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Adding Ultrasound in the Management of Soft Tissue Disorders of the Shoulder: A Randomized Placebo-Controlled Trial

Yeim Kurtai Gürsel, Yasemin Ulus, Aye Bilgiç, Gülay Dinçer and Geert JMG van der Heijden

Y Kurtai Gürsel, MD, is Assistant Professor, Faculty of Medicine, Department of Physical Medicine and Rehabilitation, University of Ankara, Ankara, Turkey.
Y Ulus, MD, is Specialist in Physical Medicine and Rehabilitation, Department of Physical Medicine and Rehabilitation, Bayndr Hospital, Ankara, Turkey
A Bilgiç, MD, is Assistant Professor, University of Ankara, Faculty of Medicine, Department of Physical Medicine and Rehabilitation, University of Ankara
G Dinçer, MD, is Professor, Faculty of Medicine, Department of Physical Medicine and Rehabilitation, University of Ankara
GJMG van der Heijden, PhD, is Clinical Epidemiologist and Physiotherapist, Julius Center for Health Sciences and Primary Care, University Medical Center, Utrecht, the Netherlands

Address all correspondence to Dr Kurtai Gürsel at Sedat Simavi Sok, MESA 6.Blok 37/32 Çankaya, Ankara, Turkey (ykurtais{at}ttnet.net.tr)

Background and Purpose. There is still a lack of evidence about the beneficial effects of ultrasound (US) intervention for the management of soft tissue problems. Thus, this study was designed to assess the effectiveness of US over a placebo intervention when added to other physical therapy interventions and exercise in the management of shoulder disorders. Subjects and Methods. Forty patients who were diagnosed by ultrasonography or magnetic resonance imaging to have a periarticular soft tissue disorder of the shoulder were randomly assigned to either a group that received true US (n=20; mean time since onset of pain=8.7 months, SD=8.8, range=1–36) or a group that received sham US (n=20; mean time since onset of pain=8.1 months, SD=10.8, range=1–42). Besides true or sham US (10 minutes), superficial heat (10 minutes), electrical stimulation (15 minutes), and an exercise program (15–30 minutes) were administered to both groups 5 days each week for 3 weeks. Results. Subjects showed within-group improvements in pain, range of motion, Shoulder Disability Questionnaire scores, and Health Assessment Questionnaire scores with the intervention, but the differences did not reach significance when compared between the groups. Discussion and Conclusion. The results suggest that true US, compared with sham US, brings no further benefit when applied in addition to other physical therapy interventions in the management of soft tissue disorders of the shoulder.

Key Words: Physical therapy • Randomized clinical trial • Shoulder • Soft tissue disorders • Ultrasound

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