{
  "abstract": "Objectives While extracorporeal shockwave therapy (ESWT) may be an efficacious adjunctive treatment option for musculoskeletal injuries, current research is limited by significant heterogeneity within treatment protocols. This study aims to establish international expert consensus recommendations on ESWT terminology, parameters, procedural considerations, contraindications and side effects in the application of ESWT to sports injuries.Methods A systematic literature search was performed on the use of ESWT for musculoskeletal and sports medicine injuries to identify potential panellists, followed by the development of a steering committee-led questionnaire. A three-stage, modified Delphi questionnaire was provided to a panel of 41 international clinical and research experts across 13 countries. Panellists had the opportunity to suggest edits to existing statements or recommend additional statements in Round 1. Consensus was defined as≥75% agreement.Results All 41 panellists completed Rounds 1, 2 and 3. Consensus was reached on 69/118 statements (58.5%), including recommendations on terminology and fundamental concepts, indications for use, procedural aspects for tendinopathy and bone pathologies, treatment correlations with imaging, periprocedural and postprocedural considerations, absolute and relative contraindications and potential side effects. Of the 49 statements that did not reach consensus, 17/49 (34.7%) were related to procedural aspects of bone pathology.Conclusion This international panel presents recommendations on ESWT terminology, indications and treatment considerations to guide ESWT use and decision-making by sports medicine clinicians. While our panel supported the use of ESWT in the treatment of bone pathologies, certain procedural aspects of ESWT specific to these injuries did not reach consensus and require further investigation.",
  "authors": [
    {
      "affiliations": [
        "Department of Physical Medicine and Rehabilitation, Harvard Medical School/Spaulding Rehabilitation Hospital, Boston, Massachusetts, USA"
      ],
      "name": "Hye Chang Rhim"
    },
    {
      "affiliations": [
        "Department of Rehabilitation and Regenerative Medicine, Columbia University Vagelos College of Physicians and Surgeons, New York, New York, USA"
      ],
      "name": "Mani Singh"
    },
    {
      "affiliations": [
        "Department of Trauma and Orthopaedic Surgery, Sapienza University of Rome, Faculty of Medicine and Psychology, Sant'Andrea Hospital, Rome, Italy"
      ],
      "name": "Nicola Maffulli"
    },
    {
      "affiliations": [
        "Bay Area Surgical Specialists, Palo Alto, California, USA"
      ],
      "name": "Amol Saxena"
    },
    {
      "affiliations": [
        "Bosque University Medical School, Bogota, Colombia"
      ],
      "name": "Carlos Leal"
    },
    {
      "affiliations": [
        "Technical University Munich, Munchen, Germany"
      ],
      "name": "Ludger Gerdesmeyer"
    },
    {
      "affiliations": [
        "Department of Orthopaedic Surgery and Biomedical Engineering, Campbell Clinic/University of Tennessee College of Medicine, Memphis, Tennessee, USA"
      ],
      "name": "Kristina Quirolgico"
    },
    {
      "affiliations": [
        "WellSpan Orthopedics, Lewisburg PA, Pennsylvania, USA"
      ],
      "name": "John P Furia"
    },
    {
      "affiliations": [
        "Gelderse Vallei Hospital and Center for Human Movement Sciences, University Medical Centre Groningen, Groningen, The Netherlands"
      ],
      "name": "Johannes Zwerver"
    },
    {
      "affiliations": [
        "College of Nursing, Taipei Medical University, Taipei, Taiwan"
      ],
      "name": "Chun-De Liao"
    },
    {
      "affiliations": [
        "Department of Orthopedics, Buenos Aires British Hospital, Buenos Aires, Argentina"
      ],
      "name": "Daniel Moya"
    },
    {
      "affiliations": [
        "Department of Physical Medicine and Rehabilitation, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan"
      ],
      "name": "Shih-Wei Huang"
    },
    {
      "affiliations": [
        "Department of Physical Medicine and Rehabilitation, Harvard Medical School/Spaulding Rehabilitation Hospital, Boston, Massachusetts, USA"
      ],
      "name": "David M Robinson"
    },
    {
      "affiliations": [
        "Department of Physical Medicine and Rehabilitation, Harvard Medical School/Spaulding Rehabilitation Hospital, Boston, Massachusetts, USA"
      ],
      "name": "Johnny Jarnagin"
    },
    {
      "affiliations": [
        "Department of Physical Medicine and Rehabilitation, Harvard Medical School/Spaulding Rehabilitation Hospital, Boston, Massachusetts, USA"
      ],
      "name": "Joseph Ruiz"
    },
    {
      "affiliations": [
        "Department of Orthopedics, Corewell Health, Grand Rapids, Michigan, USA"
      ],
      "name": "Kayle E Noble-Taylor"
    },
    {
      "affiliations": [
        "Advanced Medical Centre, Riyadh, Saudi Arabia"
      ],
      "name": "Hazem Alkhawashki"
    },
    {
      "affiliations": [
        "Stanford University School of Medicine, Stanford, California, USA"
      ],
      "name": "Brice W Blatz"
    },
    {
      "affiliations": [
        "Department of Physical Medicine and Rehabilitation, Harvard Medical School/Spaulding Rehabilitation Hospital, Boston, Massachusetts, USA"
      ],
      "name": "Joanne Borg-Stein"
    },
    {
      "affiliations": [
        "NYU Langone Health, New York, New York, USA"
      ],
      "name": "Lauren Borowski"
    },
    {
      "affiliations": [
        "New Jersey Regenerative Institute, Parsippany, New Jersey, USA"
      ],
      "name": "Jay Bowen"
    },
    {
      "affiliations": [
        "The Running Institute, Chicago, Illinois, USA"
      ],
      "name": "Michael Chin"
    },
    {
      "affiliations": [
        "Orangetown Podiatry, Orangeburg, New York, USA"
      ],
      "name": "Robert M Conenello"
    },
    {
      "affiliations": [
        "Division of Physical Medicine and Rehabilitation, Stanford University School of Medicine, Stanford, California, USA"
      ],
      "name": "Michael Fredericson"
    },
    {
      "affiliations": [
        "Elite Sports Podiatry, Clearwater, Florida, USA"
      ],
      "name": "Brian W Fullem"
    },
    {
      "affiliations": [
        "Department of Physical Therapy, University of Delaware, Newark, Delaware, USA"
      ],
      "name": "Karin Gravare Silbernagel"
    },
    {
      "affiliations": [
        "Institute of Interdisciplinary Exercise Science and Sports Medicine, MSH Medical School Hamburg, Hamburg, Germany"
      ],
      "name": "Karsten Hollander"
    },
    {
      "affiliations": [
        "Department of Physical Medicine and Rehabilitation, Mayo Clinic, Minneapolis, Minnesota, USA"
      ],
      "name": "Elena J Jelsing"
    },
    {
      "affiliations": [
        "Twin Cities Orthopedics, Minneapolis, Minnesota, USA"
      ],
      "name": "Paul Langer"
    },
    {
      "affiliations": [
        "Emory Orthopedics and Spine Center, Atlanta, Georgia, USA"
      ],
      "name": "Kenneth Mautner"
    },
    {
      "affiliations": [
        "Department of Physical Medicine and Rehabilitation, University of Colorado School of Medicine, Aurora, Colorado, USA"
      ],
      "name": "Adele Meron"
    },
    {
      "affiliations": [
        "Atlantic Health System, Morristown, New Jersey, USA"
      ],
      "name": "Robert Monaco"
    },
    {
      "affiliations": [
        "Dartmouth College Geisel School of Medicine, Hanover, New Hampshire, USA"
      ],
      "name": "Rowan V Paul"
    },
    {
      "affiliations": [
        "University of Virginia, Charlottesville, Virginia, USA"
      ],
      "name": "Sara Raiser"
    },
    {
      "affiliations": [
        "Menlo Medical Clinic, Menlo Park, California, USA"
      ],
      "name": "James W Ratcliff"
    },
    {
      "affiliations": [
        "The Orthohealing Center, Los Angeles, California, USA"
      ],
      "name": "Steven Sampson"
    },
    {
      "affiliations": [
        "Ludwig Boltzmann Institute for Traumatology, Vienna, Austria"
      ],
      "name": "Wolfgang Schaden"
    },
    {
      "affiliations": [
        "Atlanta Sports Podiatry, Atlanta, Georgia, USA"
      ],
      "name": "Jay Spector"
    },
    {
      "affiliations": [
        "Department of Orthopedic Surgery, Beijing United Family Hospital, Beijing, Beijing, China"
      ],
      "name": "Wei Sun"
    },
    {
      "affiliations": [
        "Department of Physical Medicine and Rehabilitation, Columbia University Vagelos College of Physicians and Surgeons, New York, New York, USA"
      ],
      "name": "Isaac P Syrop"
    },
    {
      "affiliations": [
        "Sports Medicine and Joint Center, Funabashi Orthopaedic Hospital, Funabashi, Japan"
      ],
      "name": "Kenji Takahashi"
    },
    {
      "affiliations": [
        "Singapore Sport and Exercise Medicine Centre, Singapore"
      ],
      "name": "Benedict Tan"
    },
    {
      "affiliations": [
        "Hospital for Special Surgery, New York, New York, USA"
      ],
      "name": "James F Wyss"
    },
    {
      "affiliations": [
        "Israel Shockwave Center, Petach Tikva, Israel"
      ],
      "name": "Dan Zin"
    },
    {
      "affiliations": [
        "Department of Rehabilitation Medicine, Weill Cornell Medicine, New York, New York, USA"
      ],
      "name": "Jennifer Soo Hoo"
    },
    {
      "affiliations": [
        "Department of Physical Medicine and Rehabilitation, Harvard Medical School/Spaulding Rehabilitation Hospital, Boston, Massachusetts, USA"
      ],
      "name": "Adam S Tenforde"
    }
  ],
  "title": "Recommendations for use of extracorporeal shockwave therapy in sports medicine: an international modified Delphi study",
  "uid": "63951bd2-02a8-5cfb-95ec-27da8f1922e0"
}