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|Wirksamkeit des ultaschalls mit unterschiedlicher intensitat bei degenerativer tendopathie der schulterregion (Investigation into the efficiency of ultrasound of different intensities in degenerative tendopathy of the shoulder) [German]|
|Smolenski UC, Jeremies KJ, Schreiber TU|
|Physikalische Medizin, Rehabilitationsmedizin, Kurortmedizin 2001 Apr;11(2):62-67|
|8/10 [Eligibility criteria: Yes; Random allocation: Yes; Concealed allocation: No; Baseline comparability: Yes; Blind subjects: Yes; Blind therapists: Yes; Blind assessors: Yes; Adequate follow-up: Yes; Intention-to-treat analysis: No; Between-group comparisons: Yes; Point estimates and variability: Yes. Note: Eligibility criteria item does not contribute to total score] *This score has been confirmed*|
PURPOSE: Ultrasound is one of the most effective depth heat procedures with specific heat patterns at several tissues. Analgesic, prokinetic and antiphlogistic effectives are used; application technique, series patterns and dosage are of decisive importance. The present study deals with the question of dosage dependence of ultrasound therapy in the shoulder region with sonographically different soft-tissue affections. MATERIALS AND METHODS: 108 patients with humeroscapular periarthropathy and current statement of pain, complaints for at least one month and sonographically demonstrated changes were involved in the study. The patients were divided into three diagnostic groups according to Hedtmann and Fett: a = degenerative changes, b = tendinosis calcarea, c = partial defects of the tendon: randomized classification of the 3x36 diagnostic groups was performed into three intensity groups: 0.3W/cm2 (placebo), 0.7 W/cm2 and 1.0W/cm2. Treatment was a monotherapy using continuous ultrasound for six minutes daily during two weeks. Study design was a controlled randomized single blind investigation, approved by the Ethics Committee. Objects were pain assessment (VAS), an evaluation of the therapy by the patient, mobility test as well as the determination of the erythrocyte sedimentation rate and the C-reactive protein. Statistic were done using the Chi-square test, the U-test according to Mann and Whitney, the Friedman-test and the Student's t-test. RESULTS: There were no significant differences between the groups with regard to age, sex and duration of disease. Disorders on the right-hand side were significantly more frequently. Pain was reduced in the diagnostics groups overall as well as in all of the three intensity groups, high US dosage has not resulted in significantly higher pain reduction. Evaluation of pain in rest showed no differences according to diagnosis or intensity groups. No inflammatory activity was produced during treatment. Two weeks of ultrasound monotherapy could not influence the locomotor function at all without any medical gymnastics procedure. CONCLUSIONS: The present study shows, that ultrasound has effects on pain at periarthropathies of the shoulder, but US did not show any specific-dependent effects in pain reduction. Furthermore, there is no answer to questions about intensity thresholds or therapeutic ultrasound.