Better research needed on the use of shockwave therapy in animals – review
Only weak scientific evidence exists for the favorable effects of extracorporeal shock wave therapy in conditions affecting bones, ligaments, tendons and muscles in horses and dogs, according to the authors of a review just released. to be published.
The researchers found that more and better research is needed to better understand the potential benefits of the technique in animals.
Shockwave therapy is increasingly being used to treat musculoskeletal disorders in animals and humans, Anna Boström and her colleagues noted in the journal. Animals.
During the treatment, shock waves are delivered to the tissues by an applicator directly applied to the affected area. There are several variations, including focused and radial shockwaves and high energy treatments, as well as low energy treatments.
The technique was originally developed to dissolve urinary tract stones in humans. Early in this development, it was noted that the treatment seemed to increase the density of nearby bones.
This then led to the use of shockwave therapy in an increasing variety of musculoskeletal problems.
“Veterinarians as well as complementary and alternative practitioners who treat animals are now using this technique to treat, for example, horses with tendon and ligament injuries, spinal problems and arthritis,” noted the review team.
The mechanism of action is not completely known, however, and the scientific evidence of any benefit in animals has been questioned.
The researchers performed a systematic review of published studies on the use of shockwave therapy in veterinary medicine for horses, dogs, and cats, with an emphasis on effects on clinical outcomes.
They searched for relevant articles published from 1980 to 2020 in three major databases, identifying 27 relevant articles on the effects of shockwave therapy in horses, nine in dogs, but none in cats.
“The review found that there is only weak scientific evidence for favorable effects on conditions affecting the bones, ligaments, tendons and muscles of horses and dogs,” they said.
“The reasons for the weak scientific evidence were that the studies were few, most involved only a small number of animals, many had methodological problems or, when favorable results were reported, they were not reported. reproduced in independent studies.
Few articles at low risk of bias were identified, they said.
For a few issues, including short-term pain relief, ligament conditions and osteoarthritis, some results look promising, they said, warranting further exploration in high-quality studies.
Overall, the scientific evidence for the clinical effects of shockwave therapy in horses, dogs and cats is limited, they said, with significant gaps in scientific knowledge.
Discussing their findings, the review team said there are likely several reasons why high-quality studies of shockwave therapy have rarely been done in sporting and companion animals.
“A possible explanation is that extracorporeal shock wave therapy is already accepted as an effective treatment method in veterinary medicine based on clinical experiences and reported positive effects.
“Furthermore, assessment of the design of many of the studies covered by our review indicates that there is limited experience on how to conduct research of sufficient quality to justify acceptance or rejection of the therapy by the community of research and veterinary practice.”
They said a limitation for drawing conclusions about the treatment effects of the technique in sport and companion animals is the many differences in the studies reviewed regarding study design, use of controls, statistical power, outcome measures and follow-up time.
“The large share of low-quality studies with a high risk of bias is problematic but in itself provides a basis for the overall assessment of the current strength of scientific evidence.”
The authors stated that the large proportion of studies at high risk of bias underscores the need for higher quality research using accurate methodologies to assess the potential therapeutic effects of shockwave therapy.
The review team included Boström and Heli Hyytiäinen, from the Department of Equine and Small Animal Medicine, part of the Faculty of Veterinary Medicine at the University of Helsinki in Finland; Anna Bergh, from the Department of Clinical Sciences, part of the Swedish University of Agricultural Sciences; and Kjell Asplund, from the Department of Public Health and Clinical Medicine at Umeå University, also in Sweden.
Bostrom, A.; Bergh, A.; Hyytiäinen, H.; Asplund, K. Systematic review of complementary and alternative veterinary medicine in sporting and companion animals: extracorporeal shock wave therapy. Animals 2022, 12, 3124. https://doi.org/10.3390/ani12223124
The review, published under a Creative Commons Licensecan be read here.