Clinical trials of ultrasound treatment in soft tissue injury: A review and critique

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Abstract
Although the use of ultrasound in the treatment of soft tissue injuries has been widely adopted by physiotherapists, relatively few investigations into its effectiveness have been undertaken. Of 18 studies identified, almost all were found to be methodologically flawed. These flaws included a lack of control groups, poor matching of groups, failure to adopt a double-blind design and a lack of statistical analysis. Variation in the parameters of ultrasound treatment and assessment measures are also explored. Only one study incorporating a placebo group found response to ultrasound to be superior to response to placebo and this review concludes that the case for ultrasonic treatment of soft tissue injuries is not well founded at present. The need to conduct well-controlled, discriminative studies employing standardised criteria is discussed. The standardisation of diagnostic, treatment and assessment criteria permits meaningful comparisons between studies and, where appropriate, pooling of data. This in turn, it is suggested, may permit clinically based physiotherapists to contribute to the development of a research database and encourage research-based practice.

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