Background and Purpose. Therapeutic ultrasound is one of the most widely and frequently used electrophysical agents. Despite over 60 years of clinical use, the effectiveness of ultrasound for treating people with pain, musculoskeletal injuries, and soft tissue lesions remains questionable. This article presents a systematic review of randomized controlled trials (RCTs) in which ultrasound was used to treat people with those conditions. Each trial was designed to investigate the contributions of active and placebo ultrasound to the patient outcomes measured. Depending on the condition, ultrasound (active and placebo) was used alone or in conjunction with other interventions in a manner designed to identify its contribution and distinguish it from those of other interventions.
Methods. Thirty-five English-language RCTs were published between 1975 and 1999. Each RCT identified was scrutinized for patient outcomes and methodological adequacy. Results. Ten of the 35 RCTs were judged to have acceptable methods using criteria based on those developed by Sackett et al. Of these RCTs, the results of 2 trials suggest that therapeutic ultrasound is more effective in treating some clinical problems (carpal tunnel syndrome and calcific tendinitis of the shoulder) than placebo ultrasound, and the results of 8 trials suggest that it is not.
Discussion and Conclusion. There was little evidence that active therapeutic ultrasound is more effective than placebo ultrasound for treating people with pain or a range of musculoskeletal injuries or for promoting soft tissue healing. The few studies deemed to have adequate methods examined a wide range of patient problems. The dosages used in these studies varied considerably, often for no discernable reason. [Robertson VJ, Baker KG. A review of therapeutic ultrasound: effectiveness studies.
VJ Robertson, PT, PhD, is Associate Professor, School of Physiotherapy, La Trobe University, Bundoora, Victoria 3086, Australia (V.Robertson@latrobe.edu.au). She was Visiting Professor, Division of Physical Therapy, University of Miami, Miami, Fla, when this article was written. Address all correspondence to Dr Robertson.
KG Baker, PT, PhD, is Senior Lecturer, Department of Health Science, Faculty of Health, Science, and Technology, UNITEC, Auckland, New Zealand. He was Lecturer, School of Physiotherapy, Faculty of Health Sciences, University of Sydney, when this article was written.
Both authors provided concept/project design, writing, and data collection and analysis. Dr Robertson provided project management and consultation (including review of manuscript before submission).
This article, was submitted February 18, 2000, and was accepted March 5, 2001.