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Chiropractic continuing education is crucial for professionals in this field to stay updated with the latest techniques and treatments. Among the various modalities used in chiropractic care, therapeutic ultrasound has gained attention for its potential benefits in managing pain, musculoskeletal injuries, and promoting soft tissue healing.Ultrasound in Chiropractic Practice: A Closer Look
Nussbaum1 and Robertson and Spurritt2 have highlighted that ultrasound is one of the most frequently used electrophysical agents (EPAs) in physical therapy practice. Its widespread use is observed in countries such as Canada, Australia, Denmark, Finland, New Zealand, Switzerland, the United Kingdom, and the United States. Physical therapists often employ ultrasound for its physiological effects and expected clinical results.
Assessing the Effectiveness of Therapeutic Ultrasound
This article presents a systematic review that aims to determine whether there is sufficient evidence to support the effectiveness of therapeutic ultrasound. Specifically, we investigate whether active ultrasound used alone or in combination with other interventions produces different outcomes compared to placebo ultrasound under similar conditions.
Challenges and Flaws in Early Studies
Early clinical trials assessing the effectiveness of therapeutic ultrasound were often marred by methodological flaws. Holmes and Rudland12, for instance, found that most trials lacked control groups, standardized treatment and assessment criteria, and proper statistical analyses. Gam and Johannsen5 similarly reviewed articles published between 1950 and 1992 and concluded that only a small fraction of them met methodological standards.
Recent Systematic Reviews and Meta-Analyses
Van der Heijden et al13 initially concluded that ultrasound is not effective for soft tissue lesions of the shoulder, but their research methodology was criticized for its inadequacy. In a recent systematic review, van der Windt et al15 analyzed a substantial number of studies and found little evidence to support the use of active ultrasound therapy for musculoskeletal disorders.
Why a New Review is Necessary
Given the ongoing significance of ultrasound in physical therapy, a fresh systematic review of ultrasound's effectiveness for pain and soft tissue healing is warranted. We have identified additional randomized controlled trials (RCTs) not reviewed by van der Windt et al. These trials focus on various aspects of ultrasound treatment, including tissue healing, pain management, and functional improvement.
Randomized Controlled Trials: The Gold Standard
Randomized controlled trials (RCTs) are widely regarded as the gold standard for comparing the effectiveness of different treatments. While other research methods can provide valuable insights into ultrasound's effects, RCTs offer the most credible evidence of its clinical applicability.
Methodology and Content Analysis
In this systematic review, we adopt a two-stage approach. First, we rigorously assess the methodological adequacy of relevant RCTs. We base our criteria on established standards, as developed by Sackett et al42. Subsequently, we analyze the content of these studies to judge the clinical effectiveness of therapeutic ultrasound in treating pain, musculoskeletal disorders, and promoting soft tissue healing.
Research Outcomes
From the initial pool of 35 studies, our analysis narrowed it down to 10 relevant studies. Of these, two demonstrated significant differences between subjects treated with active ultrasound and those treated with placebo ultrasound. In the remaining eight studies, no such differences were found. Stay current with CCEDseminars, our blog and chiropractic continuing education courses!
Chiropractic continuing education is a dynamic field, and the role of therapeutic ultrasound remains a topic of interest. As more research emerges, it's essential to critically assess the evidence to make informed decisions about its use in chiropractic practice. Stay tuned for more updates on this important topic from CCEDseminars! Click HERE to get started on your chiropractic continuing education journey!
Resources:
https://academic.oup.com/ptj/article/81/7/1339/2857679