Randomised controlled trials (RCTs) of therapeutic ultrasound (pulsed or continuous) in adult patients (minimum age 18 years) with soft tissue shoulder injury (acute or chronic) who were experiencing shoulder pain were eligible for inclusion. Trials had to provide outcomes on pain, muscle strength, range of motion, function impairment or disability measures. Trials were excluded if they included patients with fracture, dislocation, neurological involvement, rheumatism, autoimmune conditions, osteoarthritis, surgery or trigger points. Trials were excluded if they employed diagnostic ultrasound, iontophoresis, did not provide sufficient data to calculate spatial average-temporal average (SATA) or total energy and if they provided outcomes that were the examiner’s impression of change.
Included trials assessed both pulsed and continuous therapeutic ultrasound with a total energy that ranged from 181J to 8151J. The average number of treatments ranging from six to 39 sessions. Comparators included mobilisation, exercise, massage and non-steroidal anti-inflammatory drugs (NSAIDs) delivered individually or as multiple concurrent treatments. Patients were treated for various soft tissue shoulder pathologies (such as calcific tendinitis, supraspinatus tendinitis and bursitis). Duration of symptoms of the conditions, where reported, ranged up to more than 12 months. Outcomes assessed included pain, calcium deposits, range of motion, function and disability.
Pairs of authors independently performed study selection. Pair consensus was needed for inclusion in the review.