Comment: The quality of evidence is downgraded by limitations in study quality (poor reporting of trial methods and results, inadequate or unclear allocation concealment, lack of blinding)and byimprecise results (limited study size for each comparison).
A Cochrane review [Abstract] 1 on the effects of ultrasound therapy in the treatment of acute ankle sprains included 6 studies with a total of 606 subjects. 5 trials included comparisons of ultrasound therapy with sham ultrasound. 3 trials included single comparisons of ultrasound with 3 other treatments. None of the trials demonstrated statistically significant differences between true and sham ultrasound therapy for any outcome measure at one to four weeks of follow-up. The pooled risk ratio for general improvement at one week was 1.04 (random-effects model, 95% CI 0.92 to 1.17) for active versus sham ultrasound. The differences between intervention groups were generally small, between zero and six per cent, for most dichotomous outcomes.
The potential treatment effects of ultrasound appear to be generally small and of probably of limited clinical importance, especially in the context of the usually short-term recovery period for these injuries.
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