<clinical_study>
  <!-- This xml conforms to an XML Schema at:
    https://clinicaltrials.gov/ct2/html/images/info/public.xsd -->
  <required_header>
    <download_date>ClinicalTrials.gov processed this data on September 20, 2023</download_date>
    <link_text>Link to the current ClinicalTrials.gov record.</link_text>
    <url>https://clinicaltrials.gov/ct2/show/NCT03835182</url>
  </required_header>
  <id_info>
    <org_study_id>KA13/236</org_study_id>
    <nct_id>NCT03835182</nct_id>
  </id_info>
  <brief_title>Efficacy of Ultrasound Versus Short Wave Diathermy in the Treatment of a Slipped Disc of the Lower Back</brief_title>
  <official_title>Efficacy of Ultrasound Versus Short Wave Diathermy in the Treatment of Lumbar Disc Herniation: a Randomised Control Study</official_title>
  <sponsors>
    <lead_sponsor>
      <agency>Baskent University</agency>
      <agency_class>Other</agency_class>
    </lead_sponsor>
  </sponsors>
  <source>Baskent University</source>
  <oversight_info>
    <has_dmc>No</has_dmc>
    <is_fda_regulated_drug>No</is_fda_regulated_drug>
    <is_fda_regulated_device>No</is_fda_regulated_device>
    <is_us_export>No</is_us_export>
  </oversight_info>
  <brief_summary>
    <textblock>
      Chronic low back pain is a common problem which results in reduced functionality, quality of&#xD;
      life and general well being. Conservative treatment includes patient education, exercise,&#xD;
      maintaining a healthy body mass index and appropriate modifications to activities of daily&#xD;
      living. Physical modalities are used to support the mainstay of treatment and include&#xD;
      superficial heat, transcutaneous electrical nerve stimulation (TENS), ultrasound, short wave&#xD;
      diathermy , traction, and complimentary therapies.&#xD;
&#xD;
      In the clinical practice of the investigators, diathermy, in the form of ultrasound and short&#xD;
      wave, is used to heat deeper tissues, increase tissue elasticity and metabolic rate and&#xD;
      reduce pain and muscle spasm. The medical literature to date states that further studies are&#xD;
      required to compare the efficacy of different diathermy modalities in the treatment of lower&#xD;
      back pain.&#xD;
&#xD;
      The aim of this study was to compare the efficacy of ultrasound to that of short wave&#xD;
      diathermy and a treatment program which does not include diathermy in the treatment of a&#xD;
      slipped disc.&#xD;
    </textblock>
  </brief_summary>
  <detailed_description>
    <textblock>
      Chronic lumbar pain is a common problem which results in reduced functionality, quality of&#xD;
      life and well being. Chronic low back pain also results in many missed days of work and so is&#xD;
      an economic burden as well as a social one. Subacute and chronic conservative treatment of&#xD;
      low back pain secondary to a herniated disc of the lower back includes education, lifestyle&#xD;
      modifications, and maintenance of a normal body mass index. Physical therapy includes range&#xD;
      of motion, strengthening and aerobic exercises alongside use of physical therapy modalities&#xD;
      such as superficial heating, low frequency analgesic modalities such as TENS and deep heating&#xD;
      modalities such as ultrasonic waves and short wave diathermy.&#xD;
&#xD;
      In Physical Medicine and Rehabilitation departments in Turkey, diathermy is commonly used as&#xD;
      an adjunct to exercise in the inpatient treatment of disc herniation of the lumbar region.&#xD;
      However, systematic reviews of the effects of diathermy in the form of ultrasound and short&#xD;
      wave emphasise the necessity for further studies of their efficacy in the treatment of pain&#xD;
      and impact on functionality and quality of life.&#xD;
&#xD;
      Therefore, in this study the investigators aim to compare the efficacy of ultrasound and&#xD;
      short wave diathermy in treating pain, improving disability and quality of life in patients&#xD;
      with chronic low back pain secondary to disc herniation of the lumbar vertebrae.&#xD;
    </textblock>
  </detailed_description>
  <overall_status>Completed</overall_status>
  <start_date type="Actual">September 14, 2018</start_date>
  <completion_date type="Actual">December 31, 2021</completion_date>
  <primary_completion_date type="Actual">December 31, 2021</primary_completion_date>
  <phase>N/A</phase>
  <study_type>Interventional</study_type>
  <has_expanded_access>No</has_expanded_access>
  <study_design_info>
    <allocation>Randomized</allocation>
    <intervention_model>Factorial Assignment</intervention_model>
    <intervention_model_description>Three groups of patients, each containing 31 patients, will be included in the study. Patients in each group will receive a total of ten sessions of physical therapy over a two week period. Each week the patients will receive five sessions of physical therapy on consecutive days. The first group will be treated with a hotpack (20minutes) transcutaneous electrical nerve stimulation applied to the lower back (frequency, ultrasound 1MHz frequency (ten minutes), abdominal and lower back muscle strengthening exercises. The second group will be treated with hotpack, TENS and exercises as previously described plus short wave diathermy at 27.12MHz frequency for ten minutes applied to the lower back. The third group will receive hotpack, TENS applied to the lower back and strengthening exercises as previously described.</intervention_model_description>
    <primary_purpose>Treatment</primary_purpose>
    <masking>Single (Investigator)</masking>
    <masking_description>The investigator assessing the patient before and post treatment will be blind to the treatment received by the patient.</masking_description>
  </study_design_info>
  <primary_outcome>
    <measure>Change in level of pain</measure>
    <time_frame>Before treatment, 2 weeks after the commencement of treatment, 6 weeks after the commencement of treatment, 14 weeks after the commencement of treatment</time_frame>
    <description>visual analogue scale (VAS) score from 0 to 10cm for current pain. 0= no pain 10= the worst pain imaginable</description>
  </primary_outcome>
  <secondary_outcome>
    <measure>Change in level of Disability</measure>
    <time_frame>Before treatment, 2 weeks after the commencement of treatment, 6 weeks after the commencement of treatment, 14 weeks after the commencement of treatment</time_frame>
    <description>Modified Oswestry Low Back Pain Disability Questionnaire. The Revised Oswestry Disability Index is a condition specific outcome measure for low back pain. The index consists of ten questions with six possible responses regarding the patient's back pain, (scored from 0-5), including the severity of pain and impact on activities of daily living. The minimum obtainable score is 0, the maximum obtainable score is 50. This score is then used to calculate the index percentage using the formula: [total score/(no. of questions answered x 5)]100. The higher the percentage, the greater the level of disability due to low back pain. The minimal detectable change (90% confidence interval)is 10%, change of less than 10% maybe attributed to measurement error.</description>
  </secondary_outcome>
  <secondary_outcome>
    <measure>Change in health related quality of life</measure>
    <time_frame>Before treatment, 6 weeks after the commencement of treatment, 14 weeks after the commencement of treatment</time_frame>
    <description>Short Form 36 (SF-36).The SF 36 is a generic health survey which assesses health concepts that are pertinent to functional status and well-being such as physical function, bodily pain, role limitations due to emotional and physical problems. The sub scale values are reported: physical functioning, bodily pain, vitality, general health, social functioning, emotional role, physical role, mental health. The lowest and highest possible raw score for the subscales are as follows: physical functioning 10-30, physical role 4- 8, bodily pain 2-12, general health 5-25, vitality 4-24, social functioning 2-10, emotional role 3-6, mental health 5-30. Higher values signify better well being in all subgroups. The raw score is then used to calculate the 'transformed scale: Transformed scale= [(actual raw score- lowest possible raw score)/possible raw score range]100</description>
  </secondary_outcome>
  <number_of_arms>3</number_of_arms>
  <enrollment type="Actual">82</enrollment>
  <condition>Radiculopathy</condition>
  <condition>Low Back Pain, Mechanical</condition>
  <condition>Herniated Disk Lumbar</condition>
  <arm_group>
    <arm_group_label>Ultrasound group</arm_group_label>
    <arm_group_type>Active Comparator</arm_group_type>
    <description>Thirty one patients receiving a total of ten sessions of physical therapy over a two week period. Each week the patients will receive five session of physical therapy on consecutive days. The ultrasound group will be treated with a hotpack (20minutes) transcutaneous electrical nerve stimulation (TENS) at a frequency of 100Hz intensity adjusted to the patient's tolerability (twenty minutes) and ultrasound 1MHz frequency (ten minutes) applied to the lower back, abdominal and lower back muscle strengthening exercises.</description>
  </arm_group>
  <arm_group>
    <arm_group_label>Short wave diathermy group</arm_group_label>
    <arm_group_type>Active Comparator</arm_group_type>
    <description>The short wave diathermy group will consist of thirty one patients receiving a total of ten sessions of physical therapy over a two week period. Each week the patients will receive five session of physical therapy on consecutive days. The short wave diathermy group will be treated with a hotpack (20minutes), transcutaneous electrical nerve stimulation (TENS) at a frequency of 100Hz intensity adjusted to the patient's tolerability (twenty minutes) and short wave diathermy at a frequency of 27.12MHz (twenty minutes) applied to the lower back , abdominal and lower back muscle strengthening exercises.</description>
  </arm_group>
  <arm_group>
    <arm_group_label>Control group</arm_group_label>
    <arm_group_type>Other</arm_group_type>
    <description>The control group will consist of thirty one patients receiving a total of ten sessions of physical therapy over a two week period. Each week the patients will receive five session of physical therapy on consecutive days. The control group will be treated with a hotpack (20minutes) transcutaneous electrical nerve stimulation (TENS) at a frequency of 100Hz intensity adjusted to the patient's tolerability (twenty minutes) applied to the lower back , abdominal and lower back muscle strengthening exercises.</description>
  </arm_group>
  <intervention>
    <intervention_type>Device</intervention_type>
    <intervention_name>Ultrasound group</intervention_name>
    <description>Ultrasound 1 MHz, 1.5 W/cm2 for a total of 10 min applied to the lower back</description>
    <arm_group_label>Ultrasound group</arm_group_label>
    <other_name>TENS, hotpack, exercise</other_name>
  </intervention>
  <intervention>
    <intervention_type>Device</intervention_type>
    <intervention_name>Short wave diathermy group</intervention_name>
    <description>SWD frequency of 27.12MHz applied in continuous mode (thermic) applied to the lower back for twenty minutes</description>
    <arm_group_label>Short wave diathermy group</arm_group_label>
    <other_name>Curapuls 419 SWD (Enraf-Nonius, Delft, The Netherlands)</other_name>
    <other_name>TENS, hotpack, exercise</other_name>
  </intervention>
  <intervention>
    <intervention_type>Other</intervention_type>
    <intervention_name>Control group</intervention_name>
    <description>superficial heat, analgesic physical modality and exercise only</description>
    <arm_group_label>Control group</arm_group_label>
    <other_name>TENS, hotpack, exercise</other_name>
  </intervention>
  <eligibility>
    <criteria>
      <textblock>
        Inclusion Criteria:&#xD;
&#xD;
          -  1)Age 20-60&#xD;
&#xD;
          -  2)Presenting to the Baskent University Faculty of Medicine Physical Medicine and&#xD;
             Rehabilitation Department outpatient clinic&#xD;
&#xD;
          -  3) history of low back pain for greater than three months&#xD;
&#xD;
          -  4) Aetiology of back pain lumbar disc herniation based on history, examination and&#xD;
             computed tomography/ magnetic resonance imaging (protruded, extruded disc)&#xD;
&#xD;
        Exclusion Criteria:&#xD;
&#xD;
          -  1)lower extremity neurological deficit, 2) infectious, inflammatory, metabolic,&#xD;
             neoplastic, abdominal, pelvic aetiology of back pain. 3) a history of vertebral&#xD;
             fracture, spinal surgery, spondylolisthesis 4) heat intolerance/medical&#xD;
             contraindication to thermal treatment 5) presence of metal prosthesis&#xD;
      </textblock>
    </criteria>
    <gender>All</gender>
    <minimum_age>20 Years</minimum_age>
    <maximum_age>60 Years</maximum_age>
    <healthy_volunteers>No</healthy_volunteers>
  </eligibility>
  <overall_official>
    <last_name>Sacide N Saracgil Cosar, MD</last_name>
    <role>Study Director</role>
    <affiliation>Baskent University Faculty of Medicine</affiliation>
  </overall_official>
  <location>
    <facility>
      <name>Baskent University Faculty of Medicine, Ankara Hospital</name>
      <address>
        <city>Ankara</city>
        <zip>06800</zip>
        <country>Turkey</country>
      </address>
    </facility>
  </location>
  <location_countries>
    <country>Turkey</country>
  </location_countries>
  <reference>
    <citation>Kamper SJ, Apeldoorn AT, Chiarotto A, Smeets RJ, Ostelo RW, Guzman J, van Tulder MW. Multidisciplinary biopsychosocial rehabilitation for chronic low back pain: Cochrane systematic review and meta-analysis. BMJ. 2015 Feb 18;350:h444. doi: 10.1136/bmj.h444.</citation>
    <PMID>25694111</PMID>
  </reference>
  <reference>
    <citation>Oral A, Ketenci A. Physical Medicine and Rehabilitation Approaches in the Management of Radicular Low Back Pain. A review of the Evidence and Current Recommendations. Turkish Journal of Physlcai and Rehabilitation Medicine 59:57-68, 2013</citation>
  </reference>
  <reference>
    <citation>Chou R, Qaseem A, Snow V, Casey D, Cross JT Jr, Shekelle P, Owens DK; Clinical Efficacy Assessment Subcommittee of the American College of Physicians; American College of Physicians; American Pain Society Low Back Pain Guidelines Panel. Diagnosis and treatment of low back pain: a joint clinical practice guideline from the American College of Physicians and the American Pain Society. Ann Intern Med. 2007 Oct 2;147(7):478-91. doi: 10.7326/0003-4819-147-7-200710020-00006. Erratum In: Ann Intern Med. 2008 Feb 5;148(3):247-8.</citation>
    <PMID>17909209</PMID>
  </reference>
  <reference>
    <citation>Jegede KA, Ndu A, Grauer JN. Contemporary management of symptomatic lumbar disc herniations. Orthop Clin North Am. 2010 Apr;41(2):217-24. doi: 10.1016/j.ocl.2010.01.003.</citation>
    <PMID>20399360</PMID>
  </reference>
  <reference>
    <citation>Fiore P, Panza F, Cassatella G, Russo A, Frisardi V, Solfrizzi V, Ranieri M, Di Teo L, Santamato A. Short-term effects of high-intensity laser therapy versus ultrasound therapy in the treatment of low back pain: a randomized controlled trial. Eur J Phys Rehabil Med. 2011 Sep;47(3):367-73. Epub 2011 Jun 8.</citation>
    <PMID>21654616</PMID>
  </reference>
  <reference>
    <citation>Chou R, Huffman LH; American Pain Society; American College of Physicians. Nonpharmacologic therapies for acute and chronic low back pain: a review of the evidence for an American Pain Society/American College of Physicians clinical practice guideline. Ann Intern Med. 2007 Oct 2;147(7):492-504. doi: 10.7326/0003-4819-147-7-200710020-00007. Erratum In: Ann Intern Med. 2008 Feb 5;148(3):247-8.</citation>
    <PMID>17909210</PMID>
  </reference>
  <reference>
    <citation>Ahmed MS, Shakoor MA, Khan AA. Evaluation of the effects of shortwave diathermy in patients with chronic low back pain. Bangladesh Med Res Counc Bull. 2009 Apr;35(1):18-20. doi: 10.3329/bmrcb.v35i1.2320.</citation>
    <PMID>19637541</PMID>
  </reference>
  <verification_date>February 2022</verification_date>
  <study_first_submitted>February 4, 2019</study_first_submitted>
  <study_first_submitted_qc>February 6, 2019</study_first_submitted_qc>
  <study_first_posted type="Actual">February 8, 2019</study_first_posted>
  <last_update_submitted>February 21, 2022</last_update_submitted>
  <last_update_submitted_qc>February 21, 2022</last_update_submitted_qc>
  <last_update_posted type="Actual">February 22, 2022</last_update_posted>
  <responsible_party>
    <responsible_party_type>Principal Investigator</responsible_party_type>
    <investigator_affiliation>Baskent University</investigator_affiliation>
    <investigator_full_name>Selin Ozen</investigator_full_name>
    <investigator_title>Physical and Rehabilitation Medicine Specialist</investigator_title>
  </responsible_party>
  <keyword>lumbar vertebrae</keyword>
  <keyword>herniated disc</keyword>
  <keyword>radiculopathy</keyword>
  <keyword>low back pain</keyword>
  <keyword>short wave therapy</keyword>
  <keyword>diathermy</keyword>
  <keyword>ultrasonic waves</keyword>
  <condition_browse>
    <!-- CAUTION:  The following MeSH terms are assigned with an imperfect algorithm            -->
    <mesh_term>Intervertebral Disc Displacement</mesh_term>
    <mesh_term>Radiculopathy</mesh_term>
    <mesh_term>Back Pain</mesh_term>
    <mesh_term>Low Back Pain</mesh_term>
    <mesh_term>Hyperthermia</mesh_term>
  </condition_browse>
  <patient_data>
    <sharing_ipd>Undecided</sharing_ipd>
  </patient_data>
  <!-- Results have not yet been posted for this study                                          -->
</clinical_study>


download date: ClinicalTrials.gov processed this data on September 20, 2023
link text: Link to the current ClinicalTrials.gov record.
url: https://clinicaltrials.gov/ct2/show/NCT03835182
org study id: KA13/236
nct id: NCT03835182
lead sponsor: 
has dmc: No
is fda regulated drug: No
is fda regulated device: No
is us export: No
Chronic low back pain is a common problem which results in reduced functionality, quality of
      life and general well being. Conservative treatment includes patient education, exercise,
      maintaining a healthy body mass index and appropriate modifications to activities of daily
      living. Physical modalities are used to support the mainstay of treatment and include
      superficial heat, transcutaneous electrical nerve stimulation (TENS), ultrasound, short wave
      diathermy , traction, and complimentary therapies.

      In the clinical practice of the investigators, diathermy, in the form of ultrasound and short
      wave, is used to heat deeper tissues, increase tissue elasticity and metabolic rate and
      reduce pain and muscle spasm. The medical literature to date states that further studies are
      required to compare the efficacy of different diathermy modalities in the treatment of lower
      back pain.

      The aim of this study was to compare the efficacy of ultrasound to that of short wave
      diathermy and a treatment program which does not include diathermy in the treatment of a
      slipped disc.
Chronic lumbar pain is a common problem which results in reduced functionality, quality of
      life and well being. Chronic low back pain also results in many missed days of work and so is
      an economic burden as well as a social one. Subacute and chronic conservative treatment of
      low back pain secondary to a herniated disc of the lower back includes education, lifestyle
      modifications, and maintenance of a normal body mass index. Physical therapy includes range
      of motion, strengthening and aerobic exercises alongside use of physical therapy modalities
      such as superficial heating, low frequency analgesic modalities such as TENS and deep heating
      modalities such as ultrasonic waves and short wave diathermy.

      In Physical Medicine and Rehabilitation departments in Turkey, diathermy is commonly used as
      an adjunct to exercise in the inpatient treatment of disc herniation of the lumbar region.
      However, systematic reviews of the effects of diathermy in the form of ultrasound and short
      wave emphasise the necessity for further studies of their efficacy in the treatment of pain
      and impact on functionality and quality of life.

      Therefore, in this study the investigators aim to compare the efficacy of ultrasound and
      short wave diathermy in treating pain, improving disability and quality of life in patients
      with chronic low back pain secondary to disc herniation of the lumbar vertebrae.
allocation: Randomized
intervention model: Factorial Assignment
intervention model description: Three groups of patients, each containing 31 patients, will be included in the study. Patients in each group will receive a total of ten sessions of physical therapy over a two week period. Each week the patients will receive five sessions of physical therapy on consecutive days. The first group will be treated with a hotpack (20minutes) transcutaneous electrical nerve stimulation applied to the lower back (frequency, ultrasound 1MHz frequency (ten minutes), abdominal and lower back muscle strengthening exercises. The second group will be treated with hotpack, TENS and exercises as previously described plus short wave diathermy at 27.12MHz frequency for ten minutes applied to the lower back. The third group will receive hotpack, TENS applied to the lower back and strengthening exercises as previously described.
primary purpose: Treatment
masking: Single (Investigator)
masking description: The investigator assessing the patient before and post treatment will be blind to the treatment received by the patient.
measure: Change in level of pain
time frame: Before treatment, 2 weeks after the commencement of treatment, 6 weeks after the commencement of treatment, 14 weeks after the commencement of treatment
description: visual analogue scale (VAS) score from 0 to 10cm for current pain. 0= no pain 10= the worst pain imaginable
measure: Change in level of Disability
time frame: Before treatment, 2 weeks after the commencement of treatment, 6 weeks after the commencement of treatment, 14 weeks after the commencement of treatment
description: Modified Oswestry Low Back Pain Disability Questionnaire. The Revised Oswestry Disability Index is a condition specific outcome measure for low back pain. The index consists of ten questions with six possible responses regarding the patient's back pain, (scored from 0-5), including the severity of pain and impact on activities of daily living. The minimum obtainable score is 0, the maximum obtainable score is 50. This score is then used to calculate the index percentage using the formula: [total score/(no. of questions answered x 5)]100. The higher the percentage, the greater the level of disability due to low back pain. The minimal detectable change (90% confidence interval)is 10%, change of less than 10% maybe attributed to measurement error.
measure: Change in health related quality of life
time frame: Before treatment, 6 weeks after the commencement of treatment, 14 weeks after the commencement of treatment
description: Short Form 36 (SF-36).The SF 36 is a generic health survey which assesses health concepts that are pertinent to functional status and well-being such as physical function, bodily pain, role limitations due to emotional and physical problems. The sub scale values are reported: physical functioning, bodily pain, vitality, general health, social functioning, emotional role, physical role, mental health. The lowest and highest possible raw score for the subscales are as follows: physical functioning 10-30, physical role 4- 8, bodily pain 2-12, general health 5-25, vitality 4-24, social functioning 2-10, emotional role 3-6, mental health 5-30. Higher values signify better well being in all subgroups. The raw score is then used to calculate the 'transformed scale: Transformed scale= [(actual raw score- lowest possible raw score)/possible raw score range]100
arm group label: Ultrasound group
arm group type: Active Comparator
description: Thirty one patients receiving a total of ten sessions of physical therapy over a two week period. Each week the patients will receive five session of physical therapy on consecutive days. The ultrasound group will be treated with a hotpack (20minutes) transcutaneous electrical nerve stimulation (TENS) at a frequency of 100Hz intensity adjusted to the patient's tolerability (twenty minutes) and ultrasound 1MHz frequency (ten minutes) applied to the lower back, abdominal and lower back muscle strengthening exercises.
arm group label: Short wave diathermy group
arm group type: Active Comparator
description: The short wave diathermy group will consist of thirty one patients receiving a total of ten sessions of physical therapy over a two week period. Each week the patients will receive five session of physical therapy on consecutive days. The short wave diathermy group will be treated with a hotpack (20minutes), transcutaneous electrical nerve stimulation (TENS) at a frequency of 100Hz intensity adjusted to the patient's tolerability (twenty minutes) and short wave diathermy at a frequency of 27.12MHz (twenty minutes) applied to the lower back , abdominal and lower back muscle strengthening exercises.
arm group label: Control group
arm group type: Other
description: The control group will consist of thirty one patients receiving a total of ten sessions of physical therapy over a two week period. Each week the patients will receive five session of physical therapy on consecutive days. The control group will be treated with a hotpack (20minutes) transcutaneous electrical nerve stimulation (TENS) at a frequency of 100Hz intensity adjusted to the patient's tolerability (twenty minutes) applied to the lower back , abdominal and lower back muscle strengthening exercises.
intervention type: Device
intervention name: Ultrasound group
description: Ultrasound 1 MHz, 1.5 W/cm2 for a total of 10 min applied to the lower back
arm group label: Ultrasound group
other name: TENS, hotpack, exercise
intervention type: Device
intervention name: Short wave diathermy group
description: SWD frequency of 27.12MHz applied in continuous mode (thermic) applied to the lower back for twenty minutes
arm group label: Short wave diathermy group
other name: Curapuls 419 SWD (Enraf-Nonius, Delft, The Netherlands)
other name: TENS, hotpack, exercise
intervention type: Other
intervention name: Control group
description: superficial heat, analgesic physical modality and exercise only
arm group label: Control group
other name: TENS, hotpack, exercise
criteria: 
gender: All
minimum age: 20 Years
maximum age: 60 Years
healthy volunteers: No
last name: Sacide N Saracgil Cosar, MD
role: Study Director
affiliation: Baskent University Faculty of Medicine
facility: 
country: Turkey
citation: Kamper SJ, Apeldoorn AT, Chiarotto A, Smeets RJ, Ostelo RW, Guzman J, van Tulder MW. Multidisciplinary biopsychosocial rehabilitation for chronic low back pain: Cochrane systematic review and meta-analysis. BMJ. 2015 Feb 18;350:h444. doi: 10.1136/bmj.h444.
PMID: 25694111
citation: Oral A, Ketenci A. Physical Medicine and Rehabilitation Approaches in the Management of Radicular Low Back Pain. A review of the Evidence and Current Recommendations. Turkish Journal of Physlcai and Rehabilitation Medicine 59:57-68, 2013
citation: Chou R, Qaseem A, Snow V, Casey D, Cross JT Jr, Shekelle P, Owens DK; Clinical Efficacy Assessment Subcommittee of the American College of Physicians; American College of Physicians; American Pain Society Low Back Pain Guidelines Panel. Diagnosis and treatment of low back pain: a joint clinical practice guideline from the American College of Physicians and the American Pain Society. Ann Intern Med. 2007 Oct 2;147(7):478-91. doi: 10.7326/0003-4819-147-7-200710020-00006. Erratum In: Ann Intern Med. 2008 Feb 5;148(3):247-8.
PMID: 17909209
citation: Jegede KA, Ndu A, Grauer JN. Contemporary management of symptomatic lumbar disc herniations. Orthop Clin North Am. 2010 Apr;41(2):217-24. doi: 10.1016/j.ocl.2010.01.003.
PMID: 20399360
citation: Fiore P, Panza F, Cassatella G, Russo A, Frisardi V, Solfrizzi V, Ranieri M, Di Teo L, Santamato A. Short-term effects of high-intensity laser therapy versus ultrasound therapy in the treatment of low back pain: a randomized controlled trial. Eur J Phys Rehabil Med. 2011 Sep;47(3):367-73. Epub 2011 Jun 8.
PMID: 21654616
citation: Chou R, Huffman LH; American Pain Society; American College of Physicians. Nonpharmacologic therapies for acute and chronic low back pain: a review of the evidence for an American Pain Society/American College of Physicians clinical practice guideline. Ann Intern Med. 2007 Oct 2;147(7):492-504. doi: 10.7326/0003-4819-147-7-200710020-00007. Erratum In: Ann Intern Med. 2008 Feb 5;148(3):247-8.
PMID: 17909210
citation: Ahmed MS, Shakoor MA, Khan AA. Evaluation of the effects of shortwave diathermy in patients with chronic low back pain. Bangladesh Med Res Counc Bull. 2009 Apr;35(1):18-20. doi: 10.3329/bmrcb.v35i1.2320.
PMID: 19637541
responsible party type: Principal Investigator
investigator affiliation: Baskent University
investigator full name: Selin Ozen
investigator title: Physical and Rehabilitation Medicine Specialist
mesh term: Intervertebral Disc Displacement
mesh term: Radiculopathy
mesh term: Back Pain
mesh term: Low Back Pain
mesh term: Hyperthermia
sharing ipd: Undecided