Therapeutic Ultrasound is a well established and commonly used practice in the field of Physiotherapy and Rehabilitative sciences. Primarily ultrasound is used in the treatment and repair of soft tissue lesion management used as thermal modality. However in recent practice the non-thermal aspects of Ultrasound as intervention are being employed. Evidence indicates the dose dependant Ultrasound therapy effects the inflammatory, proliferative and remodelling phases of soft tissue injury to encourage the repair of damaged cells.
Therapeutic Ultrasound is the most commonly used modality of electro-physical agents in clinical practice. However as Ultrasound is a cyclic sound pressure wave, with a frequency of above 20 kHz, a coupling media is employed to allow the ultrasound to effectively pass through to the affected tissue. Any media that distorts, changes or effects the transferral of the ultrasonic energy to the tissue will drastically effect the results and effectiveness of the Therapeutic Ultrasound. Similarly, the composition of the target tissues will also influence the effectiveness of the Ultrasound. The speed of the sound in soft tissue is equal to v= f ·ƛ (where v is speed, f is frequency and lambda is distance in mm)
Absorption of the applied Ultrasonic energy into the tissue is necessary for effectiveness. Tissues higher in protein content will absorb Ultrasound to a greater extent. Therefore high protein and high collagen tissues such as Ligament, tendon and scar tissue are common targets in the treatment of soft tissue lesions, as there is a significant decrease in problems associated with wave reflection, such as the reflection of the Ultrasound energy (I= Iₒ e- µx ) (where I is initial intensity, x is the depth of tissue in mm and µ is the attenuation due to coefficient)
Results and Discussion
The therapeutic results of Ultrasound are definitively similar to those of other electro-physical therapies such as laser, and pulsed electromagnetic therapy. All three deliver the desired transferral of energy, resulting in cellular up-regulation. Despite this, Ultrasound is the most effective and commonly used medium in the treatment of soft tissue lesions, as these highly collagenous tissues better absorb the then mechanical energy. Later study is being focused on the application of Ultrasound treatments, through various dressing mediums to increase the effectiveness of ultrasound, whilst the effected tissues are supported via clinical mediums. This would meant that effective treatment could be administered whilst the supporting and containing inflammation. This could also reduce the frequency of infection.