary of latest evidence related to the effectiveness and safety of EPSW in pain relief, improvement of functional status, quality of life, and psychological disorders in patients with LBP. Conclusion: The findings of this study may provide possible guidance for LBP treated by EPSW. Dissemination and ethics: Ethical approval is not required in this study, because it will not collect the original data from individual patient. The results are expected to publish through a peer-reviewed journal. Systematic review registration: PROSPERO CRD42019120501.

This aims to investigate the effect of combined use of radial extracorporeal shock wave therapy (rESWT) and conventional rehabilitation therapy on postoperative rehabilitation of children with spastic cerebral palsy. Children with spastic cerebral palsy 6 weeks after multistage surgery were randomly divided into treatment group (received rESWT and conventional rehabilitation therapy) and control group (received conventional rehabilitation only). Before treatment, 2 weeks and 1 month after treatment, the Gross Motor Function Measure (GMFM), modified Ashworth Scale (MAS) of the hamstrings and triceps, plantar area and plantar pressure were examined for efficacy assessment. A total of 82 children with spastic cerebral palsy were recruited, including 43 children in treatment group and 39 children in control group. There was no significant difference in the age, MAS score, and GMFM score between the 2 groups before treatment. There were statistically significant differences between the 2 groups at 2 weeks and 4 weeks after treatment, including the MAS score, GMFM score, plantar area and plantar pressure (P

Background: Previous clinical studies have reported that extracorporeal shock wave (EPSW) is an effective treatment for patients with tennis elbow (TE). However, no systematic review has assessed its effectiveness and safety for the treatment of TE. Methods: In this systematic review, we will search the potential eligible literature from the following electronic databases: Central, Embase, MEDLINE, CINAHL, and CNKI from inception to the present. All literatures of randomized controlled trials of EPSW for TE will be considered without language restrictions. Two reviewers will independently select the studies, extract the data, and evaluate the methodology quality. All disagreements between those 2 reviewers will be resolved by a third reviewer involved through discussion. Outcome data will be pooled by RevMan 5.3 software if the heterogeneity is reasonable. Reporting bias will also be conducted if more than 10 included studies can be reached. Results: This systematic review will evaluate the clinical effectiveness and safety of EPSW for TE. Conclusion: The findings of this study will summarize the current evidence of EPSW on TE outcomes and may provide guidance for both clinical practice and further studies. Dissemination and ethics: This systematic review does not need ethical approval, because it does not utilize the individual patient data. Its findings are expected to publish in peer-reviewed journals. Systematic review registration: PROSPERO CRD42019119687.

This retrospective study investigated the efficacy and safety of extracorporeal shock wave (EPSW) combined with hyaluronic acid (HA) for patients with knee osteoarthritis (KOA). This retrospective study included 70 patients with KOA. Of those subjects, 35 of them received EPSW combined HA, and were allocated to a treatment group, while the other 35 participants received HA alone and were allocated to a control group. Patients in both groups were treated for a total of 8 weeks. The primary outcome was measured by visual analog scale (VAS). The secondary outcomes were measured by Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), and knee injury and osteoarthritis outcome score (KOOS). In addition, adverse events (AEs) were also evaluated. All outcomes were measured before and after the treatment. After the treatment, patients in the treatment group exhibited better efficacy in VAS (P