THERAPEUTIC ULTRASOUND IN PATIENTS WITH KNEE OSTEOARTHRITIS

COMPARISON OF TWO DIFFERENT THERAPEUTIC ULTRASOUND TECHNIQUES IN COMBINATION WITH STANDARD PHYSICAL THERAPY VERSUS STANDARD PHYSICAL THERAPY ALONE IN PATIENTS WITH KNEE OSTEOARTHRITIS

Knee osteoarthritis is a common condition that causes pain, stiffness, and reduced physical function. Therapeutic ultrasound is frequently used in physical medicine and rehabilitation to reduce pain and improve joint function in patients with knee osteoarthritis; however, different ultrasound application techniques are used in clinical practice.

The aim of this study was to compare the effectiveness of two different therapeutic ultrasound techniques in patients with knee osteoarthritis. Participants with knee osteoarthritis received therapeutic ultrasound treatment using one of two application techniques according to a predefined treatment protocol. Clinical outcomes related to pain and functional status were evaluated before and after treatment.

This completed study provides information on whether different ultrasound application techniques lead to differences in clinical outcomes in patients with knee osteoarthritis and may help guide clinical decision-making in rehabilitation practice.

Study Overview

• Status: Completed
• Conditions: Knee Osteoarthritis
• Intervention / Treatment: Device: hot pack; Device: transcutaneus electrical nerve stimulatıon; Behavioral: exersice terapy; Device: continius ultrasound; Device: pulsed ultrasound

Detailed Description

This study was designed as a prospective, parallel-group interventional study to evaluate the clinical effectiveness of different therapeutic ultrasound application techniques in patients diagnosed with knee osteoarthritis.

Eligible participants with knee osteoarthritis were allocated into treatment groups according to the predefined study protocol. Therapeutic ultrasound was applied using two different techniques under standardized treatment parameters. All participants received treatment sessions over a defined treatment period.

Clinical outcome measures related to pain intensity and functional status were assessed at baseline and after completion of the treatment protocol. Outcome assessments were performed by an evaluator blinded to group allocation.

The primary objective of the study was to compare the effects of different therapeutic ultrasound techniques on pain reduction and functional improvement in patients with knee osteoarthritis. Secondary objectives included evaluating changes in physical function following treatment.

• Study Type: Interventional
• Enrollment (Actual): 46
• Phase: Not Applicable

Contacts and Locations

Study Locations

• Turkey (Türkiye)
  • Istanbul, Turkey (Türkiye)
    • Prof .Dr .Cemil Taşcioğlu City Hospital

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Adult; Older Adult
• Accepts Healthy Volunteers: No

Description

Inclusion Criteria:

Age between 40 and 75 years,Clınıcal and radıografıc dıagnosısı of knee osteoartrıtsı accordıng to Amerıcan College of Rheumatology crıteria,Kellegren Lawrencw grade 2-3 osteoartritis,prencense of knee pain for at least 3 months,ability to ambulate independently, ability to understand and comply with study procedures

Exclusion Criteria:

• History of knee surgery or ıntraartıkuler ınjection within the 6 last month,severe knee osteoaertırtıcs (kellegren lawrence grade 4),Neurological disorders affecting lower exremity functıon ,pulmoner or systemic disease limitin participitian,pregnancy,current partpiciant ın another clinical trial

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Treatment
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: Single

Number of Arms

3

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: continius ultrasound group; hot pack,tens,exercise terapy ,continius ultasound	Device: hot pack; superficial heat therapy applied to the knee joınt using hot packs before other pyhsical terapy modalites .Hot packs are applied for approximately 15-20 minutes per session; Device: transcutaneus electrical nerve stimulatıon; TENS is a non-invasive electrical stimulation technique applied through surface electrodes to modulate sensory nerve activity without producing muscle contraction.; Behavioral: exersice terapy; Exercise therapy is a structured, planned, and repetitive physical intervention designed to improve or maintain physical function, mobility, strength, balance, and overall health through targeted therapeutic exercises.; Device: continius ultrasound; Continuous ultrasound is a therapeutic modality in which high-frequency sound waves are delivered continuously to biological tissues to produce predominantly thermal effects, leading to increased tissue temperature, enhanced blood flow, improved tissue extensibility, and pain modulation.
Experimental: pulse ultrasound group; hot pack,tens,exercise terapy,pulsed ultrasound	Device: hot pack; superficial heat therapy applied to the knee joınt using hot packs before other pyhsical terapy modalites .Hot packs are applied for approximately 15-20 minutes per session; Device: transcutaneus electrical nerve stimulatıon; TENS is a non-invasive electrical stimulation technique applied through surface electrodes to modulate sensory nerve activity without producing muscle contraction.; Behavioral: exersice terapy; Exercise therapy is a structured, planned, and repetitive physical intervention designed to improve or maintain physical function, mobility, strength, balance, and overall health through targeted therapeutic exercises.; Device: pulsed ultrasound; Pulsed ultrasound is a therapeutic ultrasound modality in which acoustic energy is delivered intermittently rather than continuously, resulting in predominantly non-thermal mechanical effects such as cavitation and acoustic microstreaming that promote tissue healing and reduce inflammation.
Experimental: control group; hot pack,tens,exercise terapy	Device: hot pack; superficial heat therapy applied to the knee joınt using hot packs before other pyhsical terapy modalites .Hot packs are applied for approximately 15-20 minutes per session; Device: transcutaneus electrical nerve stimulatıon; TENS is a non-invasive electrical stimulation technique applied through surface electrodes to modulate sensory nerve activity without producing muscle contraction.; Behavioral: exersice terapy; Exercise therapy is a structured, planned, and repetitive physical intervention designed to improve or maintain physical function, mobility, strength, balance, and overall health through targeted therapeutic exercises.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
pain intensity assessed by visuel analog scale (VAS)	Pain intensity was assessed using a 10-cm visual analog scale (VAS), where 0 indicates no pain and 10 indicates the worst imaginable pain. Participants marked their perceived knee pain level at each assessment point.	baseline,immediately after treatment, and 2 months post-tratment
knee joint stiffness assessed by WOMAC stiffness subscale	Knee joint stiffness was evaluated using the stiffness subscale of the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC). Higher scores indicate greater stiffness and symptom severity.	baseline,immediately after treatment and at 2 months post treatment
lesquesne algofunctional ındex score	Functional impairment related to knee osteoarthritis was assessed using the Lequesne algofunctional index, which evaluates pain, walking distance, and activities of daily living. Higher scores reflect greater functional disability.	baseline,immediately after treatment,and at 2 months post-treatment

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Quadriceps muscle strength assesed by isokinetic dynamometry	Quadriceps muscle strength was measured using isokinetic dynamometry under standardized testing conditions. Peak torque values were recorded to assess muscle strength performance.	baseline,immediately after treatment and 2 monthspost treatment

Collaborators and Investigators

• Sponsor: Kanuni Sultan Suleyman Training and Research Hospital
• Investigators: Principal Investigator: Dilek Ün oguzhanasiltürk, Kanuni Sultan and Süleyman Training Resarch Hospital

Study record dates

Study Major Dates

• Study Start (Actual): June 1, 2009
• Primary Completion (Actual): June 1, 2010
• Study Completion (Actual): September 1, 2010

Study Registration Dates

• First Submitted: December 21, 2025
• First Submitted That Met QC Criteria: January 6, 2026
• First Posted (Actual): January 7, 2026

Study Record Updates

• Last Update Posted (Actual): January 7, 2026
• Last Update Submitted That Met QC Criteria: January 6, 2026
• Last Verified: January 1, 2026

More Information

Terms related to this study

• Keywords: Physical Therapy; Knee pain; Functional outcome; Therapeutic ultrasound; Ultrasound application techniques
• Additional Relevant MeSH Terms: Musculoskeletal Diseases; Arthritis; Joint Diseases; Rheumatic Diseases; Osteoarthritis; Osteoarthritis, Knee
• Other Study ID Numbers: okm-230

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO
• IPD Plan Description: İndividual participipant data will not be shared,as data sharing was not included in the study protocol and ethics committee approval ,and paricipant confidentiality must be maintained.

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No