Guest guest Posted November 8, 2011 Report Share Posted November 8, 2011 These type studies contrasting Ultrasound to Traction or Manipulation bother me. I suspect they overlooked the " art " of physical therapy. The thought of Ultrasound as a " stand-alone " treatment for back pain sounds like an old school medical prescription. I have 2 major concerns with condemning ultrasound as an effective modality in the treatment of back pain. (1) Ultrasound is a modality with several useful effects. It can be used to heat and area prior to treatment and stretching, partially break the pain cycle with trigger point effects, and increase circulation to a damaged area. This is used as a modality to allow improved treatment with stretch, mechanical, mobility, exercise, etc. I hope PT moved past it being a stand-alone treatment many years ago but should not condemn its useful effects as an adjunct to treatment. (2) More importantly, I think many therapist totally forgot how to actually apply this modality. I have observed so many moving the sound head quickly, too large of an area, in-appropriate site selection, inappropriate intensity or mode, .... they just turn the darn machine on, chat with the patient or day dream, as that sound head burns up the 7 minutes on a timer. In observation, I fear the majority just run the motions and forget the science. Ultrasound and other modalities are often considered " old-fashioned " or " out-dated " treatments... however, I think they are still vital when incorporated " correctly " into modern treatment plans. I applaud anyone who goes takes the time and effort to build a research study to improve therapy; and, I am speaking in general terms not specific to this actual study. I believe in Evidenced Based Treatment; but, we must also incorporate the Art of treatment into studies to improve the science of PT. Steve Passmore PT, MS Healthy Recruiting Tools spass@... Phone: Fax: “What We Did For You Yesterday Is History… What Can We Do For You Today” Recruiting Tools: Cold Calls ~ List Enhancement ~ Direct Mailers ~ Card Design ~ Recruiting Software New on PTManager Blog Your Daily Posterous Spaces Update October 23rd, 2011 Ultrasound, Shock Wave Not Effective for Low Back Pain --Doctors Lounge<http://ptmanagerblog.com/ultrasound-shock-wave-not-effective-for-low- b> Posted about 22 hours ago by [image: _portrait_thumb] Kovacek, PT, DPT, MSA <http://posterous.com/users/1l1oCkDWEWjv> to PTManager<http://ptmanagerblog.com> [image: Like this post]<http://posterous.com/likes/create?post_id=76510365> Ultrasound, Shock Wave Not Effective for Low Back Pain Last Updated: October 21, 2011. *Available evidence shows that different treatments of acute low back pain give similar results* Share <http://www.addthis.com/bookmark.php?v=250 & username=doctorslounge> | <http://www.doctorslounge.com/index.php/news/pb/23989#> <http://www.addthis.com/bookmark.php?v=250 & winname=addthis & pub=doctorslounge & source=tbx-250 & lng=en-US & s=myspace & url=http%3A%2F%2Fwww.doctorslounge.com%2 Findex.php%2Fnews%2Fpb%2F23989 & title=Ultrasound%2C%20Shock%20Wave%20Not%20Ef fective%20for%20Low%20Back%20Pain%20--Doctors%20Lounge & ate=AT-doctorslounge/ -/-/4ea2bdcb5c9ba72f/1 & frommenu=1 & uid=4ea2bdcbf3c30039 & pre=http%3A%2F%2Fnews ..google.com%2Fnwshp%3Ftab%3Dcn & tt=0> <http://www.addthis.com/bookmark.php?v=250 & winname=addthis & pub=doctorslounge & source=tbx-250 & lng=en-US & s=google & url=http%3A%2F%2Fwww.doctorslounge.com%2F index.php%2Fnews%2Fpb%2F23989 & title=Ultrasound%2C%20Shock%20Wave%20Not%20Eff ective%20for%20Low%20Back%20Pain%20--Doctors%20Lounge & ate=AT-doctorslounge/- /-/4ea2bdcb5c9ba72f/2 & frommenu=1 & uid=4ea2bdcb9620f2d2 & pre=http%3A%2F%2Fnews. google.com%2Fnwshp%3Ftab%3Dcn & tt=0> <http://www.doctorslounge.com/index.php/news/pb/23989#> Comments: (0) <http://www.doctorslounge.com/index.php/comments/page/23989> Tell-a-Friend <http://www.doctorslounge.com/index.php/site/recommend/23989> ------------------------------ *Related* *The available evidence does not support the effectiveness of ultrasound or shock wave for treating low back pain, according to a review published in the October issue of The Spine Journal.* FRIDAY, Oct. 21 (HealthDay News) -- The available evidence does not support the effectiveness of ultrasound or shock wave for treating low back pain (LBP), according to a review published in the October issue of *The Spine Journal*. Jesús Seco, M.D., Ph.D., from the University of León in Ponferrada, Spain, and colleagues reviewed available literature to July 2009 to assess the evidence for efficacy, effectiveness, cost-effectiveness, and safety of ultrasound and a shock wave device in treating LBP. A total of 13 randomized controlled trials (RCTs) comparing vibrotherapy with placebo or with other treatments for LBP were identified, of which four complied with the inclusion criteria and included 252 patients. Additional data were obtained from authors of original studies and the risk of bias of each study was assessed using Cochrane Back Review Group criteria. The investigators found that ultrasound, traction, and low-power laser gave similar results for acute patients with LBP and leg pain due to disc herniation. Ultrasound was less effective than spinal manipulation in chronic LBP patients without leg pain. In these patients, a shock wave device and transcutaneous electrical nerve stimulation produced similar results. Of the three RCTs on ultrasound, two had a high risk of bias. Only one study compared ultrasound versus a sham procedure, but results were unreliable due to inappropriate sham procedure, low sample size, and no adjustment for potential confounders. " The available trials do not demonstrate the efficacy or effectiveness of ultrasound and shock wave for treating LBP, whether acute or chronic, with or without leg pain, " the authors write. Abstract<http://www.thespinejournalonline.com/article/S1529-9430%2811%290012 6-4/abstract> Full Text (subscription or payment may be required)<http://www.thespinejournalonline.com/article/S1529-9430%2811%29001 26-4/fulltext> via doctorslounge.com <http://www.doctorslounge.com/index.php/news/pb/23989> Does Anodyne Light Therapy Improve Peripheral Neuropathy in Diabetes?<http://ptmanagerblog.com/does-anodyne-light-therapy-improve-periph eral> Posted about 22 hours ago by [image: _portrait_thumb] Kovacek, PT, DPT, MSA <http://posterous.com/users/1l1oCkDWEWjv> to PTManager<http://ptmanagerblog.com> [image: Like this post]<http://posterous.com/likes/create?post_id=76510758> Does Anodyne Light Therapy Improve Peripheral Neuropathy in Diabetes? A double-blind, sham-controlled, randomized trial to evaluate monochromatic infrared photoenergy 1. Lawrence A. Lavery<http://care.diabetesjournals.org/search?author1=Lawrence+A.+Lavery & so rtspec=date & submit=Submit>, DPM, MPH, 2. P. Murdoch<http://care.diabetesjournals.org/search?author1=+P.+Murdoch & s ortspec=date & submit=Submit>, MD, 3. Jayme <http://care.diabetesjournals.org/search?author1=Jayme+ & sort spec=date & submit=Submit>, MD and 4. C. Lavery<http://care.diabetesjournals.org/search?author1=+C.+Lavery & sorts pec=date & submit=Submit>, MD + <http://care.diabetesjournals.org/content/31/2/316.full#> Author Affiliations 1. From the Department of Surgery, Texas A & M University Health and Science Center College of Medicine, and White Hospital, Temple, Texas 1. Address correspondence and reprint requests to Lawrence A. Lavery, 703 Highland Spring Ln., town, TX 78633. E-mail: lklavery@...<http://care.diabetesjournals.org/content/31/2/316.full/ma ilto:lklavery@...> Quote Link to comment Share on other sites More sharing options...
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