Intervention Review

Therapeutic ultrasound for treating patellofemoral pain syndrome

  1. Lucie Brosseau1,*,
  2. Lynn Casimiro2,
  3. Vivian Welch3,
  4. Sarah Milne4,
  5. Beverley Shea5,
  6. Maria Judd6,
  7. George A Wells7,
  8. Peter Tugwell3

Editorial Group: Cochrane Musculoskeletal Group

Published Online: 21 JAN 2009

Assessed as up-to-date: 27 AUG 2001

DOI: 10.1002/14651858.CD003375

Database Title

Additional Information

How to Cite

Brosseau L, Casimiro L, Welch V, Milne S, Shea B, Judd M, Wells GA, Tugwell P. Therapeutic ultrasound for treating patellofemoral pain syndrome. Cochrane Database of Systematic Reviews 2001, Issue 4. Art. No.: CD003375. DOI: 10.1002/14651858.CD003375.

Author Information

  1. 1

    University of Ottawa, School of Rehabilitation Sciences, Faculty of Health Sciences, Ottawa, Ontario, Canada

  2. 2

    University of Ottawa, School of Rehabilitation Sciences, Ottawa, Ontario, Canada

  3. 3

    University of Ottawa, Centre for Global Health, Institute of Population Health, Ottawa, Ontario, Canada

  4. 4

    Children's Hospital of Eastern Ontario, Rehabilitation Center, Ottawa, Ontario, Canada

  5. 5

    University of Ottawa, Institute of Population Health, Ottawa, Ontario, Canada

  6. 6

    Canadian Health Services Research Foundation/Fondation canadienne de la recherche sur les services de santé, Research Use/Agente principale de programme, Utilisation de la Recherche, Ottawa, Ontario, Canada

  7. 7

    University of Ottawa Heart Institute, Cardiovascular Research Reference Centre, Ottawa, Ontario, Canada

*Lucie Brosseau, School of Rehabilitation Sciences, Faculty of Health Sciences, University of Ottawa, 451 Smyth Road, Ottawa, Ontario, K1H 8M5, Canada. lbrossea@uottawa.ca.

Publication History

  1. Publication Status: Edited (no change to conclusions)
  2. Published Online: 21 JAN 2009

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Abstract

  1. Top of page
  2. Abstract
  3. Plain language summary
  4. 摘要

Background

Therapeutic ultrasound is one of several rehabilitation interventions suggested for the management of pain due to patellofemoral knee pain syndrome.

Objectives

To assess the effectiveness and side effects of ultrasound therapy for treating patellofemoral knee pain syndrome.

Search methods

We searched the Cochrane Musculoskeletal Review Group register, Cochrane Field of Physical and Related Therapies register, Cochrane Controlled Trials Register, MEDLINE, EMBASE, HealthSTAR, Sports Discus, CINAHL,and PEDro databases (to December 2000) according to the sensitive search strategy for RCTs designed for the Cochrane Collaboration. The search was complemented with handsearching of the reference lists. Key experts in the area were contacted for any further articles.

Selection criteria

All randomized controlled trials (RCTs), controlled clinical trials (CCTs), case-control and cohort studies comparing therapeutic ultrasound against placebo or another active intervention in people with patellofemoral pain syndrome were selected according to an a priori protocol.

Data collection and analysis

Two reviewers determined the studies to be included based on a priori inclusion criteria. Data were independently extracted by the same two reviewers and checked by a third reviewer (BS) using a previously developed form. The same two reviewers independently assessed the methodological quality of the RCTs and CCTs using a validated scale. The data analysis was performed using Peto odds ratios.

Main results

The search retrieved 85 articles. Of the eight that were potentially relevant, only one RCT, including 53 participants with patellofemoral pain syndrome, was identified for this review. All participants received an exercise program as concurrent therapy. Ultrasound combined with ice massage contrast (n of 13), where n equals the number of participants, was not statistically different from ice massage alone (n = 16) in terms of participant-rated pain relief or quadriceps and hamstring strengthening. In the ultrasound and ice massage group, 46% (6 of 13) reported improved pain relief compared to 31% (4 of 13) in the ice massage alone group. This difference of 15% does not meet international standards for clinically important improvements in osteoarthritis, which is 20%. Side effects were not reported.

Authors' conclusions

Ultrasound therapy was not shown to have a clinically important effect on pain relief for people with patellofemoral pain syndrome. These conclusions are limited by the poor reporting of the therapeutic application of the ultrasound and low methodological quality of the one trial included. No conclusions can be drawn concerning the use, or non-use, of ultrasound for treating patellofemoral pain syndrome. More well-designed studies are needed.

 

Plain language summary

  1. Top of page
  2. Abstract
  3. Plain language summary
  4. 摘要

Ultrasound therapy had no clinical benefit on pain relief or muscle strength in people with patellofemoral knee pain syndrome

Therapeutic ultrasound is a commonly used modality in treating patellofemoral knee pain syndrome. Only one RCT, including 53 participants with patellofemoral pain syndrome, was identified for this review. All participants received an exercise program as concurrent therapy. Ultrasound combined with heat and ice massage was not different from ice massage alone in terms of participant-rated pain relief or quadriceps and hamstring strengthening. These conclusions are limited by poor reporting of the characteristics of application of the therapeutic ultrasound and poor methodological quality of the single trial.

 

摘要

  1. Top of page
  2. Abstract
  3. Plain language summary
  4. 摘要

背景

治療性超音波治療髕股關節疼痛症候群

治療性超音波是治療髕股關節疼痛症候群之許多復建治療之一。

目標

研究治療性超音波治療髕股關節疼痛症候群之效果及副作用。

搜尋策略

搜尋包括Cochrane Musculoskeletal Review Group register, Cochrane Field of Physical and Related Therapies register, Cochrane Controlled Trials Register, MEDLINE, EMBASE, HealthSTAR, Sports Discus, CINAHL, and PEDro (直到2000年12月)，同時搜尋所選文章之參考文獻及聯絡專家。

選擇標準

所有比較治療性超音波與安慰劑或其他治療髕股關節疼痛症候群之隨機對照試驗研究，及不隨機之臨床試驗研究。

資料收集與分析

兩位作者獨立進行資料摘錄，並評估摘錄資料的品質。資料以Peto odds ratios做分析。

主要結論

85篇臨床試驗中只有8篇相關，但其中只有1篇臨床試驗(53位患者)符合納入分析。所有患者同時接受運動治療，超音波加冰敷(13位患者)與只有冰敷(16)相比，就疼痛及股四頭肌肌力增強上而言並無顯著差異。超音波加冰敷組46% (6 of 13)有疼痛減少與只有冰敷組31% (4 of 13) 有疼痛減少，並未達國際臨床進步標準﹝20% ﹞。無副作用報告。

作者結論

治療性超音波治療髕股關節疼痛症候群之效果並無顯著差異。本文結論因研究篇數、研究品質等因素而其結論受限制，需更良好設計之研究。

翻譯人

本摘要由林口長庚醫院余光輝翻譯。

此翻譯計畫由臺灣國家衛生研究院(National Health Research Institutes, Taiwan)統籌。

總結

超音波治療膝蓋髕股關節疼痛症候群在緩解疼痛或加強患者肌肉力量並無臨床獲益。治療性超音波是一種常用的方式來治療膝關節髕股關節疼痛症候群。只有一個隨機對照試驗，包括53位髕股關節疼痛症候群患者，被確定可納入這項review。所有參與者都接受了運動計畫合併治療。與只用冰按摩相比，超音波結合熱和冰按摩在參與者疼痛緩解或股四頭肌和膕繩肌的加強並沒有不同。因為較差的治療性超音波應用報告和較差的單一試驗方法學品質讓這些結論是有限制性的。

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