A randomised controlled trial of ‘clockwise’ ultrasound for low back pain (original) (raw)
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BMC Musculoskeletal Disorders, 2011
Background: Chronic non-specific low-back pain (LBP) is one of the most common and expensive musculoskeletal disorders in industrialized countries. Similar to other countries in the world, LBP is a common health and socioeconomic problem in Iran. One of the most widely used modalities in the field of physiotherapy for treating LBP is therapeutic ultrasound. Despite its common use, there is still inconclusive evidence to support its effectiveness in this group of patients. This randomised trial will evaluate the effectiveness of continuous ultrasound in addition to exercise therapy in patients with chronic LBP. Methods and design: A total of 46 patients, between the ages 18 and 65 years old who have had LBP for more than three months will be recruited from university hospitals. Participants will be randomized to receive continuous ultrasound plus exercise therapy or placebo ultrasound plus exercise therapy. These groups will be treated for 10 sessions during a period of 4 weeks. Primary outcome measures will be functional disability and pain intensity. Lumbar flexion and extension range of motion, as well as changes in electromyography muscle fatigue indices, will be measured as secondary outcomes. All outcome measures will be measured at baseline, after completion of the treatment sessions, and after one month.
Therapeutic ultrasound for chronic low‐back pain
2011
Background Chronic non-specific low-back pain (LBP) has become one of the main causes of disability in the adult population around the world. Therapeutic ultrasound is frequently used by physiotherapists in the treatment of LBP and is one of the most widely used electrophysical agents in clinical practice. Objectives The objective of this review is to determine the effectiveness of therapeutic ultrasound in the management of chronic non-specific LBP. Search methods Electronic searches were performed using CENTRAL, MEDLINE, EMBASE, PEDro, and PsycLIT databases in October 2013. Reference lists of eligible studies and relevant systematic reviews were checked and forward citation searching was also performed. Selection criteria Randomised controlled trials on therapeutic ultrasound for non-specific chronic LBP were included. Data collection and analysis Two review authors independently assessed the risk of bias of each trial and extracted the data. When sufficient clinical and statistical homogeneity existed, a meta-analysis was performed. The quality of the evidence for each comparison was determined using the GRADE approach. Therapeutic ultrasound for chronic low-back pain (Review)
Effect of Ultrasound Therapy in the management of Chronic Nonspecific Low Back Pain
Journal of National Institute of Neurosciences Bangladesh, 2022
Background: Chronic non-specific low-back pain (NSLBP) has become one of the main causes of disability in the adult population around the world. Therapeutic ultrasound is frequently used by physiatrists in the treatment of LBP and is one of the most widely used electro-physical agents in clinical practice. Objective: To see the effects of ultrasound therapy (UST) in the patients with chronic nonspecific low back pain. Methodology: This randomized control trial was performed in the Department of Physical Medicine & Rehabilitation of Dhaka Medical College Hospital during the period from December 2014 to May 2015. Patients presented with chronic nonspecific LBP in an age between 18 and 55 years of both sexes attending in the Department of Physical Medicine & Rehabilitation at Dhaka Medical College Hospital, Dhaka were included as study population. A total of 80 patients presented with chronic nonspecific LBP who had fulfilled the selection criteria were taken as study population. They ...
2012
Background: Non-specific chronic low back pain (NSCLBP) is one of the most common musculoskeletal disorders around the world including Iran. One of the most widely used modalities in the field of physiotherapy is therapeutic ultrasound (US). Despite its common use, there is still inconclusive evidence to support its effectiveness in patients with NSCLBP. The objective of this study was to evaluate the effect of continuous US compared with placebo US additional to exercise therapy for patients with NSCLBP. Methods: In this single blind placebo controlled study, 50 patients with NSCLBP were randomized into two treatment groups: 1) continuous US (1 MHz &1.5 W/cm 2) plus exercise 2) placebo US plus exercise. Patients received treatments for 4 weeks, 10 treatment sessions, 3 times per week, every other day. Treatment effects were assessed in terms of primary outcome measures: 1) functional disability, measured by Functional Rating Index, and 2) global pain, measured by a visual analog scale. Secondary outcome measures were lumbar flexion and extension range of motion (ROM), endurance time and rate of decline in median frequency of electromyography spectrum during a Biering Sorensen test. All outcome variables were measured before, after treatment, and after one-month follow-up. An intention to treat analysis was performed. Main effects of Time and Group as well as their interaction effect on outcome measures were investigated using repeated measure ANOVA. Results: Analysis showed that both groups had improved regarding function (FRI) and global pain (VAS) (P < .001). Lumbar ROM as well as holding time during the Sorensen test and median frequency slope of all measured paravertebral muscles did not change significantly in either group (P > .05). Improvement in function and lumbar ROM as well as endurance time were significantly greater in the group receiving continuous US (P < .05). Conclusions: The study showed that adding continuous US to a semi supervised exercise program significantly improved function, lumbar ROM and endurance time. Further studies including a third group of only exercise and no US can establish the possible effects of placebo US.
Turkish Journal of Rheumatology, 2010
Bu çalışmanın amacı, kronik bel ağrısı (KBA) olan hastalarda tedavide kullanılan ultrasonun (US) ağrı, fonksiyon, yaşam kalitesi ve depresyona olan etkisini değerlendirmektir. Yöntem ve Gereçler: KBA'sı olan 42 hasta rastgele iki gruba dağıtıldı. Grup 1 sıcak paket, US ve egzersiz tedavisi aldı, grup 2 kontrol grubu olarak kabul edildi (sıcak paket, plasebo US ve egzersiz tedavisi). Bütün tedaviler (US, plasebo US, sıcak paket ve egzersiz) 3 hafta süreyle haftada 5 gün uygulandı. Hastaların ağrısı visual analog skala (VAS), disabilitesi Düzeltilmiş Oswestry Özürlülük Sorgulama formu (DOÖS) ve Ağrı Özürlülük İndeksi (AÖİ), fonksiyonu 6 dakika yürüme testi (6DYT), yaşam kalitesi kısa form-36 (SF-36) ve depresyon Beck Depresyon Ölçeği (BDÖ) ile değerlendirilmiştir. Bulgular: Tedavi sonrasında her iki grupta ağrı, disabilite, yürüme performansı, yaşam kalitesi ve depresyonda çok anlamlı gelişme tespit edildi. İki grup karşılaştırıldığında VAS ağrı, 6DYT, SF-36'nın fiziksel rol ve emosyonel roldeki kısıtlılık parametrelerini içeren alt grupları ve BDÖ değerlerinde grup 1'de grup 2'ye göre daha anlamlı gelişme bulundu. Sonuç: Bu çalışmada tedavide kullanılan US'nin KBA'lı hastalarda ağrıya, yaşam kalitesinin bazı parametrelerine, fonksiyonel performansa ve depresyona etkili olduğunu tespit ettik.
SA Orthopaedic Journal, 2014
BACKGROUND: Acute low back pain (LBP) is a common condition that is encountered by many physicians with varied treatments instituted in its management. Ultrasound physiotherapy is a common modality used in its management, although its effectiveness and its role in management of acute LBP is not well known. METHODS: A randomised controlled trial was conducted to compare the effect of the addition of ultrasound therapy to a defined analgesia protocol in patients presenting with acute LBP at the Aga Khan University Hospital, Nairobi. The main outcomes were reduction in disability and pain which were evaluated using the mean change in Oswestry Disability Index (ODI) and Visual Analogue Scale (VAS) score for pain, respectively. Patients were followed up for a minimum of four weeks with assessment using the ODI and VAS at weekly clinic visits. RESULTS:Seventy-four patients were included in the study. Thirty-six patients were allocated to the analgesia with additional ultrasound group an...
Physiotherapy, 2006
Objectives To assess the short-and long-term effectiveness of spinal manipulation therapy, and to identify the effect of manipulation on lumbar muscle endurance in patients with chronic low back pain (LBP). Design A randomised controlled trial comparing manipulation and exercise treatment with ultrasound and exercise treatment. Setting An outpatient physiotherapy department. Participants One hundred and twenty patients with chronic LBP were allocated at random into the manipulation/exercise group or the ultrasound/exercise group. Interventions Both groups were given a programme of exercises. In addition, one group received spinal manipulation therapy and the other group received therapeutic ultrasound. Main outcome measures Pain intensity, functional disability, lumbar movements and muscle endurance were measured shortly before treatment, at the end of the treatment programme and 6 months after randomisation using surface electromyography. Results Following treatment, the manipulation/exercise group showed a statistically significant improvement (P = 0.001) in pain intensity [mean 16.4 mm, 95% confidence interval (CI) 6.1-26.8], functional disability (mean 8%, 95% CI 2-13) and spinal mobility (flexion: mean 9.4 mm, 95% CI 5.5-13.4; extension: mean 3.4 mm, 95% CI 1.0-5.8). There was no significant difference (P = 0.068) between the two groups in the median frequency of surface electromyography (multifidus: mean 6.8 Hz, 95% CI 1.24-14.91; iliocostalis: mean 2.4 Hz, 95% CI 2.5-7.1), although a significant difference (P = 0.013) was found in the median frequency slope of surface electromyography in favour of spinal manipulation for multifidus alone (mean 0.3, 95% CI 0.1-0.5). A significant difference was also found between the two groups in favour of the manipulation/exercise group at 6-month follow-up. Conclusions Although improvements were recorded in both groups, patients receiving manipulation/exercise showed a greater improvement compared with those receiving ultrasound/exercise at both the end of the treatment period and at 6-month follow-up. (M.A. Mohseni-Bandpei). problems . Sixty to eighty percent of people will suffer at least one episode of LBP sometime in their lives , and 30-40% of these will experience LBP each year . Whilst many recover regardless of the treatment they are given, a minority of patients seem resistant to treatment and develop chronic pain and disability . Chronic LBP, or LBP lasting for more than 3 months , is more difficult to treat and the outcome is less certain. Despite an increasing number of clinical and basic research studies in 0031-9406/$ -see front matter