1-20Hz Infrasound - Vibrotherapy, percussion therapy 20Hz-18KHz Audible sound - Human communication 20KHz Ultrasound - Phonophoresis 20-60KHz

Ultrasound - Dental cleaning, industrial cleaning 85KHz-3MHzUltrasound - Therapeutic heat & mechanical effects, phonophoresis 4-16MHz Ultrasound - Phonophoresis 16MHz+ Ultrasound - Diagnostic imagery

Physical and Physiological effects of ultrasound

absorption of ultrasound in the tissues oscillation of particles about their mean positio n converted into heat energy a local rise in temperature , plus other non thermal effects (Mechanical).

Thermal effects

Temp to40 and 45o hyperaemia >45oC tissue destruction useful therapeutic effect, maintain between 40 and 45oC for at least 5 minutes ( Lehman and deLateur 1982 in Robertsonp267) mild heating in the chronic phase of an injury is known to reduce pain and muscle spasm and to promote the healing processes.

Tissue temperature elevation and physiological result 1 C Increases metabolic rate 2-3 C Reduce muscle spasm and pain and increase blood flow •4 C Are necessary to increase the collagen extensibility and inhibit sympathetic activity
Therapeutic effects Enhanced soft tissue healing ‡Thermal ±increased cell metabolism, blood flow ‡Non-thermal ±increased cell membrane permeability Improvement of scar tissue, thickened tissue, haematomas ‡Thermal ±increased cell metabolism ‡Non-thermal ±micro-massage Decreased inflammatory response and pain ‡Thermal ±increased cell metabolism ‡Non-thermal ±enhanced skin permeability & drug phonophoresis-Micro-massage

8 W/cm2 Chronic 0.5 Underwater X30-50% Deep structure .1to 0.Acute 0.5 W/cm2 Subacute Up to 0.5 Wcm-1 Subacute SATA of up to 0.5cm 1MHz Ultrasound 1/2 value depth = 4cm Deeper tissue heating use 1 MHz Intensity : Consider tissue area : should be no more than twice the area of the sound head.Higher dose Size of area 2xERA or Sound head multiples . otherwise increase intensity to compensate Ultrasound Intensity: Consider Acute or chronic Acute SATA of 0.1to 0.Dosage Three factors must be considered when deciding what ultrasound dosage to be used the size of the area to be treated the depth of the lesion to be treated the nature and staging of the lesion Depth of structure 3MHz Ultrasound 1/2 value depth = 2.8 Wcm-1 Chronic SATA of 0.8 to 3 W/cm2 Modify Re depth of structure Bony prom¶ < 0.8 to 3Wcm-1 Frequency Superficial 3MHz Deep 1HZ Duty cycle Non thermal pulsed Acute (20%) Sub acute (50%) Thermal continuous Chronic (100%) Intensity Tissue state .

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