Date of Award


Degree Type

Selective Evidence-Based Medicine Review

Degree Name

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. 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.