Efficacy of continuous and pulsed therapeutic ultrasound combined with exercises for knee osteoarthritis: a randomized controlled trial.

Objectives: To compare the effects of continuous and pulsed therapeutic ultrasound combined with strengthening exercises.

Design: This is a double-blind randomized controlled trial.

Setting: Pontifical Catholic University.

Subjects: One hundred participants with Grade 2-4 knee osteoarthritis and both genders were involved.

Intervention: Participants were randomized into five groups: Group I ( = 20; in the first month, continuous ultrasound was applied), Group II ( = 20; in the first month, pulsed ultrasound was applied), Group III ( = 20; in the first and second months, continuous ultrasound was applied), Group IV ( = 20; in the first and second months, pulsed ultrasound was applied) and Group V ( = 20; patients received only exercise sessions for eight weeks). All patients in the groups that received ultrasound application performed exercises in the second month of treatment. The sessions occurred three times a week.

Main Measures: Pain was assessed using the visual analogical scale, functionality was assessed using the Lequesne questionnaire, range of motion was assessed using a universal goniometer, muscular strength was assessed using a dynamometer, mobility was assessed using the Timed Up and Go test and 8-meter walk test and the activity level was assessed using the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) questionnaire.

Results: Statistically significant differences ( < 0.05) were presented by Group III in the variables pain during activities of daily living (ADLs) 5.89 (2.18), mobility assessed by 8-meter test 2.68 (2.56), in pain 10.65 (4.40), function 25.50 (10.87) and total 38.65 (15.29) of WOMAC and functionality 9.10 (5.15).

Conclusion: Prolonged applications of continuous ultrasound combined with exercises are effective in providing pain, mobility, functionality and activity in subjects with knee osteoarthritis.