title: The effect of continuous ultrasound on chronic low back pain: protocol of a randomized controlled trial.
abstract: BACKGROUND
  Chronic non-specific low-back pain (LBP) is one of the most common and expensive musculoskeletal disorders in industrialized countries. Similar to other countries in the world, LBP is a common health and socioeconomic problem in Iran. One of the most widely used modalities in the field of physiotherapy for treating LBP is therapeutic ultrasound. Despite its common use, there is still inconclusive evidence to support its effectiveness in this group of patients. This randomised trial will evaluate the effectiveness of continuous ultrasound in addition to exercise therapy in patients with chronic LBP.
  
  
  METHODS
  A total of 46 patients, between the ages 18 and 65 years old who have had LBP for more than three months will be recruited from university hospitals. Participants will be randomized to receive continuous ultrasound plus exercise therapy or placebo ultrasound plus exercise therapy. These groups will be treated for 10 sessions during a period of 4 weeks. Primary outcome measures will be functional disability and pain intensity. Lumbar flexion and extension range of motion, as well as changes in electromyography muscle fatigue indices, will be measured as secondary outcomes. All outcome measures will be measured at baseline, after completion of the treatment sessions, and after one month.
  
  
  CONCLUSIONS
  The results of this trial will help to provide some evidence regarding the use of continuous ultrasound in chronic LBP patients. This should lead to a more evidence-based approach to clinical decision making regarding the use of ultrasound for LBP.
  
  
  BACKGROUND
  Netherlands Trial Register (NTR): NTR2251.
authors.affiliation: Rehabilitation Faculty, Tehran University of Medical Sciences, Iran. s_ebadi@razi.tums.ac.ir
authors.forename: Safoora
authors.initials: S
authors.lastname: Ebadi
authors.forename: Noureddin Nakhostin
authors.initials: NN
authors.lastname: Ansari
authors.forename: Nicholas
authors.initials: N
authors.lastname: Henschke
authors.forename: Soofia
authors.initials: S
authors.lastname: Naghdi
authors.forename: Maurits W
authors.initials: MW
authors.lastname: van Tulder
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002908:Chronic Disease; D004185:Disability Evaluation; D004576:Electromyography; D005081:Exercise Therapy; D006801:Humans; D017116:Low Back Pain / Q000503:physiopathology / Q000628:therapy*; D008159:Lumbar Vertebrae / Q000503:physiopathology; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D010147:Pain Measurement; D016059:Range of Motion, Articular / Q000502:physiology; D016037:Single-Blind Method; D016896:Treatment Outcome; D014464:Ultrasonic Therapy; D055815:Young Adult