Effects of underwater ultrasound therapy on pain, inflammation, hand function and quality of life in patients with rheumatoid arthritis - a randomized controlled trial.
Márta Király, Zsuzsanna Varga, Ferenc Szanyó and 3 others
PMID 28442212WHAT IT FOUND
Underwater ultrasound reduced pain and blood marker CRP versus sham in rheumatoid arthritis, but pain benefit faded by 3 months and most hand function outcomes did not improve.
Key findings
01At week 2, the ultrasound group had a mean between-group pain difference of −8.35 mm on the 100 mm scale.
02CRP was reported as significantly lower in the ultrasound group than in the sham group at week 2 and month 3, with mean between-group differences of −5.77 and −5.07.
03Left wrist extension was the only hand function outcome with a significant between-group improvement at week 2, with a mean difference of 4.35 degrees.
STILL TO COME
How it was doneWhat they foundWhat it means for PTs
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What it does not show
Only 48 of 50 patients were analysed, and the study did not use intention-to-treat analysis. The statistical power was 60%, so the trial may miss real effects. Missing data were imputed with last observation carried forward, which can bias results. Patients had mild-to-moderate rheumatoid arthritis and stable medication, so results may not apply to severe disease or changing treatment. The trial was single-centre and small, so it is not a large definitive study.
Declared interests
The supplied text does not report a sponsor or funding source. The authors declared no conflicts of interest.
The easy way to misread this
Do not conclude that underwater ultrasound is an effective treatment for rheumatoid arthritis hand pain or function. The pain benefit was only at week 2, the 3-month pain difference was not significant, and most hand function outcomes did not improve; the study was small and underpowered.