principle: Ultrasound works on th &. @ principle of th >that when a high frequency alternating el 'e reverse piezoelectric effect. It states h Q . lectrical current is if h urrent i 4 ials, teal PARR Tal |S applied to the surfaces of suct piezoe = ic materials, mechanical deformations fol lOws in the form of oscillation of the Frequencies: 1 Mz or 3 MHz. Duty cycle: 1:1 or 1:4. . Peak Spatial Intensity ~ Average Spatial Intensity Mode: (a) Continuous, (b) Pulsed. Duration: Minimum 1-2 minutes, Maximum 10-15 minutes, Average 5 minutes. Physiological effects: Thermal effects: * Elevated tissue temperature. * Increased blood flow. * Increased tissue extensibility. Increased local metabolism. * Altered nerve conduction velocities. Non-thermal effects: * Cavitation. «Increased cellular membrane permeability. * Acoustic micro streaming. * Stimulation of fibroblast activity. Therapeutic effects: * Increased collagen tissue extensibility. ° Decreased joint stiffness. * Reduction of muscle spasm. © Decreases pain. * Stimulates tissue regeneration. Methods of Application: * Direct contact. « Water immersion. * Water bag. * Cushion contact. Indications; r i usions * Acute and chronic soft tissue dysfunctions such as, strains, sprains, and cont with associated symptoms of pain, and muscle spasm. Soft tissue and bone healing, Phonophoresis-inflammation. Contraindications: nian en * Over Hemorrhagic regions. + Areas of impaired circulations £ Anesthetic areas. + Over IMO oi * Over sites ive infecti * Over metal implants. ¢ pamier areas sind thevsyes, heart, spinal cord, stellate ganl® skull or genitals z oe the thorax in the presence of an implanted pacemaker. * Over the pelvic or lumbar areas of pregnant women er a fracture site before healing is complete.Degassed immersion | Water Transducer head is directly applied to the skin, with Bel used to transfer the energy between ult; tasound head and tissues, Both the treated area and transducer head immersed in plastic container filled with water, which serves as the coupling medium. Maintain the ultrasound head parallel to the treatment area and also maintain the distance of approximately 0.5 to 3 cm between them. 1 Merits and Demerits Flat and regular body Surface areas. Allows easy and parallel contact. a Irregular distal extremi- ties. Demerits: Air bubble formation causes block or reflection of ultra- sound waves. af on Pan Waterbag | Water Plastic bag filled with water or gel that was coated with a coupling agent. Irregularly shaped areas, Air bubbles do not form. (Cushion Gel pad Contact between the transducer head and treated area achieved through use of cushion pad/plastic films. Minimizes risk of infection when treating open wounds. THERAPY DOSAGE (474) Ki sage such as: ‘llowing factors determine the ultrasound therapy dosage i Size of the area to be treated. » Depth of lesion from surface. » Nature of lesion. ~ Parameters of ultrasound therapy: sn » Frequency and duration of ultrasounDecreases inflammatory responses. Decreases pain, spasm. Enhanced soft tissue healing. . Increase collagen tissue extensibility. Effect of Ultrasound Therapy on Tissue Repair Process: The non- thermal effects are used primarily for altering membrane permeability in order to accelerate tissue healing and repair, (111 Inflammation stage (0-3 days after injury): The effects of stable cavitation and acoustic streaming appear to increase calcium ion diffusion across the cel] membrane, These calcium ions cause’s production and release of wound healing factors like the telease of histamine from mast cells and macrophages. In this way, ultrasound has the potential to accelerate normal resolution of inflammation providing that the inflammatory stimulus is removed. This acceleration could also be due to the gentle agitation of the tissue fluid which may increase the rate of phagocytosis and the movement of particles and cells, Ultrasound therapy has a pro-inflammatory effect not an anti-inflammatory action. The acute effect of ultrasound therapy is to vasoconstrict the small arterioles to a point that local decreases in blood flow occur. Proliferative (Granulation) Stage (Starts 3 days after injury): During repair, fibroblasts may be stimulated to produce more collagen. It has been shown that ultrasound can promote collagen synthesis. This is thought to be due to increased cell membrane permeability, caused by ultrasound, allowing the entry of calcium ions which-control cellular activity. Ultrasound therapy produces greater tensile strength to the wound tissue due to the collagen tissue formation and encourages the growth of new capillaries in chronic ischemic tissue. Enhances release of growth factors from macrophages following exposure !0 therapeutic ultrasound has also been observed. This may account for the proliferation of fibroblasts, Ly Di ch 4. Remodeling stage (Last for months/years): Ultrasound therapy considered '@ improve the extensibility of mature collagen which is found in scar tissue. This remodeling leads to greater elasticity without loss of strength, Ultrasound significantly increased the strength and rate of closure of the wound. Effect of ultrasound therapy on pain and spasm: Continuous ultrasound ther@PY brings about a local change in tissue temperature, which causes increased blood flow A as ef f ism and also increases Sensory nerve conduction velocities. AN! hypothesized concept is activation of pain gate mecheninn, sen nanee pain and spaste via ultrasound or fluoroscopicx- ray focused to an accurate location. ration: aye, generation: Depth. wave generation: Superficial. it: Up to 30 minutes. re applied directly to the site where the most pain is oH 1-4/second at a potential frequency of 1000-4000 sound works on the principle of the reverse piezoelectric effect___ Vhen a high-frequency alternating electrical current, at 1 MHz or 3 MH frequeng_ d to a piezoelectric crystal which is mounted on the metal front plate of transducer vibrates at the 1 MHz or 3 MHz frequency. As a result, mechanical enya is generated from the transducer head. !9! ric Effect: When a mechanical pressure waves are passed over the pie Reena as Rey! quartz crystal, barium titanate and lead zirconate" ti ated and these mechanical waves are converted! ound machine uses piezoelectric crystals as a vibratory source ot =ID THERAPY UNIT Mains/Power supply: Delivers alternating current. pltrasound Unit: Oscillating circuit generates high frequency current (1 MHz or 3 2). Coaxial cable: Connects the ultrasound unit to the transducer head. High frequen quent conveyed by the coaxial cable to the treatment head, ne Transducer head: Contains piezoelectric crystal mounted on the metal front plate which vibrates following application of high frequency current, results mechanical Gicas, and then converts into thermal energy. Ultra sound therapy unit Transducer head Power supply Crystal ‘Face plate Block diagram of ultrasound therapy unit. Figure 2 URASONIC FIELDS _ The ultrasonic fields are the area where the ultras: There are 2 fields: 1. Near field (Fresnel zone) 2. Far field (Fraunhofer zone) a sad surface is called as the ne The ultrasoni to the transducer head sur as the nae of Bifllzasonic beam neat 0 fe CO gion inmedia GN ae eee Id or fraunhofer pats The boundary separating these Beet diet Sree Squared radius (7?) of the: transducers effective radiating area 1 ‘othe ultrasonic beam’s wavelength (4). pe calculated using the formula, The depth of the near field/therapeutic zone ca" 2? ries =, b= Wavelength onic waves are present. Where 1 = Radiu: