International Experts Establish Guidelines for Shockwave Therapy in Sports Medicine
Global panel of 41 experts reaches consensus on best practices for extracorporeal shockwave therapy to treat sports injuries and tendinopathies.
Summary
An international panel of 41 experts from 13 countries developed consensus recommendations for extracorporeal shockwave therapy (ESWT) in sports medicine. Using a three-round Delphi process, they achieved agreement on 69 of 118 statements covering terminology, treatment protocols, contraindications, and side effects. The panel supported ESWT for tendinopathies and bone pathologies, though some procedural aspects for bone injuries lacked consensus. These evidence-based guidelines aim to standardize ESWT practice and improve treatment outcomes for musculoskeletal sports injuries.
Detailed Summary
Extracorporeal shockwave therapy (ESWT) shows promise for treating sports injuries, but inconsistent protocols have limited its effectiveness. This international study aimed to establish standardized guidelines through expert consensus.
Researchers conducted a three-round modified Delphi study with 41 clinical and research experts from 13 countries. The panel included sports medicine physicians, orthopedic surgeons, and rehabilitation specialists with extensive ESWT experience. Participants evaluated 118 statements covering terminology, treatment indications, procedural protocols, contraindications, and side effects.
The experts reached consensus (≥75% agreement) on 69 statements (58.5%), establishing recommendations for ESWT terminology, treatment protocols for tendinopathies and bone pathologies, imaging correlations, and safety considerations. However, 49 statements failed to reach consensus, with 17 specifically related to bone pathology procedures.
These guidelines provide the first international consensus on ESWT best practices for sports medicine. The recommendations support using ESWT for tendinopathies and certain bone injuries while establishing standardized terminology and safety protocols. This could improve treatment consistency and outcomes across different clinical settings.
Limitations include the lack of consensus on bone pathology protocols and the expert opinion-based nature of recommendations. Future research should focus on developing evidence-based protocols for bone injuries and validating these consensus recommendations through clinical trials.
Key Findings
- International experts achieved 75% consensus on 69 of 118 ESWT practice statements
- Panel supported ESWT use for tendinopathies and bone pathologies in sports medicine
- Standardized terminology and safety protocols were established across 13 countries
- Bone pathology treatment protocols showed least consensus among experts
- Guidelines aim to reduce treatment variability and improve clinical outcomes
Methodology
Three-round modified Delphi study with 41 international experts from 13 countries. Consensus defined as ≥75% agreement on statements covering ESWT terminology, protocols, contraindications, and safety considerations.
Study Limitations
Study relies on expert opinion rather than clinical trial data. Significant disagreement persists on bone pathology protocols, with only 58.5% of statements reaching consensus. Guidelines require validation through prospective clinical studies.
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