Comparison of the Therapeutic Efficacy of Double-Modality Therapy, Phonophoresis and Cryotherapy in the Management of Musculoskeletal Injuries in Adult Nigerian Subjects

Summary: This study was designed to compare the efficacy of double-modality therapy, phonophoresis and cryotherapy in the management of pain among subjects who suffered from musculoskeletal injuries (MSIs).Sixty (60) subjects were assigned randomly to one of three groups: DMT group (n=20) received cryotherapy and 15% methyl salicylate phonophoresis, PHONO group (n=20) received 15% methyl salicylate phonophoresis and CRYO group (n=20) received cryotherapy and ‘sham’ phonophoresis. Ultrasound at an intensity of 1.5 W/cm² and frequency of 1MHz was used to apply methyl salicylate while intermittent cryotherapy was the mode of application. Subjects‘ pre- and post-treatment pain perception scores (PPS) using visual analogue scale (VAS) were assessed and the sessions of treatment in all groups were recorded. Treatment was administered on alternate days and discharges were made in all groups when subjects were pain free. A total of 275 treatment sessions was recorded – 72 (26.2%) in DMT, 105 (38.2%) in PHONO and 98 (35.6%) in CRYO group respectively which indicated no significant difference (P>0.05). Nineteen (19), thirteen (13) and twelve (12) subjects were pain free in DMT, CRYO or PHONO groups respectively after 1 to 5 treatments. The difference in the severity of pain was significant (P<0.05) in each group post-treatment which suggests that DMT, phonophoresis and cryotherapy were equally effective. The study has demonstrated therapeutic efficacy of DMT, but it was not superior to the single treatment protocol of phonophoresis or cryotherapy. However, it might take fewer sessions in the DMT group to treat and make more than 90% of the subjects pain free and fit to return to active performance.

Keywords
Cryotherapy; Double-modality therapy; Musculoskeletal injury; Phonophoresis; Ultrasound