Efficacy of Pulsed and Continuous Therapeutic Ultrasound in Myofascial Pain Syndrome

Ilter, Leman; Dilek, Banu; Batmaz, İbrahim; Ulu, Mehmet Ali; Sarıyıldız, Mustafa Akif; Nas, Kemal; Çevik, Remzi

doi:10.1097/phm.0000000000000210

Cited by 46 publications

(29 citation statements)

References 11 publications

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“…The 10 studies were fully analyzed, approved by both reviewers, and the data were extracted. In the end, eight studies11,13,19–23,25 were enrolled in quantitative synthesis because the other two studies12,24 did not provide data of effect size.…”

Section: Resultsmentioning

confidence: 99%

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Effectiveness of ultrasound therapy for myofascial pain syndrome: a systematic review and meta-analysis

Xia

Wang

Lin

et al. 2017

JPR

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ObjectiveThe objective of this review was to assess the therapeutic effect of ultrasound (US) on myofascial pain syndrome (MPS).Date sourcesPubMed, Embase, and Cochrane Library were searched to find relevant studies from January 1966 to May 2016 using keywords. Four investigators performed the data extraction.Study selectionRandomized controlled trials (RCTs) investigating the outcomes of pain and physical function between MPS patients receiving and not receiving US were selected by two researchers independently.Data extractionData were extracted from the RCTs. Risk of bias and study quality were evaluated following the recommendations of Cochrane Collaboration. Standardized mean difference (SMD) and 95% confidence interval (CI) were calculated.Data synthesisA total of 10 studies involving 428 MPS patients were included. US therapy significantly reduced pain intensity (SMD [CI]=−1.41 [−2.15, −0.67], P=0.0002) and increased pain threshold (SMD [CI]=1.08 [0.55, 1.60], P<0.0001), but had no significant effect on cervical range of motion (ROM) of lateral flexion (SMD [CI]=0.40 [−0.19, 0.99], P=0.19), rotation (SMD [CI]=0.10 [−0.33, 0.52], P=0.66), or extension or flexion (SMD [CI]=0.16 [−0.35, 0.68], P=0.53). Heterogeneity between studies was mainly attributed to differences in the follow-up time, parameter of US, course of treatment, and the control group. The overall risk of bias from the included studies was high, and the evidence proving these effect calculations were assessed as low quality.ConclusionOwing to the high risk of bias and the across-trial heterogeneity of the studies, the current evidence is not clear enough to support US as an effective method to treat MPS. Clinical trials with methodological rigorousness and adequate power are needed to confirm it in the future.

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Section: Resultsmentioning

confidence: 99%

“…Nine studies compared US with sham US, and one study compared US with blank control. Four studies11,12,21,24 compared US with placebo, which included co-intervention such as standard stretching and ROM exercises.…”

Section: Resultsmentioning

confidence: 99%

Effectiveness of ultrasound therapy for myofascial pain syndrome: a systematic review and meta-analysis

Xia

Wang

Lin

et al. 2017

JPR

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“…In similar placebo-controlled studies which evaluated the efficacy of US for the treatment of MPS, Pillay et al [14] and Ilter et al [15] demonstrated that both treatment forms of US, pulsed or continous, is superior to placebo whereas Draper et al [16] reported that US therapy decreases the tenderness of latent trigger points. In their study, which included 44 patients who had active trigger points on right trapezius muscle, Srbely and Dickey [17] applied a single session of 1 Watt/cm², 1 MHz continous US therapy for 5 minutes to the study group whereas control patients received placebo US treatment for the same duration of time and frequency.…”

Section: Discussionmentioning

confidence: 99%

Efficacy of conventional ultrasound therapy on myofascial pain syndrome: a placebo controlled study

Kavadar¹,

Caglar²,

Özen³

et al. 2015

Agri

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Summary objectives:Myofascial pain syndrome (MPS) is a complex pain syndrome characterized with trigger points (TP) in skeletal muscles. We aimed to assess the efficacy of ultrasound (US) therapy, which is one of the main devices used in physical medicine and rehabilitation, for the treatment of TP in MPS. Methods: Fifty nine patients (49 females, 10 males) with active TP on the upper trapezius fibers were randomized into the treatment (n=30) and the control groups (n=29). The treatment group received conventional US therapy for 6 minutes, on 1.5 Watt/cm 2 dose with 1 MHz frequency for 15 days whereas a placebo US therapy was administered to the control group. Prior to the treatment, immediately and 3 months later pain severity during rest and physical activity was assessed with visual analog scale (VAS), TP tenderness was measured with 0-5 scale, pressure pain threshold (PPT) was analyzed with algometer and the depression level was evaluated with Beck's depression questionnaire (BDP) by a clinician blinded to the groups. Results: The mean age of the patients were 37.43±9.07 and 35.83±5.68 years, in the treatment and control groups, respectively. Compared to the pre-treatment values VAS, 0-5 scale and BDP scores decreased (p<0.01) along with an increase in PPT (p<0.01) in both groups at the follow-up visits. 0-5 scales and BDP scores were significantly lower and PPT was significantly higher in the treatment group, compared to the control group (p<0.001). conclusion: Our results revealed that US treatment is effective on MPS.Keywords: Myofascial pain syndrome; placebo ultrasound; ultrasound. Özet amaç:Miyofasiyal ağrı sendromu (MFAS), çizgili kas içinde tetik noktalar ile karakterize bir kompleks ağrı sendromudur. Ça-lışmamızda, fizik tedavide kullanılan temel cihazlardan biri olan ultrasonun (US) tetik nokta tedavisindeki etkinliği araştırıldı. Gereç ve Yöntem: Trapez kası üst liflerinde saptanan tetik noktalara bağlı MFAS tanısı konulan 59 hasta (49 kadın, 10 erkek) randomize olarak tedavi (n=30) ve kontrol grubu (n=29) olarak iki gruba ayrıldı. Tedavi grubuna 15 gün boyunca, günde bir kez 6 dakika süreyle 1.5 Watt/cm 2 dozunda, 1 MHz devamlı konvansiyonel US tedavisi, kontrol grubuna ise aynı sürede plasebo US tedavisi uygulandı. Tedavi öncesi, tedavi sonrası ve tedaviden üç ay sonra vizüel analog skala ile olguların istirahat ve aktivite sırasındaki ağrı düzeyi, sıfır-beş skalası ile tetik nokta hassasiyeti, algometre ile tetik nokta üzerindeki basınç ağrı eşiği ve Beck depresyon ölçeği ile depresyon düzeyleri, tedavi grubunu bilmeyen bir klinisyen tarafından değerlendirildi. Bulgular: Olguların yaş ortalaması tedavi grubunda 37.43±9.07, kontrol grubunda 35.83±5.68 idi. Tedavi öncesi değerlerle karşılaştırıldığında, tedaviden sonra ve üç ay sonraki kontrollerde her iki grupta da ağrı yakınmaları, tetik nokta hassasiyeti ve depresyon düzeyinde anlamlı bir azalma (p<0.01), basınç ağrı eşiğinde anlamlı artış (p<0.01) saptanmakla birlikte, grupların birbiriyle karşılaştırılmasında ağrı, tetik nokta hassasiyeti ve...

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“…The dosage selected was equivalent to that used by Ilter et al, 30 who reported a reduction in pain at rest in patients with myofacial pain syndrome. Our aim was to deliver the same temporal average intensity typically used in nonthermal ultrasound application.…”

Section: Discussionmentioning

confidence: 99%

Immediate Effects of Therapeutic Ultrasound on Quadriceps Spinal Reflex Excitability in Patients With Knee Injury

Norte

Saliba

Hart

2015

Archives of Physical Medicine and Rehabilitation

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Efficacy of Pulsed and Continuous Therapeutic Ultrasound in Myofascial Pain Syndrome

Cited by 46 publications

References 11 publications

Effectiveness of ultrasound therapy for myofascial pain syndrome: a systematic review and meta-analysis

Effectiveness of ultrasound therapy for myofascial pain syndrome: a systematic review and meta-analysis

Efficacy of conventional ultrasound therapy on myofascial pain syndrome: a placebo controlled study

Immediate Effects of Therapeutic Ultrasound on Quadriceps Spinal Reflex Excitability in Patients With Knee Injury

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