Date of Award
Selective Evidence-Based Medicine Review
Master of Science in Health Sciences - Physician Assistant
Physician Assistant Studies
Objective: The objective of this selective EBM review is to determine whether or not “Is pulse ultrasound effective at decreasing pain in patients with knee osteoarthritis?”
Study Design: Review of three double-blind, randomized, controlled trials published after the year 2013.
Data Sources: Studies were published in peer-reviewed journals, found using PubMed database searches and were selected based on patient-oriented outcomes.
Outcome Measured: The pain Visual Analog Scale is a unidimensional, continuous scale of pain intensity usually 10cm in length, anchored by “no pain” (score of 0) and “worst imaginable pain” (score of 10). Patients self-report by placing a line on the scale to represent their current pain intensity at the time of filling out the scale (Physiopedia contributors. Visual analog scale Web site. https://www.physio-pedia.com/index.php?title=Visual_Analogue_Scale&oldid=222925. Updated 2019. Accessed December 1, 2019).
Results: In the study conducted by Cakir et al. (Efficacy of therapeutic ultrasound for the management of knee osteoarthritis. Am J Phys Med Rehabil. 2014;93(5):405-412. doi:10.1097/PHM.0000000000000033), the study did not record a significant reduction in pain when comparing pulse ultrasound to placebo treatment at the end of 10 days of treatment (95% CI 1.84 to 2.82). The trial performed by Jia et al. (Efficacy of focused low-intensity pulsed ultrasound therapy for the management of knee osteoarthritis: A randomized, double blind, placebo-controlled trial. Sci Rep. 2016;6:35453. Published 2016 Oct 17. doi:10.1038/srep35453) found that pain with movement was significantly decreased in the pulse ultrasound group compared to the placebo group at the end of treatment with a 5.44 score reduction on the Visual Analog Scale (p=0.000). The study performed by Yildiz et al. (The effectiveness of ultrasound treatment for the management of knee osteoarthritis: A randomized, placebo-controlled, double blind study. Turk J Med Sci. 2015;45(6):1187-91. PMID: 26775369) showed a significant reduction in pain with movement at the end of 10 days of treatment with a score decreased by 1.23 points more as opposed to the placebo (p=0.020).
Conclusion: The results of these studies showed that pulse ultrasound may decrease pain in patients with knee osteoarthritis; however, further investigation with similar methods, follow-up, and adjunctive treatment is warranted.
Dieffenderfer, Shannon, "Is Pulse Ultrasound Effective At Decreasing Pain In Patients With Knee Osteoarthritis?" (2020). PCOM Physician Assistant Studies Student Scholarship. 565.