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ULTRASOUND
THERAPY
Dr.Akshay Shetty
Asst. Professor
Dept of Panchakarma
SSRAMCH Inchal
Contents
• Objectives
• Introduction of Ultrasound therapy
• Production of therapeutic Ultrasound
• Physiological effects of Ultrasound
• Technique of Application of Ultrasound
therapy
• Methods of Application of Ultrasound
therapy
• Indications of Ultrasound therapy
• Contraindications of Ultrasound therapy
• Summary
• References
28/05/2020 Ultrasound Therapy (Dr.Akshay Shetty) 2
Objectives
By the end of the presentation the learners must be
able
1. To know about Introduction of Ultrasound
therapy
2. To understand the Production of therapeutic
Ultrasound
3. To know Physiological effects of Ultrasound
therapy
4. To know Technique of Application of Ultrasound
therapy
5. To know Methods of Application of Ultrasound
therapy
6. To know Indications of Ultrasound therapy
7. To know Contraindications of Ultrasound therapy
28/05/2020 Ultrasound Therapy (Dr.Akshay Shetty) 3
Introduction
of
Ultrasound
therapy
• Ultrasound refers to mechanical vibrations
,which are essentially the same as sound waves
but of higher frequency such waves are beyond
the range of human hearing and can be
therefore be called ultrasonic
• Vibration merges with sound at frequencies
around 20 Hz, vibration below this frequency is
often called infrasound or infrasonic
• Audible sound – 20-20000 Hz
• Ultrasound - Greater than 20000 Hz
• Infrasound - Less than 20 Hz
• Therapeutic ultrasound – 0.5 -5 mHz
1 – 3 mHz
28/05/2020 Ultrasound Therapy (Dr.Akshay Shetty) 4
Production of
therapeutic US
• Piezo electric effect : the production of a
small electro motive force (e.m.f) across
certain substance on being subjected to
external pressure such substance are
known as Piezo electric substance .
• Reverse Piezo electric effect: Production of
mechanical waves or vibrations due to the
application of e.m.f
28/05/2020 Ultrasound Therapy (Dr.Akshay Shetty) 5
Contd…
• Many types of crystals can be used but the
most favoured are quartz
• Which occurs naturally and some synthetic
ceramic materials such as barium titanate
and lead zirconate titanate (PZT)
• Transducer :Ultrasound unit that contain
crystal
• Power :Amount of acoustic energy per unit
time (Watts)
• Intensity :Power per unit area of the
ultrasound head (Watts/cm2)
28/05/2020 Ultrasound Therapy (Dr.Akshay Shetty) 6
Physiological
effects of
Ultrasound
• Increases collagen extensibility
• Increases metabolism of oedema and
exudation
• Increases pain threshold
• Releases histamine
• Increases nerve conduction velocities
• Reduces joint stiffness
• Reduces muscle spasm
28/05/2020 Ultrasound Therapy (Dr.Akshay Shetty) 7
Technique of
Application
of
Ultrasound
• Treatment area: the skin should be clean
and dry before applying coupling gel, the
treatment area should be no more than
twice the size of sound head (Transducer)
• Transmission media :the higher the water
conductive material the less the US energy is
absorbed by the medium and more energy is
available to produce thermal effect.
i. Water
ii. Aqueous gel
iii. Hydro gel
iv. Mineral oil
v. Coupling gel
28/05/2020 Ultrasound Therapy (Dr.Akshay Shetty) 8
Contd…
• Treatment time :generally between 5 -10
minutes ,never treat over 15 minutes
regardless of treatment area.
• Frequency of treatment
i. Acute condition: low intensity or pulsed US
once or even twice daily
6-8 days
ii. Chronic condition: may be done on alternate
days or should continue as
long as there is improvement
iii. Continuous US :subacute, Chronic
iv. Pulsed US :Acute, Inflammatory ,nerve
entrapment and neuromas in the scar
tissue
28/05/2020 Ultrasound Therapy (Dr.Akshay Shetty) 9
Methods of Application of Ultrasound
US
methods
Dierect Indirect
Immersion
Application
Bladder
application
28/05/2020 Ultrasound Therapy (Dr.Akshay Shetty) 10
Contd…
• Direct contact when using direct technique
the US head is put against the skin with only
thin layer of coupling gel.
• Treatment time :5-10 minutes
• Mode of heat transfer: Conversion
• Penetration: 4-6 cms
28/05/2020 Ultrasound Therapy (Dr.Akshay Shetty) 11
Contd…
Application
Step I: Apply generous amount of gel to clean and dry
skin
Step II :move transducer in either a circular or stroking
pattern
Step III : turn intensity up to treatment level
Step IV :each circular/stroke should overlap the
previous by ½
Step V : treatment area is limited to two times size of
transducer
Step VI :slow and deliberate
Step VII : transducer must stay in contact and in motion
to avoid overheating
28/05/2020 Ultrasound Therapy (Dr.Akshay Shetty) 12
Contd…
• Indirect method : when putting the sound
head against the skin not advisable or
possible
• The sound head is held approximately 0.5-
1.0 cm away from the skin
There are two indirect techniques-
1. Immersion application procedure
2. Bladder application procedure
 Treatment time:5-10 minutes
 Mode of heat transfer :conversion
 Penetration:4-6cms
28/05/2020 Ultrasound Therapy (Dr.Akshay Shetty) 13
Contd…
Immersion application method
Step I:Submerge part fully in tub of water
(Plastic, ceramic, rubber
fibre, glass)
Step II: Submerge US head and hold
app.0.5-1cm from skin surface
Step III :Now move US head slowly over
treatment area
Step IV :Turn up the intensity
28/05/2020 Ultrasound Therapy (Dr.Akshay Shetty) 14
Contd…
Bladder application procedure
Step I:Fill balloon with water
Step II: Coat both sides of balloon with
coupling gel
Step III: Place balloon over treatment area
Step IV : Place transducer over balloon
Step V : Increase power to desired intensity
Step VI : Balloon and water will disperse and
transmit sound waves to the
underlying tissue
28/05/2020 Ultrasound Therapy (Dr.Akshay Shetty) 15
Contd…
Post treatment procedure
• Immediately after the treatment the US
head should be wiped off and returned to
the bracket
• Next clean the coupling gel
• The intensity level should be turned back to
zero
• The patient is asked for any discomforts or
any sensations (altered)
28/05/2020 Ultrasound Therapy (Dr.Akshay Shetty) 16
Indications
of
Ultrasound
therapy
• Soft tissue injuries
• Chronic connective tissue and joint dysfunction
• Osteoarthritis
• Bursitis
• Tenosynovitis
• Tendonitis
• Capsulitis
• Ganglia
• Chronic sprain/strains
• Muscle spasm
• Nerve entrapment
28/05/2020 Ultrasound Therapy (Dr.Akshay Shetty) 17
Contraindications
of Ultrasound
therapy
• Cancer lesions
• Pregnant uterus
• Over the spinal column/brain
• Fractures
• Metal implants
• Eyes , heart, reproductive organs
• Deep venous thrombosis
28/05/2020 Ultrasound Therapy (Dr.Akshay Shetty) 18
summary
Production of therapeutic Ultrasound
Physiological effects of Ultrasound
Technique of Application of Ultrasound
therapy
Methods of Application of Ultrasound
therapy
Indications of Ultrasound therapy Contraindications of Ultrasound therapy
Introduction of
Ultrasound therapy
28/05/2020 Ultrasound Therapy (Dr.Akshay Shetty) 19
References
• Fundamentals of Physiotherapy, Venkat
Prasad
28/05/2020 Ultrasound Therapy (Dr.Akshay Shetty) 20
28/05/2020 Ultrasound Therapy (Dr.Akshay Shetty) 21

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Ultrasound therapy

  • 2. Contents • Objectives • Introduction of Ultrasound therapy • Production of therapeutic Ultrasound • Physiological effects of Ultrasound • Technique of Application of Ultrasound therapy • Methods of Application of Ultrasound therapy • Indications of Ultrasound therapy • Contraindications of Ultrasound therapy • Summary • References 28/05/2020 Ultrasound Therapy (Dr.Akshay Shetty) 2
  • 3. Objectives By the end of the presentation the learners must be able 1. To know about Introduction of Ultrasound therapy 2. To understand the Production of therapeutic Ultrasound 3. To know Physiological effects of Ultrasound therapy 4. To know Technique of Application of Ultrasound therapy 5. To know Methods of Application of Ultrasound therapy 6. To know Indications of Ultrasound therapy 7. To know Contraindications of Ultrasound therapy 28/05/2020 Ultrasound Therapy (Dr.Akshay Shetty) 3
  • 4. Introduction of Ultrasound therapy • Ultrasound refers to mechanical vibrations ,which are essentially the same as sound waves but of higher frequency such waves are beyond the range of human hearing and can be therefore be called ultrasonic • Vibration merges with sound at frequencies around 20 Hz, vibration below this frequency is often called infrasound or infrasonic • Audible sound – 20-20000 Hz • Ultrasound - Greater than 20000 Hz • Infrasound - Less than 20 Hz • Therapeutic ultrasound – 0.5 -5 mHz 1 – 3 mHz 28/05/2020 Ultrasound Therapy (Dr.Akshay Shetty) 4
  • 5. Production of therapeutic US • Piezo electric effect : the production of a small electro motive force (e.m.f) across certain substance on being subjected to external pressure such substance are known as Piezo electric substance . • Reverse Piezo electric effect: Production of mechanical waves or vibrations due to the application of e.m.f 28/05/2020 Ultrasound Therapy (Dr.Akshay Shetty) 5
  • 6. Contd… • Many types of crystals can be used but the most favoured are quartz • Which occurs naturally and some synthetic ceramic materials such as barium titanate and lead zirconate titanate (PZT) • Transducer :Ultrasound unit that contain crystal • Power :Amount of acoustic energy per unit time (Watts) • Intensity :Power per unit area of the ultrasound head (Watts/cm2) 28/05/2020 Ultrasound Therapy (Dr.Akshay Shetty) 6
  • 7. Physiological effects of Ultrasound • Increases collagen extensibility • Increases metabolism of oedema and exudation • Increases pain threshold • Releases histamine • Increases nerve conduction velocities • Reduces joint stiffness • Reduces muscle spasm 28/05/2020 Ultrasound Therapy (Dr.Akshay Shetty) 7
  • 8. Technique of Application of Ultrasound • Treatment area: the skin should be clean and dry before applying coupling gel, the treatment area should be no more than twice the size of sound head (Transducer) • Transmission media :the higher the water conductive material the less the US energy is absorbed by the medium and more energy is available to produce thermal effect. i. Water ii. Aqueous gel iii. Hydro gel iv. Mineral oil v. Coupling gel 28/05/2020 Ultrasound Therapy (Dr.Akshay Shetty) 8
  • 9. Contd… • Treatment time :generally between 5 -10 minutes ,never treat over 15 minutes regardless of treatment area. • Frequency of treatment i. Acute condition: low intensity or pulsed US once or even twice daily 6-8 days ii. Chronic condition: may be done on alternate days or should continue as long as there is improvement iii. Continuous US :subacute, Chronic iv. Pulsed US :Acute, Inflammatory ,nerve entrapment and neuromas in the scar tissue 28/05/2020 Ultrasound Therapy (Dr.Akshay Shetty) 9
  • 10. Methods of Application of Ultrasound US methods Dierect Indirect Immersion Application Bladder application 28/05/2020 Ultrasound Therapy (Dr.Akshay Shetty) 10
  • 11. Contd… • Direct contact when using direct technique the US head is put against the skin with only thin layer of coupling gel. • Treatment time :5-10 minutes • Mode of heat transfer: Conversion • Penetration: 4-6 cms 28/05/2020 Ultrasound Therapy (Dr.Akshay Shetty) 11
  • 12. Contd… Application Step I: Apply generous amount of gel to clean and dry skin Step II :move transducer in either a circular or stroking pattern Step III : turn intensity up to treatment level Step IV :each circular/stroke should overlap the previous by ½ Step V : treatment area is limited to two times size of transducer Step VI :slow and deliberate Step VII : transducer must stay in contact and in motion to avoid overheating 28/05/2020 Ultrasound Therapy (Dr.Akshay Shetty) 12
  • 13. Contd… • Indirect method : when putting the sound head against the skin not advisable or possible • The sound head is held approximately 0.5- 1.0 cm away from the skin There are two indirect techniques- 1. Immersion application procedure 2. Bladder application procedure  Treatment time:5-10 minutes  Mode of heat transfer :conversion  Penetration:4-6cms 28/05/2020 Ultrasound Therapy (Dr.Akshay Shetty) 13
  • 14. Contd… Immersion application method Step I:Submerge part fully in tub of water (Plastic, ceramic, rubber fibre, glass) Step II: Submerge US head and hold app.0.5-1cm from skin surface Step III :Now move US head slowly over treatment area Step IV :Turn up the intensity 28/05/2020 Ultrasound Therapy (Dr.Akshay Shetty) 14
  • 15. Contd… Bladder application procedure Step I:Fill balloon with water Step II: Coat both sides of balloon with coupling gel Step III: Place balloon over treatment area Step IV : Place transducer over balloon Step V : Increase power to desired intensity Step VI : Balloon and water will disperse and transmit sound waves to the underlying tissue 28/05/2020 Ultrasound Therapy (Dr.Akshay Shetty) 15
  • 16. Contd… Post treatment procedure • Immediately after the treatment the US head should be wiped off and returned to the bracket • Next clean the coupling gel • The intensity level should be turned back to zero • The patient is asked for any discomforts or any sensations (altered) 28/05/2020 Ultrasound Therapy (Dr.Akshay Shetty) 16
  • 17. Indications of Ultrasound therapy • Soft tissue injuries • Chronic connective tissue and joint dysfunction • Osteoarthritis • Bursitis • Tenosynovitis • Tendonitis • Capsulitis • Ganglia • Chronic sprain/strains • Muscle spasm • Nerve entrapment 28/05/2020 Ultrasound Therapy (Dr.Akshay Shetty) 17
  • 18. Contraindications of Ultrasound therapy • Cancer lesions • Pregnant uterus • Over the spinal column/brain • Fractures • Metal implants • Eyes , heart, reproductive organs • Deep venous thrombosis 28/05/2020 Ultrasound Therapy (Dr.Akshay Shetty) 18
  • 19. summary Production of therapeutic Ultrasound Physiological effects of Ultrasound Technique of Application of Ultrasound therapy Methods of Application of Ultrasound therapy Indications of Ultrasound therapy Contraindications of Ultrasound therapy Introduction of Ultrasound therapy 28/05/2020 Ultrasound Therapy (Dr.Akshay Shetty) 19
  • 20. References • Fundamentals of Physiotherapy, Venkat Prasad 28/05/2020 Ultrasound Therapy (Dr.Akshay Shetty) 20
  • 21. 28/05/2020 Ultrasound Therapy (Dr.Akshay Shetty) 21