Review article

Physical modalities in musculoskeletal disorders: evidence-based?

Guy G. VANDERSTRAETEN ; Physical Medicine and Rehabilitation, Ghent, University Hospital, Gent, Belgium
Willem M. de MUYNCK ; Department of Applied Physics, Eindhoven University of Technology, Eindhoven, The Netherlands
Bayram KAYMAK ; Hacettepe University, Department of Physical and Rehabilitation Medicine, Ankara, Turkey

Abstract

A variety of physical modalities are applied in the treatment and rehabilitation of musculoskeletal disorders, but the efficacy of these passive interventions is still controversial. Despite the well-known physiological effects, there are either no clinical data or there is insufficient clinical information on the effectiveness of many techniques used in electrotherapy. As a consequence, we are often unable to make clinical recommendation regarding specific interventions. Because of these often disappointing results based on evidence-based research in electrotherapy, the Belgian government has decided not to reimburse a large number of treatments in this sector. Interventions that have been demonstrated effective through clear evidence in randomised clinical trials and with a good risk-benefit ratio are rather limited as far as musculoskeletal disorders are concerned. Most studies on low-frequency, medium-frequency (including interferential current) and high-frequency currents show the lack of clinical scientific evidence, which is in contrast with the frequent use of electrotherapy all over Europe. The application of these therapies should be further evaluated. The problem in most studies is the lack of practical uniformity (parameters, frequency, duration, etc.). Double-blind studies are not always possible and the diagnosis is not always very clear. Therefore, there is a need for more objective clinical strategies. We should also relativise some of the results because when there is no clear evidence for a specific treatment, it does not mean that this therapy does not work.

Keywords

electrotherapy; electrical therapy; musculoskeletal disorders; evidence-based

Hrčak ID:

135256

URI

https://hrcak.srce.hr/135256

Publication date:

13.6.2011.

Article data in other languages: croatian

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