Rheumatology Advance Access published online on January 11, 2007
Rheumatology, doi:10.1093/rheumatology/kel423
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A prospective double blind placebo-controlled randomized trial of ultrasound in the physiotherapy treatment of shoulder pain
1School of Health Sciences, University of Birmingham, B15 2TT, 2Physiotherapy Department, Torbay Hospital, Lawes Bridge, Torquay TQ2 7AA, 3Primary Care Musculoskeletal Research Centre, Keele University, Keele ST5 5BG, 4Cancer Research UK Clinical Trials Unit, Institute for Cancer Studies, Birmingham B15 2TT, 5Warwick Clinical Trials Unit, University of Warwick, Coventry CV4 7AL and 6Birmingham Clinical Trials Unit, University of Birmingham B15 2RR, UK.
Correspondence to:
R. Ainsworth, Consultant Physiotherapist, Physiotherapy Department, Torbay Hospital, Lawes Bridge, Torquay TQ2 7AA, UK.E-mail: roberta.ainsworth{at}nhs.net
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Abstract |
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Objective. To compare the effectiveness of manual therapy and ultrasound (US) with manual therapy and placebo ultrasound (placebo US) in the treatment of new episodes of unilateral shoulder pain referred for physiotherapy.
Methods. In a multicentre, double blind, placebo-controlled randomized trial, participants were recruited with a clinical diagnosis of unilateral shoulder pain from nine primary care physiotherapy departments in Birmingham, UK. Recruitment took place from January 1999 to September 2001. Participants were 18 yrs old and above. Participants all received advice and home exercises and were randomized to additionally receive manual therapy plus US or manual therapy plus placebo US. The primary outcome measure was the Shoulder Disability Questionnaire (SDQ-UK). Outcomes were assessed at baseline, 2 weeks, 6 weeks and 6 months. Analysis was by intention to treat.
Results. A total of 221 participants (mean age 56 yrs) were recruited. 113 participants were randomized to US and 108 to placebo US. There was 76% follow up at 6 weeks and 71% at 6 months. The mean (95% CI) reduction in SDQ scores at 6 weeks was 17 points (13–26) for US and 13 points (9–17) for placebo US (P = 0.06). There were no statistically significant differences at the 5% level in mean changes between groups at any of the time points.
Conclusions. The addition of US was not superior to placebo US when used as part of a package of physiotherapy in the short-term management of shoulder pain. This has important implications for physiotherapy practice.
KEY WORDS: Ultrasound, Shoulder pain, Physiotherapy, Double blind, Randomized trial
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