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Efficacy of Therapeutic Ultrasound for the Management of Knee Osteoarthritis: A Randomized, Controlled, and Double-Blind Study

Cakir, Serap MD; Hepguler, Simin MD; Ozturk, Cihat MD; Korkmaz, Murat MD; Isleten, Banu MD; Atamaz, Funda Calis MD

American Journal of Physical Medicine & Rehabilitation: May 2014 - Volume 93 - Issue 5 - p 405–412
doi: 10.1097/PHM.0000000000000033
Original Research Articles

Objective The aim of this study was to compare whether the effectiveness of continuous ultrasound (US) was superior against pulsed US and against sham US in knee osteoarthritis.

Design A randomized controlled study was carried out on 60 patients diagnosed with knee osteoarthritis according to American College of Rheumatology. The patients were randomized into the following three treatments: (1) continuous US (at a frequency of 1 MHz with intensity of 1 W/cm2), (2) pulse US (same frequency and intensity on 1:4 pulse ratio), and (3) sham US. All treatments were applied with 5-cm2 head US device five times a week for 2 weeks in addition to home exercise program including quadriceps isometric exercise, muscle strength exercises, and stretching exercises of the lower extremity muscles for at least three times per week. Assessments were performed at baseline, at the end of the treatment, and at the end of the treatments and at the sixth month using the following measurements: Western Ontario and McMaster University Osteoarthritis Index–pain, stiffness, function, visual analog scale–pain at rest, visual analog scale–pain on movement, visual analog scale–disease severity, and 20-m walking time. Among these parameters, the Western Ontario and McMaster University Osteoarthritis Index–pain was the primary outcome.

Results All groups showed a significant improvement in all parameters in both following visits (P < 0.05). However, there was no significant difference between the groups. Although the mean reduction percent in Western Ontario and McMaster University Osteoarthritis Index–pain was significantly higher in group I (continuous US) when compared to sham group (46.5% vs 28.9%, P < 0.05) at the end of the treatment, this result was not found in other pain parameters.

Conclusions The present study demonstrated that all assessment parameters significantly improved in all groups without a significant difference. This result suggested that therapeutic US provided no additional benefit in improving pain and functions in addition to exercise training.

From the Department of Physical Medicine and Rehabilitation, Medical Faculty of Ege University, Izmir, Turkey.

All correspondence and requests for reprints should be addressed to: Funda Calis Atamaz, MD, Ege Universitesi Tip Fakultesi, Fiziksel Tıp ve Rehabilitasyon Anabilim Dali, Bornova, Izmir 35040, Turkey.

Equipment and financial support were provided by Ege University for this project.

Financial disclosure statements have been obtained, and no conflicts of interest have been reported by the authors or by any individuals in control of the content of this article.

© 2014 by Lippincott Williams & Wilkins