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Therapeutic Ultrasound, Local Effects - Coggle Diagram
Therapeutic Ultrasound
Sound energy via mechanical vibration to tissue
Stimulate healing
Sound waves
Longitudinal waves
Consisting of areas of compression and rarefaction
Non Thermal
Acoustic Streaming
small scale eddying of fluids near a vibrating structure
Affects diffusion rates and membrane permeability
Sodium ion permeability is altered
Changes in cell membrane potential
Calcium ion transport modified
Alteration in enzyme control mechanisms of various metabolic processes
Protein synthesis
Cellular secretions
Cavitation
Formation of gas filled voids within tissues and body fluids
Unstable
Stable
Formation and growth of gas bubbles by accumulation of dissolved gas in the medium
Stable cavitation and acoustic streaming effects
Cell membrane upregulation
Increases activity level of whole cell
Altered protein synthesis
Altered release of cell contents
Altered local blood flow
Altered vascular permeability
Angiogenesis
Altered collagen content and alignment
Tissue Repair
Inflammatory
Stimulating effect of various cells
Mast cells
Platelets
White cells with phagocytic roles
Removes debris and increases phagocytic activity
Macrophages
Induces granulation of mast cells
Causes release of arachidonic acid
= Precursor for synthesis of prostaglandins and leukotriene
Act as inflammatory mediators
Increased activity of these cells - pro-inflammatory effects
Optimises inflammatory response
Therefore optimises tissue repair
More efficiently tissue can progress to proliferation stage
Triggers vasodilation
Proliferative
(Scar Production)
Stimulatory effect
Cellular upregulation
Primary targets
Fibroblasts
Endothelial cells
Myofibroblasts
Pro proliferative
Optimises production of scar tissue
Wound contraction and enhanced repair tissue strength
Increases
Protein Synthesis
Enhanced fibroplasia
Collagen synthesis
Remodelling
Refinement of generic scar
Adopts functional characteristics of tissue being repaired
Orientation of collagen fibres
Change in collagen type
Type III to Type I
Increasing tensile strength and enhancing scar mobility
Settings
Depth of target tissue
Superficial: under 2 cm
Use 3MHz
Deep(er): 2-6cm
Use 1MHz
Pulse Ratio
Acute
1:4, 1:3
Subacute
1:3, 1:2
Chronic
1:2, 1:1, Continuous
Intensity
Acute
0.1-0.3 W/cm2
Subacute
0.2-0.5 W/cm2
Chronic
0.3-0.8 W/cm2
Formula
TIME = 1 Minute x No of times treatment head fits into lesion x Pulse ration (added together)
Local Effects
Enhance collagen production, extensibility and quality
Reduce scar tissue/ adhesions/ spasms/ pain
Increase tissue pliability
Increase fibroblast proliferation
Stimulate and repair soft tissue
Accelerate wound healing
Reduce edema
Increase blood flow