Double-modality therapy in the management of closed soft tissue injuries among sports men and women in Jos, North Central, Nigeria
Background: The use of phonophoresis and cryotherapy in isolation or in combination with other therapies in the management of CSTIs associated with sports has been reported. On the contrary, the combine therapy protocol lacks sufficient evidence base to support its efficacy or superiority over the single protocol.
Objective: This prospective study was designed to investigate the efficacy of phonophoresis and cryotherapy as doublemodality therapy (combine therapy) in the management of pain among sports men and women who sustained closed soft tissue injuries (CSTIs).
Methods: Twenty (20) subjects who sustained various sports related CSTIs were recruited for this study. Three (3) subjects dropped out of the study as a result of non-compliance and only seventeen (17) completed treatment. Subjects' pre- and post-treatment pain perception scores (PPS) using visual analogue scale (VAS) were assessed and the treatment sessions were recorded. Continuous ultrasound at an intensity of 1.5 2 W/cm and frequency of 1 MHz for 8 minutes was used to apply methyl salicylate by direct contact method while intermittent (ice pack) cryotherapy for a total of 20 minutes was the mode of application on alternate days respectively. The study was designed for a period of 4 weeks.
Results: Sixteen (94%) subjects had less pain or were pain free and fit for discharge within the first week of treatment while the overall discharge pattern indicates that all (100%) subjects were pain free and fit for discharge on the completion of 10 sessions of treatment. The pre and post-treatment PPS (5.47 ± 0.94 and 2.00 ± 0.79) shows the difference in pain severity was statistically significant (P < 0.05) which suggests optimal pain relief.
Conclusion: The double-modality therapy (combine therapy) has demonstrated significant therapeutic efficacy and it may suggest a paradigm shift from the conventional procedure of applying cryotherapy as a single treatment protocol for hours before resorting to phonophoresis. Furthermore, the discharge pattern suggests it might take fewer sessions to treat and make more than 90% of the subjects pain free and fit to return to active sports performance.
Keywords: Cryotherapy, Double-modality therapy, Closed soft tissue injuries, Phonophoresis, Ultrasound, Sport men and women