Ultrasound Therapy Basics

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Questions and Answers

What is the primary function of the transducer in ultrasound therapy?

To measure the depth of tissue penetration

To convert electrical energy into mechanical vibrations (correct)

To amplify sound waves before reaching the tissue

To enhance thermal effects during treatment

Which frequency is suitable for targeting superficial tissues during ultrasound treatment?

2mHz

3mHz (correct)

4mHz

1mHz

What does a lower Beam Nonuniformity Ratio (BNR) indicate in ultrasound therapy?

A higher risk of creating hot spots

More uniform intensity of the sound wave (correct)

Reduced effectiveness of the treatment

More variable intensity of the ultrasound beam

What is the Effective Radiating Area (ERA) in ultrasound therapy?

The area from which ultrasound energy radiates Signup and view all the answers

Which of these is considered a poor conductor for ultrasound treatment?

Air Signup and view all the answers

Which technique is primarily used to remove edema, waste, and toxins from the body?

Lymphatic Massage Signup and view all the answers

What is the primary purpose of friction massage?

To increase extensibility of the area Signup and view all the answers

Which manual therapy technique focuses on breaking adhesions in the fascia?

Myofascial Release Signup and view all the answers

In what situation is petrissage particularly indicated?

Late stages of healing Signup and view all the answers

Which massage technique employs strokes directed towards the heart?

Effleurage Signup and view all the answers

What is one of the primary benefits of controlled microtrauma in therapy?

Promotes local inflammatory response Signup and view all the answers

What is the purpose of cupping therapy?

To create a vacuum that aids in detoxification Signup and view all the answers

How long should cups typically be left on during a cupping session?

10 minutes Signup and view all the answers

Which color of cup indicates a severe stagnation and blockage to a specific area?

Dark purple Signup and view all the answers

What component is essential for electrical current to exist?

A material that allows electron passage Signup and view all the answers

What does the term 'ampere' refer to in electrical principles?

The measure of current Signup and view all the answers

Which alternating current pattern is described as having no true positive or negative pole?

Sine wave Signup and view all the answers

What should patients expect after both IASTM and cupping treatments?

Persistent redness and marks that may last several days Signup and view all the answers

What is the duty cycle related to when using ultrasound?

The ratio of on-time to off-time in pulsing Signup and view all the answers

Which of the following physiological effects is NOT associated with thermal ultrasound?

Decreased sensory nerve conduction Signup and view all the answers

What level of tissue temperature rise is typically associated with moderate heating?

2-3°C Signup and view all the answers

Which of the following is a primary contraindication for using ultrasound treatment?

Acute conditions Signup and view all the answers

What is a potential adverse effect of incorrect ultrasound application?

Burns from high frequency Signup and view all the answers

In phonophoresis, what is the primary purpose of using ultrasound?

To aid in delivering medication to localized tissues Signup and view all the answers

Which frequency would cause ultrasound to be absorbed more rapidly by tissue?

3 mHz Signup and view all the answers

What does an increase in tissue temperature of 4°C during ultrasound treatment indicate?

Vigorous heating and alteration of collagen properties Signup and view all the answers

What is the main purpose of pain stimulation?

To make stimulation more comfortable Signup and view all the answers

Which parameter represents the time required for each phase to complete its shape?

Phase Duration Signup and view all the answers

Which theory does high pulse frequency target for pain control?

Gate Control Theory Signup and view all the answers

Why should intensity be adjusted to tolerance in pain control?

To completely avoid muscle contractions Signup and view all the answers

What is the recommended treatment time for pain control using IFC/Premod?

20-30 minutes Signup and view all the answers

What type of tissues are more effectively stimulated by electrical stimulation?

Excitable tissues Signup and view all the answers

Which of the following best describes the function of electrode leads?

To connect electrodes to the generator Signup and view all the answers

What is a common practice to reduce skin electrode resistance?

Moisten electrodes with water or conductive gel Signup and view all the answers

What typically determines the size of electrodes used in electrical stimulation?

Current density Signup and view all the answers

What type of current should be used for chronic pain according to the Endogenous Opiate Theory?

Low pulse frequency and long phase duration Signup and view all the answers

Study Notes

Ultrasound

Ultrasound is a deep tissue hearing modality that can pass through skin and subcutaneous fat layers to reach muscles, tendons, ligaments, joint capsules, and scar tissue.
Ultrasound uses a non-thermal mechanism, but the setting and goal of treatment can affect its thermal properties.
The transducer, also known as the sound head, converts electrical energy into sound waves.
Different sizes of transducers are available based on the size of the treatment area.
Ultrasound waves are produced by an alternating current that flows through a piezoelectric crystal in the transducer. The crystal vibrates rapidly, creating sound waves.
The Effective Radiating Area (ERA) is the area of the transducer from which ultrasound energy radiates, primarily in the middle.
General rule: treatment area should be twice the size of the sound head.
Spatial Peak Intensity (SPI) is the peak intensity of the ultrasound beam.
Spatial Average Intensity (SPA) is the average intensity of the ultrasound beam across the ERA.
Beam Nonuniformity Ratio (BNR) is the ratio of SPI to SPA. Lower BNR indicates a more even intensity of sound waves, minimizing "hot spot" risk.
Air is a poor conductor of ultrasound, while ultrasound gel, diclofenac, and water-based products are good conductors.
Duty cycle refers to the pulsed non-thermal effects of ultrasound, while continuous thermal effects are associated with a constant duty cycle.
Higher frequency (3 MHz) leads to faster absorption of ultrasound. Lower frequency (1 MHz) leads to slower absorption.

Thermal Ultrasound

Thermal ultrasound increases blood flow, reduces muscle spasm, enhances extensibility, and increases sensory and motor nerve conduction.
It can improve tissue healing by increasing tissue strength, collagen synthesis, and fibroblastic activity.
Thermal ultrasound also increases tissue elasticity and pain threshold.
Temperature rise with thermal ultrasound:
- 1°C: mild heating, increases metabolic activity
- 2-3°C: moderate heating, reduces muscle spasm, increases blood flow, reduces chronic inflammation
- 4°C: vigorous heating, alters elastic properties of collagen
Factors to consider when determining thermal ultrasound parameters: frequency, duration, and intensity.
The Tissue Temperature Rise (TTR) formula can be used to calculate treatment time: 0.2 x (frequency in MHz) x (intensity in W/cm²) = TTR. Time = TTR/x.

Non-Thermal Ultrasound

Non-thermal ultrasound, specifically pulsed ultrasound, is used for its effects on tissue healing and cellular activity.
It can increase cell activity through pressure from sound waves, reducing capillary leakage.
There is limited evidence supporting the use of non-thermal ultrasound.

Contraindications for Ultrasound

Acute conditions
Over eyes, heart, skull, genitals
Over cancerous tumors
Over the spinal cord
Over fracture sites
Active infection
Impaired circulation
Plastic implants
Pelvic/lumbar areas in menstruating females
Pregnancy over pelvic/lumbar areas

Ultrasound Applications: Phonophoresis

Phonophoresis uses ultrasound to deliver medication to local tissues.
Anti-inflammatory medications like diclofenac are commonly used.
Advantages of phonophoresis include targeted delivery of medication, reduced systemic side effects, and potential for increased efficacy compared to topical application.
Skin condition is a factor in phonophoresis: tattoos, wounds/cuts, and dryness can affect medication penetration.

Adverse Effects of Ultrasound

Minimal adverse effects if used correctly.
Burns can occur with high-frequency application.
Cross-contamination risk: clean sound heads after each use.

Manual Therapy

Massage therapy involves treating a specific area while being comfortable for both the therapist and the patient.
Professionalism in massage therapy encompasses ethical considerations, personal appearance, hygiene, appropriate touching, and avoiding unnecessary exposure.
Hand washing before and after treatment, appropriate jewelry, and nail care are important aspects of hygiene.

Methods of Manual Therapy Techniques

Deep Tissue Massage: targets individual deep muscle fibers, releases adhesions, and increases blood flow.
Lymphatic Massage: works on the lymphatic system, removing edema, waste, and toxins from the body.
Myofascial Release: aims to break adhesions and restrictions in the body's fascia.
Instrumented Assisted: uses tools to facilitate massage techniques.
Active Release Technique: combines deep tissue and myofascial release.

Effleurage

Effleurage is a stroking technique performed from distal to proximal, primarily using hands.
It can be deep or superficial, targeting muscle strains and improving circulation.
Techniques involve strokes directed towards the heart, utilizing thumbs, and focusing on contact points.

Petrissage

Petrissage involves lifting, kneading, and rolling motions.
It targets specific areas in muscles and frees adhesions by stretching and separating muscle fibers, fascia, and scar tissue.
Indications include late stages of healing, chronic injuries, multiple muscle involvement, and superficial muscles.
Techniques involve using one or two hands to grip, lift, and move the underlying muscle tissue back and forth.

Friction

Friction massage increases tissue extensibility.
Two types: circular friction and transverse friction.
Friction can be painful - it is a controlled microtrauma technique that stimulates local inflammation and healing activities.
Benefits include breaking down adhesions, initiating remodelling, and allowing full functional restoration.
Treatment time is typically 5-10 minutes or until petechiae (red splotches on skin) appear.

Cupping

Cupping uses cups to create a vacuum on the skin, drawing blood to the surface and pulling toxins from the body.
Increases blood circulation to muscles and tissues, supplies oxygen to cells, aids in realignment (knots), and releases/drains excess fluids and toxins.
Glass, rubber, silicone, and plastic cups are used.
Cup size and number depend on the treatment area.
1.5-2 full pumps are applied, with cups remaining on for 10 minutes.
Cups can be used in a gliding technique.

Color Meaning in Cupping

White: Blood deficiency
Pink: Normal healthy blood circulation
Dark pink: Moderate stagnation
Dark purple: Severe stagnation, blockage, indicating improvement in blood flow and adhesion breakdown
Pink with purple dots: Congestion and toxins in the area

Expected Results with IASTM/Cupping

Discomfort during and after treatment.
Redness or marks may last days to weeks.
Tenderness to the touch.
Inflammation.
Pre-treatment education of patients is essential.

Electrical Stimulation Principles: IFC/Premod

Electrical current is the flow of electrons.
Requirements for electrical current: source of electrons (voltage), conductive material, and driving force (voltage).
Electrons possess positive and negative charges.

Ampere (A): unit for measuring current.
Coulomb (C): unit for measuring electrical charge.
Voltage (V): measurement of electrical force.
Ohm: unit for measuring resistance.

Alternating Current (AC)

AC current changes direction from positive to negative.
No true positive or negative pole.
Basic pattern is a sine wave.
AC can be used for pain stimulation, making the stimulation more comfortable.

Parameter Vocabulary for Electrical Stimulation

Baseline (horizontal axis): represents time.
Phase duration: time required for each phase to complete its shape.
Pulse duration: distance the pulse covers on the baseline from the beginning to the end of the phase(s).
Interphase: time between phases of a pulse.

Rise time: time it takes current to increase from 0 to its peak.
Decay time: time it takes current to decrease from its peak to zero.
On/Off time: duration of current flow versus no flow.
Duty cycle: ratio of on time to total treatment time.

How IFC/Premod Works

Electrical stimulation for pain control, decreasing pain perception.
Can be used effectively in conjunction with other modalities.

Pain Control: Gate Control Theory

High pulse frequency (50-180 pulses per second).
Short pulse duration (75-150 microseconds).
Intensity adjusted to tolerance (strong but comfortable), avoiding muscle contraction.
Sensory level, targeting A-beta nerves.
Effective for acute pain, blocking pain receptors and limiting pain transmission.
Treatment time 20-30 minutes.

Pain Control: Endogenous Opiate Theory

Low pulse frequency (0-10 pulses).
Long phase duration (300-400 microseconds).
Intensity adjusted to tolerance, allowing comfortable muscle contractions.
Motor level, targeting motor nerves.
Effective for chronic pain, releasing enkephalins and endorphins to produce an opiate effect on pain transmission.

Tissues

Excitable tissues: nerves, muscle fibers; directly influenced by electrical stimulation.
Non-excitable tissues: bone, cartilage, tendons, adipose tissue, ligaments; less directly influenced by electrical stimulation.
Electrical stimulation is more effective on excitable tissue than non-excitable tissue.

Electrode Leads

Connect electrodes to the generator.
Minimum of 2 leads are required to complete the electrical path.
FDA regulations require electrode lead wires with jacks that prevent unintended contact between the patient and the electrical power source.

Electrodes

Introduce electrical current to the body from the stimulator via the electrode leads.
Types: carbon, adhesive.
Conductive medium: reduces resistance and provides even distribution of current.

Skin Electrode Resistance

Moistening electrodes with water or conductive gel reduces resistance.
Removing dirt, oil, or flaky skin with alcohol improves conductivity.
Removing excess hair reduces impedance.

Electrode Size

Current density: voltage per unit area.
Smaller electrodes have higher current density.
Larger electrodes produce stronger, more comfortable contractions.
Electrode size often depends on the size of the treatment area and desired effect.

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Description

Explore the fundamentals of ultrasound therapy, including its mechanisms, applications, and the components involved, such as transducers and intensity measures. This quiz covers how ultrasound interacts with different tissues and how it can be effectively applied in therapeutic settings.