CHAMGAP
APPROVEDReviewed and approved by the Chamgap Editorial Team (2026-07-24). The draft was written by AI, the existence of all 4 cited sources was verified at the original page, and the verdict passed blind grading and adversarial audit. Methodology v0.6.
Verdict No. 1888 · Search date 2026-07-24 · Methodology v0.6

Therapeutic ultrasound,
does it really help with Additional pain and function improvement when added to exercise and heat for rotator cuff disease?

30-Second Summary
D
Evidence Grade D · 28 · Safety acceptable
Adding therapeutic ultrasound to exercise did not show extra improvement in rotator-cuff pain or function
Proper use is generally safe, but caution is needed over areas with impaired sensation, growth plates, the pregnant uterus, malignancy, or infection.
What the
research shows
Therapeutic ultrasound earns D with 28 points because reliable added benefit for noncalcific rotator-cuff disease remains unsupported. The pooled Constant-Murley between-group difference was -0.26 points (95% CI -3.84 to 3.32), I-squared 0%, from only two trials and 60 participants.
What the
ads claim
Warmth during treatment or within-group recovery should not be presented as a specific ultrasound effect. The relevant estimate subtracts common exercise, heat, and natural recovery.
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Useful facts when choosing a product

  • The pooled Constant-Murley estimate was -0.26 points (95% CI -3.84 to 3.32), I-squared 0%, from two trials and 60 participants.
  • Analan 2015 included only 22 participants, 11 per group.
  • Verdicts 1728, 1746, and 1770 concern low back pain, knee osteoarthritis, and acute ankle sprain, respectively.
Gap Measurement · Verdict 1888 · D 28
What advertising claims
What independent, higher-quality research supports
△ GAP
01

What the research actually shows

Desmeules et al. 2015 pooled ultrasound added to exercise in two trials and 60 participants: Constant-Murley between-group difference -0.26 points (95% CI -3.84 to 3.32), I-squared 0%. The confidence interval exists, but the evidence is too small for a definitive conclusion. Verdict 1728 is D with 28 points for chronic nonspecific low back pain, verdict 1746 is C with 42 points for knee osteoarthritis, and verdict 1770 is D with 24 points for acute ankle sprain; all are different indications.

02

Why this is classified as D (28)

Repeated null direction is limited by small trials, unavailable confidence intervals in some studies, and a pooled estimate from only two trials and 60 participants, giving D with 28 points without definitive refutation.

Counterpoint. Calcific tendinitis and different ultrasound protocols require separate claim-specific assessment.

Rejudgment record. Cross-check applied — Repeated null direction in small trials plus a pooled estimate from two trials and 60 participants, insufficient for precise definitive refutation

Scoring profile behind this grade
EndpointPPatient-reported treatment goal - the symptom is the goal
ReplicationRXRepeatedly refuted in the same indication
IndependenceI2Decisive evidence is publicly or non-profit funded
Effect sizeE0Null
PrecisionC0The confidence interval leaves room for benefit

The scoring table and the verdict agree (D).

Sub-claim grades by effect

This ingredient is marketed for several effects. A single overall grade blends strong and weak claims together, so each effect is graded separately here. The overall grade reflects the strongest disconfirming or core claim.

Effect (sub-claim)GradeBasis
Additional shoulder-pain reduction beyond exerciseDThe between-group comparison versus sham was null.
Additional shoulder-function improvement beyond exerciseDBetween-group UCLA and Constant-Murley differences were null.
Additional rotator-cuff strength improvementDNo additional effect was found for isokinetic strength.

Cross-check — Codex and Claude

This verdict was drafted by Codex through literature review and source-existence checks, cross-checked through blind grading and adversarial audit, and settled by reapplying the methodology boundary rules. Cases with split grades were resolved through rejudgment.
03

Evidence Table

StudyDesignSampleFundingEndpointResultWeight
Analan PD et al. 2015Randomized double-blind sham-ultrasound-controlled trial22Funding source not reported; conducted by university-hospital investigatorsBetween-group add-on effects on VAS pain, UCLA and Constant-Murley function, and isokinetic strengthPrimary efficacy failed, with P>0.05 for all between-group comparisonsDirect null small trial
Page MJ et al. 2016Cochrane systematic review of randomized trials2,388Public Australian NHMRC and academic support; funding of included trials was incompletely reportedPain, function, quality of life, and treatment successClinical benefit from adding ultrasound to other physical therapy was uncertain or absentLow-certainty repeated evidence
Desmeules F et al. 2015Systematic review and meta-analysis60As reported in the articleConstant-Murley function with ultrasound added to exerciseBetween-group difference -0.26 points (95% CI -3.84 to 3.32), I-squared 0%Existing but small pooled estimate
Desmeules F et al. 2015Systematic review and meta-analysis60As reported in the articleConstant-Murley function with ultrasound added to exerciseBetween-group difference -0.26 points (95% CI -3.84 to 3.32), I-squared 0%Existing but small pooled estimate
§

Receipt — 4 References

All 4 cited sources were verified for existence at the original page (as of 2026-07-24).

Analan PD, Leblebici B, Adam M. Effects of therapeutic ultrasound and exercise on pain, function, and isokinetic shoulder rotator strength of patients with rotator cuff disease. J Phys Ther Sci. 2015;27(10):3113-3117. PMID: 26644656. PMCID: PMC4668147. DOI: 10.1589/jpts.27.3113.
checked
Page MJ, Green S, Mrocki MA, et al. Electrotherapy modalities for rotator cuff disease. Cochrane Database Syst Rev. 2016;2016(6):CD012225. PMID: 27283591. PMCID: PMC8570637. DOI: 10.1002/14651858.CD012225.
checked
Desmeules F, Boudreault J, Roy JS, Dionne C, Frémont P, MacDermid JC. The efficacy of therapeutic ultrasound for rotator cuff tendinopathy: a systematic review and meta-analysis. Physical Therapy in Sport. 2015;16(3):276-284. DOI: 10.1016/j.ptsp.2014.09.004.
checked
Desmeules F, Boudreault J, Roy JS, Dionne C, Frémont P, MacDermid JC. The efficacy of therapeutic ultrasound for rotator cuff tendinopathy: a systematic review and meta-analysis. Physical Therapy in Sport. 2015;16(3):276-284. DOI: 10.1016/j.ptsp.2014.09.004.
checked
Draft and rewrite: Codex (AI) · Verification: Codex blind grading and adversarial audit · Final adjudication: Claude
Reviewed and approved: Chamgap Editorial Team · Approval date: 2026-07-24 · Corrections: none

Cite this verdict

Therapeutic ultrasound x rotator-cuff pain and function Evidence Grade D card
[Chamgap] Therapeutic ultrasound x rotator-cuff pain and function — Evidence Grade D·28. 4 cited sources checked. Source: https://chamgap.com/en/verdicts/joint-bone/therapeutic-ultrasound-rotator-cuff-pain-function/ · CC BY 4.0

CC BY 4.0 — free to use with attribution; do not distort grades, numbers, or verdict meaning.

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What this document does and does not do

Chamgap is an information source. It reports what research has and has not confirmed; it does not tell readers what to take or buy. That decision belongs to readers and, when needed, medical or legal professionals. This verdict reflects literature available up to the search date and may change as new research appears. Nothing here is medical advice.