The aim of our study was to evaluate effectiveness of ultrasound treatment applied with exercise therapy in patients with ankylosing spondylitis. Fifty-two patients, who were diagnosed according to modified New York criteria, were aged 25-60, and have spine pain, were randomly assigned to two groups. Ultrasound (US) and exercise therapy were applied to treatment group (27); placebo US treatment and exercise therapy were applied to control group (25). Patients were evaluated before treatment, at the end of treatment, and 4 weeks after the treatment. Daily and night pain, morning stiffness, patient global assessment (PGA), doctor global assessment (DGA), Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), Bath Ankylosing Spondylitis Functional Index (BASFI), Bath Ankylosing Spondylitis Metrology Index (BASMI), Ankylosing Spondylitis Quality of Life (ASQoL) questionnaire, Ankylosing Spondylitis Disease Activity Score (ASDAS) erythrocyte sedimentation rate (ESR), and ASDAS C-reactive protein (CRP) were used as clinical parameters. In US group, all parameters showed significant improvements at 2 and 6 weeks, in comparison with the baseline. In placebo US group, significant improvement was obtained for all parameters (except tragus-to-wall distance and modified Schober test at 2 weeks and lumbar side flexion and modified Schober test at 6 weeks). Comparison of the groups showed significantly superior results of US group for parameters of BASMI (p < 0.05), tragus-wall distance (p < 0.05), PGA (p < 0.01), and DGA (p < 0.05) at 2 weeks as well as for the parameters of daily pain (p < 0.01), PGA (p < 0.05), DGA (p < 0.01), BASDAI (p < 0.05), ASDAS-CRP (p < 0.05), ASDAS-ESR (p < 0.01), lumbar side flexion (p < 0.01), the modified Schober test (p < 0.01), and ASQoL (p < 0.05) at 6 weeks. Our study showed that ultrasound treatment increases the effect of exercise in patients with ankylosing spondylitis.

Short wave diathermy is more effective in subacromial impingement syndrome without NP.

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Background: Shoulder pain is one of the most common types of musculoskeletal pain in the adult population. Subacromial impingement syndrome (SIS) has been reported to be the most frequent etiologic factor for shoulder pain (1). A conservative approach comprising non-steroid anti-inflammatory drugs (NSAID), subacromial injections, exercise, and several physical therapy agents is recommended as the first step treatment for SIS (2). Although interferential current (IFC) is a common electrotherapeutic modality used to treat musculoskeletal pain, there isn't any randomized controlled trial investigating its clinical efficacy on SIS (3). Objectives: To investigate the effectiveness of IFC treatment in patients with SIS. Methods: In this double blind, placebo controlled study, patients with shoulder pain, who had been diagnosed SIS according to clinical evaluation and subacromial injection test were randomly assigned to the IFC or placebo groups. Exercise, cryotherapy, and NSAID were applied to the all groups. Daily 20 min per session, 5 days per week, for 2 weeks 10 sessions IFC with alternative method were applied to the IFC group while sham IFC therapy were applied to the placebo group with the same protocol. Visual analog scale (VAS), Constant Murley Scale (CMS) and Shoulder Disability Questionnaire (SDQ) were used for evaluation at baseline, post-treatment and 1 month post-treatment. Results: A total of 60 patients were completed the study; 26 (43.3%) were male and mean age was 50.02±9.10 years. There was not a significant difference in demographic and clinical data of the patients between the IFC (n=30) and placebo (n=30) groups (p>0.05). Significant improvement in all parameters was observed on post-treatment and 1 month post-treatment evaluations compared to baseline evaluations in both groups (p<0.01). Comparison of the VAS, CMS and SDQ scores between the two groups did not show significant difference either pre-treatment or post-treatment (p>0.05). Conclusions: This study showed that IFC treatment does not provide additional benefit to NSAID, cryotherapy and exercise program in the treatment of SIS. Further studies are needed to investigate the long-term effects of IFC therapy.

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