On average, automatically created plans are superior to manually created treatment plans. For particular plans, experienced physicists were able to perform better than scripts or AP; thus, the benefit is greatest when time is short or staff inexperienced.
Immediate und serielle Wirkungen auf die Druckschmerzschwelle Ultrasound therapy of epicondylopathia humeri -immediate and serial treatment effects on the pressure pain threshold: Ultrasound has been used since decades for the treatment of painful musculoskeletal disorders, with high doses up to 3W/cm2. Since the 8Oies a tendency to low dose treatment (0.1 -1 W/cm2) can be observed. In the same period a growing number of investigations and reviews with negative resuits were published, which severely throw doubt on the therapeutical effectiveness of therapeutical ultrasound. Objective: Objective of this study were informations concerning immediate-, serial-and intensity dependent effects of ultrasound therapy. Being a classical indication for ultrasound therapy, the epicondylitis (,,tennis elbow") has been chosen as a model disorder. Methods: 30 patients with chronical epicondylitis (21, 9 m) were randomly assigned to 3 treatment groups. Each patient received a 6 mm treatment on 5 consecutive days. The low dose group received 0.3W/cm2; the placebo group 0W/cm2. Both groups were double blinded. The high dose group was treated by individual doses, causing a painless sensation of heat (mean: 1.2 W/cm2). This group therefore was not blinded. For measurement of the pressure pain threshold (PPT) an automatic device has been established, which developed a linear increasing force (1 kp/s) until the beginning of a painful sensation. The PPT was measured before, and a mm, 5 mm and 10 mm after treatment. A follow-up took place 5 days after the last treatment (day 10), combined with a visual analogue scale (VAS) measurement. Results: Immediat effects: Only the high dose therapy lead to a short PPT increase compared to initial values (÷ 0.28 kp; p = 0.03), but not compared to control. Serial effects: Only high dose therapy showed an increase of PPT. This effect, however, was only at follow-up (day 10) of statistical and clinical significance (+ 0.73 kp; p = 0.015). A similar result showed the VAS pain rating score (-34%; p = 0.002). Conclusions: The results lead to the conclusion, that ultrasound has no immediate analgesic effects of clinical relevance. However, serial high dose ultrasound treatment reveals a remarkable pain reduction within some days of delay, maybe due to a curative heat stimulus. Consequences, as well for practical treatment as for design and evaluation of studies, should be taken. Investigations with rather low dose treatment and/or without follow up control maybe respon-Phys sible for some negative judgements of ultrasound therapy effectiveness in the recent literature.Zusammenfassung: Während Ultraschall jahrzehntelang mit lntensitäten bis zu 3W/cm2 zur Behandlung muskuloskelettaler Schmerzen angewendet wurde, ist seit den 8Oer jahren eine Tendenz zu wesentlich niedrigeren Dosierungen (ca. 0,1 -1 W/ cm2) zu beobachten. Parallel hierzu mehren sich Untersuchungen und Reviews mit negativen Ergebnissen, weiche den therapeutischen Nutzen von Ultraschall zunehmend in Zweifel ziehen. Ziel: Ziel der Arbeit war d...
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.