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Ultrasonic therapy

Ultrasonic therapy. By Abdullah Radwan. Definition:. It is a mechanical vibration, identical to the sound. It is produced by electric energy converted to mechanical energy by crystal.

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Ultrasonic therapy

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  1. Ultrasonic therapy By Abdullah Radwan

  2. Definition: • It is a mechanical vibration, identical to the sound. It is produced by electric energy converted to mechanical energy by crystal. • It is defined as a form of acoustic vibration occurring at frequencies too high to be perceived by the human ear (above 17.000 cycles per second).

  3. Characteristics of ultrasonic waves: • The first step of producing ultrasonic energy is the generation of HFC (high frequency current) similar to the diathermy. • They are longitudinal compression waves consisting of "to" and "fro" movements of particles, in the direction in which the rays are traveling. • The propagation of ultrasonic waves needs some material medium capable of being compressed through which they travel. • As the particles move to and fro, areas of compression alternates with areas of rarefaction. • The waves travel more easily through some media than others, not readily transmitted by air.

  4. Ultrasonic waves

  5. Compression and rarefaction

  6. Cont., 6. They can travel 20 times faster in solids and 4 times faster in fluids than in air. (their velocity varies in different media). 7. The frequencies of waves used for medical purposes are between 500.000- 3.000.000 cycles/sec, i.e. 0.5- 3 megacycle and the most desirable for therapeutic application is between 0.7- 3.3 (MHZ) megacycles. 8. The average intensity used in practice is between 0.5- 4 watts/cm2. 9. The wave length is approximately 0.15 cm. 10. They differ from EMV (electromagnetic waves) in the following: a. U/S wave travels in air by a velocity of 330 meters/sec, while EMW travels by 3 × 108 meters/sec. b. EMW consists of "up" and "down" movements, while US wave consists of "to" and "fro" movements. c. EMW can be transmitted through space and medium, while US can be transmitted only through medium.

  7. Production of US waves: In the US generator, the following occurs: • When the machine is turned on, the high frequency current which is produced causes oscillation of the crystal of quartz or some similar materials e.g. Barium titanate. Lithium sulphate • In front of the crystal lies a metal diaphragm which is made to vibrate by oscillation of the crystal. • The ultrasonic waves are emitted from the diaphragm, which forms the face of the treatment head. • The output is measured in watts/cm2 -ranged between 0.5/4 watts for different purposes. • The ultrasonic therapy may be interrupted or continuous.

  8. Physiological effects of US: Introduction: • It was demonstrated that ultrasonic absorption occurs primarily in the tissue proteins. • The ultrasonic waves passes into the tissues in a beam, the intensity of radiation is greatest opposite the center of the head. • The waves diverge to some extent and are absorbed by the tissues so their intensity decreases as the distance from the head increases. • The depth of penetration depends on the frequency of the wave, the higher the frequency the more is the penetration power. • Maximum energy absorption in soft tissue occurs from 2 to 5 cm.

  9. تابع Physiological effects of US: • Thermal effects: • Mechanical effects: • Chemical effects: • Biological effects:

  10. Thermal effects: • Increased arterial flow. • Increased vascularity & temperature. • Changes in tissue metabolism. • Pain relief. • Relaxation of muscle spasm. • Increased permeability of biological membranes. • Changes in the conduction velocity of nerves.

  11. Mechanical effects: • Micro-massage. • Loosening adherent tissues & separate collagen fibers from each other probably due to softening of cement substance. • When pulsed beam is used thermal effects are minimal so that mechanical effects are produced without discomfort to the patient.

  12. Chemical effects: • Enhances enzymatic activity inside the cells. • Increased intracellular metabolism. • Increased excitation of the cells. • Accelerated diffusion rates and permeability of tissues. • low intensity ultrasound stimulate the growth of living tissues.

  13. Biological effects: • Affects the extensibility of connective tissue due to thermal denaturation of proteins of the tendons.

  14. Relief of pain • Due to: 1. thermal effect aided by, 2. mechanical effect, 3. a direct effect on the nerves leading to analgesic and spasmolytic effect.

  15. Indications of US: • Bursitis or tendinitis of the shoulder. • Bursitis of the hip joint. • Cervical strain. • Low back pain. • Neuroma. • Herpes Zoster neuralgia. • Scar tissue. • Athletes injuries. • Ulcers e.g. chronic varicose ulcer, decubitus ulcer.

  16. Contraindications of US: • On the brain, spinal cord, eye, ear, heart or reproductive organs. • Epiphysis of growing bone. • Area of impaired circulation as occlusive vascular disorders. • Area of impaired sensation. • Acute infection. • Malignant ulcer. • Hemorrhagic disorders.

  17. Dangers and complications of US: • Burns if: • Increased intensity. • Head is stationary. • Incomplete contact between head and tissue. • Head over superficial bone. • Cavitation: due to increased dose. • Overdosage: increased symptoms. If symptoms increased after 3 settings  stop. • Damage of the apparatus.

  18. Methods of application 1. stroking or circular massage (coupling method) -The motion should be enough to insure proper absorption and also fast enough not to produce a feeling of excess heat or pain. - A suitable coupling agent is used, aquasonic gel. • The ultrasonic beam should enter the tissues at right angle to the surface. 2. Radiation in a water bath (immersion method) • Used for irregular surfaces, hypersensitive areas. • Circular manner or up and down movement at a distance of 0.5- 1 inch from the treated part, the surface of the treatment head should be parallel to that of the skin.

  19. 3. On water surface: • If there is contraindication to immersion of the part in water. • The skin of the part to be treated is just in contact with water. 4. The water bag: -Head is placed over a rubber bag containing boiled water and adapted to the curvatures of the treated part.

  20. Treatment technique • Preparation of the apparatus • Preparation of the patient • Application of treatment

  21. Suggested doses • Using mineral oil or aqua-sonic gel coupling: • Acute → 0.5- 1.5 watts/cm2 • Chronic → 1.0- 2.0 watts/cm2 • Using underwater technique: • Acute → 1.0- 2.0 watts/cm2 • Chronic → 1.5- 2.5 watts/cm2 A dose of 3 watts/cm2 used only for large ms groups.

  22. Suggested durations and frequencies • 3- 15 min. • Daily • Twice /day • 3 times/week.

  23. Children use • About 0.5 watts/cm2 • Once daily • Twice daily • Or on alternate days

  24. Thank you

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