Ultrsound – Dennis M., Occupational Therapist
Ultrasound is considered a deep heat modality, to heat deeper lying tissues and to heal tissue through its mechanical effects. Therapeutic Ultrasound can be used to heat superficially (zero to 1 cm) and greater depths to 5 cm or more. Therapeutic Ultrasound in the United States uses 1 mhz and 3 mhz frequencies. A frequency of 1 mhz will provide deeper penetration than 3 mhz! Therapeutic Ultrasound uses a large and small application head depending on the size of the area to be applied and depth of tissue penetration. Therapeutic Ultrasound can be used either in a continuous or pulsed mode. Continuous mode is most often used for its deep heating thermal effects. Therapeutic Ultrasound is used for the following purpose(s): increase range of motion; tissue healing; decrease pain; decrease chronic inflammation and edema to facilitate greater increase in function for the patient. Pulsed mode is normally used to facilitate tissue repair by using its mechanical vibrations. A general guide to initial Therapeutic Ultrasound application is as follow(s): Acute care: 0.2 cm2 pulsed at 10 to 20%; Sub-acute phase mild heating 0.2 to 0.8 w/cm2 at 50% pulsed; Chronic phase therapeutic healing is 0.8 to 2.0 w/cm2 100% continuous. Therapeutic Ultrasound is also used to enhance the delivery of topically applied drugs thru a process call Phonophoresis, which is safe and painless. Phonophoresis actively transports the medication into the underlying targeted tissue. Therapeutic Ultrasound in the form of Phonophoresis has been shown to accelerate the tissue repair process. Before applying any medication it is important to take into consideration the patients reaction(s) to medication(s) to be applied and any known allergies to medication(s) to be applied, as well as interactive effects of any current medication(s) a patient may be taking. Therapeutic Ultrasound and Phonophoresis are always applied using an ultrasound gel with the sound head, moving in a slowly, overlapping circular motions at 4 cm per second with the total treatment area approximately twice the size of the sound head. Therapeutic Ultrasound should never be applied over the eyes; reproductive organs; area of a cardiac pacemaker; malignancy or tumors; during pregnancy; epiphyseal growth plates of children; areas of thrombophlebitis; plastic components and breast implants. This brief article provides only a broad overview of Therapeutic Ultrasound and Phonophoresis and the following resources are recommended for further study: Physical Agent Modalities by Dr. Alfred G. Bracciano; Physical Agents in Rehabilitation by Dr. Michelle H. Cameron.