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Phys Sportsmed. 2015 Nov;43(4):366-74. doi: 10.1080/00913847.2015.1095617. Epub 2015 Oct 15.

Sustained acoustic medicine: wearable, long duration ultrasonic therapy for the treatment of tendinopathy.

Author information

a Division of Sports Medicine, Department of Family Medicine , The Ohio State University , Columbus , OH , USA.
b Biomedical Engineering , The Ohio State University , Columbus , OH , USA.
c Moore PT , Darien , CT , USA.
d Sport and Orthopaedic Physical Therapy , Fairfield , CT , USA.
e Department of Orthopaedic Surgery, Duke Sports Medicine Center, Duke University , Durham , NC , USA.
f ZetrOZ, Inc ., Trumbull , CT , USA.



The effectiveness of sustained acoustic medicine to alleviate pain and improve function in subjects with elbow or Achilles tendinopathy was evaluated through a level IV case series study. Subjects were trained to self-apply the wearable, long-duration, low-intensity ultrasonic device on their affected body part at home for 4 hours a day, at least 5 times per week over 6 weeks. Twenty-five subjects with clinician-diagnosed tendinopathy of the elbow (medial or lateral epicondyle) or Achilles tendon were enrolled.


Pain measurements were recorded before, during, and after daily intervention using an 11-point numeric rating scale (NRS). Function of the injured limb was assessed biweekly using dynamometry. Repeated measures ANOVAs and paired-samples t-tests were used to examine the effect of treatment over time.


Among subjects with elbow tendinopathy (n = 20), a 3.94 ± 2.15 point reduction in pain (p = 0.002) was observed over the 6-week study and a 2.83 ± 5.52 kg improvement in grip strength (p = 0.04) was observed over the first two weeks. In addition, a significant reduction in pain was observed within the 4-h treatment sessions (p < 0.001). Among 5 subjects with Achilles tendinopathy, a reduction in pain and improvement in strength was also observed.


Daily multi-hour ultrasonic therapy was associated with improved pain and increased function in subjects with chronic tendon injuries. This trial showed the safety and feasibility of self-administration of sustained acoustic medicine, and suggests that this therapy may be clinically beneficial in the treatment of tendinopathies of the elbow and Achilles tendon. A randomized controlled trial appears warranted to more definitively investigate the therapeutic potential of this treatment modality. Registered at, NCT02466308.


LITUS; Pain; Sustained acoustic medicine; Tendinopathy; Therapeutic ultrasound

[Indexed for MEDLINE]

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