الفهرس 
Title : Comparative study between different duty cycles of ultrasound diclofenac phonophoresis in management of chronic lateral epicondylitis: randomized controlled tria
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Abstract
Background: Lateral epicondylitis, is the most common elbow overuse syndrome. It is injury that affects the common extensor muscleswith pain radiated to the forearm. Therapeutic ultrasound is the most common therapeutic modality used in the treatment of lateral epicondylitis, but selection of the optimal protocol for duty cycles needs further investigations.
Purpose: This study was conducted to investigate and compare the effect of different duty cycles of ultrasound diclofenac phonophoresis on pain intensity level and handgrip strength in the management of chronic lateral epicondylitis. Subjects: Seventy-six patients suffering from chronic lateral epicondylitis participated in this study. Methods: Patients were divided randomly into four groups: group (A) treated with continuousultrasoundphonophoresiswith afrequency of1MHz,intensity of1.5W/Cm2 for 2 minutes, and program of therapeutic exercises (strengthening, stretching and occupational exercises) , group (B) treated with pulsed USphonophoresiswith1:1dutycyclewithafrequencyof1MHz,anintensityof1.5W/Cm2for4minutes and the same exercises, group (C) treated with pulsed USphonophoresiswith1:4dutycyclewithafrequencyof1MHz,intensityof1.5W/Cm2for10minutes and the same exercises, and group (D) treated with the exercises only. All patients were assessed at the beginning and at the end of the fourth week of treatment program by visual analogue scale (VAS) for measuringpain intensity and by hand dynamometer formeasuring grip strength. Results: Although there was a significant improvement in the four groups, the results showed a significant improvement in the intensity of pain and grip strength in favor of group (A), with no difference between groups (B), (C), and (D) in the same measurements. Conclusion: it was concluded that continuous Ultrasounddiclofenac phonophoresisis more effective than pulsed Ultrasounddiclofenac phonophoresisin the management of chronic lateral epicondylitis.