Search this journal:     Advanced search
Original Research

A randomised controlled trial of ‘clockwise’ ultrasound for low back pain

Adriaan Louw, Kory Zimney, Merrill R. Landers, Mark Luttrell, Bob Clair, Joshua Mills

South African Journal of Physiotherapy; Vol 72, No 1 (2016), 7 pages. doi: 10.4102/sajp.v72i1.306

Submitted: 12 November 2015
Published:  28 July 2016


Aims: To examine how the choice of words explaining ultrasound (US) may influence the outcome of physiotherapy treatment for low back pain (LBP).
Methods: Sixty-seven patients with LBP < 3 months were randomly allocated to one of three groups – traditional education about US (control group [CG]), inflated education about US (experimental group [EG]) or extra-inflated education about US (extra-experimental group [EEG]). Each patient received the exact same application of US that has shown clinical efficacy for LBP (1.5 Watts/cm2 for 10 minutes at 1 Megahertz, pulsed 20% over a 20 cm2 area), but received different explanations (CG, EG or EEG). Before and immediately after US,measurements of LBP and leg pain (numeric rating scale), lumbar flexion (distance to floor) and straight leg raise (SLR) (inclinometer) were taken. Statistical analysis consisted of mixed-factorial analyses of variance and chi-square analyses to measure differences between the three groups, as well as meeting or exceeding minimal detectable changes (MDCs) for pain, lumbar flexion and SLR.
Results: Both EG and EEG groups showed a statistically significant improvement for SLR (p < 0.0001), while the CG did not. The EEG group participants were 4.4 times (95% confidence interval: 1.1 to 17.5) more likely to improve beyond the MDC than the CG. No significant differences were found between the groups for LBP, leg pain or lumbar flexion.
Conclusion: The choice of words when applying a treatment in physiotherapy can alter the efficacy of the treatment.

Full Text:  |  HTML  |  EPUB  |  XML  |  PDF (1MB)

Author affiliations

Adriaan Louw, International Spine & Pain Institute, United States
Kory Zimney, University of South Dakota, United States
Merrill R. Landers, University of Las Vegas Nevada, United States
Mark Luttrell, Bird Physical Therapy, United States
Bob Clair, Clair Physical Therapy, United States
Joshua Mills, Wasatch Peak Physical Therapy, United States


Back Pain; Ultrasound; Words; Placebo; Alliance


Total abstract views: 14580
Total article views: 9082


No related citations found

Comments on this article

Before posting your comment, please read our policy.

ISSN: 0379-6175 (print) | ISSN: 2410-8219 (online)

Connect on: Facebook, Twitter, Google+, LinkedIn and YouTube

Subscribe to our newsletter

All articles published in this journal are licensed under the Creative Commons Attribution 4.0 International (CC BY 4.0) license, unless otherwise stated.

Website design & content: ©2018 AOSIS (Pty) Ltd. All rights reserved. No unauthorised duplication allowed.

AOSIS Publishing | Empowering Africa through access to knowledge
Postnet Suite #110, Private Bag X19, Durbanville, South Africa, 7551
Tel: 086 1000 381
Tel: +27 21 975 2602
Fax: 086 5004 974

publishing(AT) replace (AT) with @

Please read the privacy statement.