Adjuvant Therapy for Rehabilitation

We included two studies that used non-validated patient outcome measures. The study examining the effect of low-intensity ultrasound reported statistically significant improvement in number of patients with no pain and radiographic union; however no long term or permanent benefit related to a validated outcome measure was demonstrated with the use of low-intensity ultrasound.⁹⁰ The second study demonstrated the value of ice at 3 and 5 days but no benefit for pulsed electromagnetic field therapy (PEMF).⁹¹ The additional cost of ultrasound along with the less reliable evidence resulted in the downgrading of this recommendation to “Limited.”