Hello
I think you should all read the articles first. we can't throw the baby out
with the bath water. the authors say for the biophysical effects: "this
conclusion is based on the absence of evidence for biological rationale for
the use of therapeutic ultrasound" this is rather than evidence that
actually says it doesn't work. they point out that you cannot separate the
biophysical effects as thermal and non thermal because one effect cannot be
occurring in the absence of the other - they are not separable.
one may need to be more specific in the outcome desired based on structure,
damage and area of use. who knows???? no one has really done enough proper
studies to say yeh or neh.
In the other study on effects of ultrasound - there were hardly any trials
that were methodologically correct. the authors say: "Any clinically
significant effects should, by now, have been identified in a number of
rigorous studies they showed which patient outcomes are improved by using
therapeutic ultrasound. In our review we found this was not the case.
furthermore, in the few methodologically adequate studies that exist,
treatment was provided for a wide range of problems; thus few conclusions
can be drawn. Similarly, no replications exist of studies with significant
findings."
and there are lots of bits like this the article so I tend to feel that
discussing an article when it has not been read is dangerous. in my line of
work I don't use US but it deserves a fair representation of the studies
done.
I think a good debate would be the value of RCTs in some situations....but
that is another story
Cheers,
Anna.
Anna Lee
Principal,
Work Ready Industrial Athlete Centre
Write to me at: [log in to unmask]
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Phone: (612) 95197436
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----- Original Message -----
From: "Henry Tsao" <[log in to unmask]>
To: <[log in to unmask]>
Sent: Wednesday, 22 August 2001 9:49
Subject: Re: ultrasound
> Frank,
>
> I understand your point, but I guess where I am coming from is that the
> majority of RCT's on U/S show significantly no effect. However, we have to
> ask ourselves the question, why are there a small proportion of RCT's that
> do show some significant effect if it doesn't work?? Is there something
that
> we have forgotten to take into account between these studies?? I think
this
> is an important question to ask ourselves, and not just take the article
for
> what it has to say.
>
> >There is a big difference between matters not having been proven to work,
> >and matters having been proven to not work. The first we can still use
> >(things do not have to be proven to work, for them to work), but the
second
> >is not exactly a credit to our profession, in my opinion.
>
> ***I sort of agree with you. But I think there is also a difference
between
> proof and effectiveness. U/S has been proven not to have an true effect in
> human subjects according to this study, but some time it does seem to have
> an effect. Best example is subacute tennis elbow - U/S 1.5 W/cm2 and
retest
> their grip strength - it is amazing the improvement(this and subacute
ankle
> sprains are about the only time I use the U/S). I would be cautious in
> saying that something that has not been proven to work we can still use -
> things such as Bowen Therapy and reiki have not undergone strict RCT
> studies, but should we still use this?? (Now I will probably have these
> therapists lash out something at me :o
>
> As I said, I am not tending towards or against U/S. I went through a uni
> where a whole year was devoted to electrotherapy (and I hated it!). I just
> think we have to be selective, like all techniques, in their application.
>
> Very winding but sunny day 15 degrees in early morning Brisbane,
>
> Henry***
>
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