## 3 Results
### Methodological Quality  
Methodological quality was assessed using the AMSTAR2 criteria [27]. Two reviewers independently valued the articles included. Discrepancies within the evaluation of single items were resolved through discussion. The kappa score for the evaluation of the interrater reliability was 0.74, with a substantial agreement between reviewers. The quality varied between the studies from critically low (14 studies out of 16, 87.5%) to low (2 studies, 12.5%), as we can see in Table 2. Methodological weaknesses in several studies often referred to three critical domains: Q2, Q7 and Q15. A total of nine studies [20; 21; 28; 29; 30; 35; 36; 38] compared the efficacy of the ESWT treatment with placebo, three studies [32; 33; 34] compared ESWT with another therapy (two studies compared ESWT and corticosteroids, one study ESWT and ultrasound therapy), and four studies [11; 14; 37; 39] had more than one comparison. In their systematic review and network meta-analysis, [PERSON], [PERSON] et al. [20] compared the effectiveness of FSW of different intensity levels and RSW in 1431 patients suffering from plantar fascitis for at least 3 months. They included in their study 12 randomized clinical trials (RCTs) and performed a pairwise and network meta-analysis on the success rate of intervention and reduction in pain scales at 6 months. In both the outcomes in the study, pairwise comparisons highlighted that medium- and high-intensity FSW therapies had greater success; in the network meta-analysis, RSW had the highest effectiveness versus placebo, followed by low-, medium- and high-intensity FSW. They also investigated the relationship between intensity levels of FSW and the outcomes and found that the success of treatment was not related to intensity, though pain reduction might be dose dependent. Their conclusion is that RSW is an appropriate treatment for plantar fascitis; if FSW has to be used, the highest and mostly tolerable energy efflux density without anesthesia in the range of medium intensity is the preferable option. [PERSON], [PERSON] et al. [29] performed a meta-analysis comparing ESWT and placebo in patients diagnosed with PF with a 6 months or longer duration of pain. The treatment with ESWT had different intensities, from low (<0.1 mJ/mm\({}^{2}\)) to moderate (0.1-0.2 mJ/mm\({}^{2}\)) and high (>0.2 mJ/mm\({}^{2}\)). The outcomes of the study, assessed at 12 weeks after intervention, were the visual analogue scale (VAS), pain (during the first steps in the morning and during activity) and improvement in functional outcome using the Roles and Maudsley score. \begin{table}
\begin{tabular}{c c c c c c} \hline
**Study** & **Participants** & **Outcome** & **Intervention/Control** & **Results** & **Conclusions** \\ \hline \multirow{8}{*}{[PERSON], [PERSON] et al., 2019 [38]} & & & ESWT divided & & \\  & & & into three & & \\  & & & intensity levels: & & \\  & & & low & & \\  & & & (EFD \textless{} 0.1\text{m}/\text{mm}^{2}\); & & \\  & & & medium & & \\  & & & (0.1–0.2 mJ/mm\({}^{2}\)); & & \\  & & & high & & \\  & & & (\(\geq\)0.2 mJ/mm\({}^{2}\)). & & \\  & & & Distinction & & \\  & & & between RSW & & \\  & & & and FSW & & \\ \hline \end{tabular} Legenda: CS—corticosteroids; AOFAS—American Orthopedic Foot and Ankle Society; EFD—energy flux density; FFL—Foot Functional Index; OR—odds ratio; PFPS—plantar fascitis pain and disability scale; RM score—Roles and Maudsley score; VAS—visual analogue scale.  
\end{table} 
Table 1: _Cont._The study involved 1287 patients and concluded that moderate- and high-intensity ESWT treatments are effective in reducing pain and improving function in patients with chronic plantar fascitis. [PERSON], [PERSON] et al. [30] in their meta-analysis compared the effectiveness of ESWT treatment with placebo on patients suffering from PF for a minimum of 3 months.