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. 2020 Jul 5;2020(7):CD009169. doi: 10.1002/14651858.CD009169.pub3

Ansari 2006.

Study characteristics
Methods RCT conducted in outpatient physiotherapy clinic (secondary care setting)
Participants 15 participants were randomised, who were aged 18 to 65 years with non‐radiating, non‐specific low back pain lasting for more than 3 months. Exclusion criteria were: abnormal neurological status; concomitant severe disease; psychiatric illness; current psychotherapy; pathological lumbosacral X‐rays (except for minor degenerative changes); rheumatic inflammatory disease; planned hospitalisation; addiction to any kind of substance; and any contraindication to ultrasound therapy.
Interventions Intervention (I) group (n = 5) received 1 MHz continuous ultrasound, at 1.5 W/cm² for 10 sessions, 3 days per week. Duration of ultrasound application was calculated according to the formula: total treatment time = planned average local exposure time x (tissue area/effective radiation area of applicator).
Control (C) group (n = 5) received placebo ultrasound for 10 sessions, 3 days per week.
Outcomes Mean (SD) pre‐ and post‐treatment scores on Functional Rating Index were: (I) 56.5 (20.35), 34.5 (13.5); and (C) 46.95 (14.38), 39.9 (16.5). Mean (SD) pre‐ and post‐treatment degrees of flexion range of motion were: (I) 117.4 (2.5), 128.6 (14.3); and (C) 103.4 (13.39), 109.2 (10.6). Mean (SD) pre‐ and post‐treatment degrees of extension range of motion were: (I) 23.8 (4.15), 30 (6.4); and (C) 27.2 (3.03), 29 (4.2).
No between‐group difference was seen for H‐reflex parameters (electroneurophysiological evaluation) or in lumbar spine lateral flexion (left and right) range of motion.
Notes No conflict of interest declared with regard to commercial funding.
Risk of bias
Bias Authors' judgement Support for judgement
Random sequence generation (selection bias) Unclear risk Method for determining randomisation sequence not reported in text.
Allocation concealment (selection bias) Unclear risk Not reported in text
Blinding of participants and personnel (performance bias)
Participants Low risk Participants blinded to group allocation.
Blinding of participants and personnel (performance bias)
Care providers High risk Care providers not blinded.
Blinding of outcome assessment (detection bias)
All outcomes Low risk Primary outcome measure is self‐reported, participants blind to group allocation.
Incomplete outcome data (attrition bias)
Dropout rate described High risk Dropout rate described, 30% of sample dropped out.
Incomplete outcome data (attrition bias)
Intention‐to‐treat High risk Participants who dropped out were excluded from analysis.
Selective reporting (reporting bias) Unclear risk No trial pre‐registration or published protocol was available.
Similar groups High risk Large differences in gender, age, BMI between groups
Co‐interventions Low risk Participants advised not to commence new treatments.
Compliance High risk High proportion of dropouts due to noncompliance.
Timing of outcome measures Low risk Similar timing of outcome assessment (post‐treatment) for both groups.