The effect of continuous ultrasound on chronic low back pain: protocol of a randomized controlled trial (original) (raw)
Related papers
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.
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 ...
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)
The aim of this study was to investigate the effect of continuous ultrasound (US) plus exercise on the endurance of paravertebral muscles of patients with chronic non specific low back pain (CNSLBP). METHODS AND MATERIALS: In this pilot, pretest-posttest study, 22 patients with CNSLBP participated. Patients received 10 sessions of treatment, including continuous US plus exercise therapy, over a period of four consecutive weeks. Median frequency slopes of Iliocostalis and Multifidus muscles as well as holding time during Biering-Sorensen test were measured using surface electromyography. In addition, function and pain were measured using Functional Rating Index (FRI) questionnaire and VAS. RESULTS: Five females and 15 males with a mean age of 31.7 years completed the treatment. Descriptive data showed a decrease of 0.01 and 0.02 mean in median frequency slope of right and left Iliocostalis respectively and a mean of 0.08 decrease for both right and left Multifidus muscles. Endurance time increased 1.8 seconds mean. Both function (17%) and pain (24%) improved post treatment. CONCLUSION: Larger population studies in the context of high quality, randomized clinical trial are needed to validate the results.
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
Application of rehabilitative ultrasound in the assessment of low back pain: A literature review
Journal of Bodywork and Movement Therapies, 2011
Low back pain (LBP) is one of the most common work-related conditions affecting all populations both in industrialized and non-industrialized countries, with reported high prevalence and incidence rates and huge direct and indirect costs. Among various suggested causes of LBP, dysfunction of back muscles, particularly lumbar multifidus and transverse abdominis, has been the subject of considerable research during last decades. Of the available imaging techniques, ultrasound (US) imaging technique is increasingly used to assess muscle dimensions and function as a valid, reliable and non-invasive approach. The purpose of the present study was to review the previously published studies (1990e2009) concerning the merit of US imaging of lumbar and abdominal muscles with particular attention to its clinical application in patients with LBP. Studies showed wide variation in terms of methodology, sample size, procedure, definition of LBP, heterogeneous sample, method of analyzing US imaging, US imaging parameters, etc. However, a convincing body of evidence was identified that supports US imaging as a reliable and valid tool both to differentiate patients with LBP from normal subjects and to monitor the effect of rehabilitation programs. ª
A randomised controlled trial of ‘clockwise’ ultrasound for low back pain
South African Journal of Physiotherapy, 2016
Aims: To examine how the choice of words explaining ultrasound (US) may influence the outcome of physiotherapy treatment for low back pain (LBP).Methods: Sixty-seven patients with LBP < 3 months were randomly allocated to one of three groups – traditional education about US (control group [CG]), inflated education about US (experimental group [EG]) or extra-inflated education about US (extra-experimental group [EEG]). Each patient received the exact same application of US that has shown clinical efficacy for LBP (1.5 Watts/cm2 for 10 minutes at 1 Megahertz, pulsed 20% over a 20 cm2 area), but received different explanations (CG, EG or EEG). Before and immediately after US,measurements of LBP and leg pain (numeric rating scale), lumbar flexion (distance to floor) and straight leg raise (SLR) (inclinometer) were taken. Statistical analysis consisted of mixed-factorial analyses of variance and chi-square analyses to measure differences between the three groups, as well as meeting or...