We think you have liked this presentation. If you wish to download it, please recommend it to your friends in any social system. Share buttons are a little bit lower. Thank you!
Presentation is loading. Please wait.
Published bySydney Newton
Modified over 2 years ago
© 2005 – FA Davis Therapeutic Ultrasound Clinical Application
© 2005 – FA Davis FDA Labeling Requirements Output frequency Effective Radiating Area (ERA) Beam Nonuniformity Ratio (BNR) Beam profile Date of last service/calibration should also be posted on the unit
© 2005 – FA Davis Treatment Area US heats a limited area –About the size of a catsup packet Treatment area should be 2 to 3 times the size of the ERA For larger areas, divide the treatment area into smaller zones
© 2005 – FA Davis Coupling Methods Direct Coupling Immersion Method Pad/Bladder Method
© 2005 – FA Davis Coupling Methods Ultrasonic energy cannot pass through the air A coupling medium is required Medium should be water-based Coupling method should confirm to the body area The body area should be clean and relatively hair-free
© 2005 – FA Davis Direct Coupling Gel or Creams Only use approved coupling agents Apply liberally to area Remove air bubbles by passing sound head over area (before power is increased)
© 2005 – FA Davis Direct Coupling Move the sound head s-l-o-w-l-y –4 cm/sec Moving the head faster decreases heating If the patient describes discomfort, decrease the output intensity
© 2005 – FA Davis Coupling Ability of Various Media SubstanceTransmission Saran Wrap98 Lidex ge, fluocinonide (.05%)97 Thera-Gesic97 Mineral oil97 US Transmission gel96 US Transmission lotion90 Chempad-L68 Hydrocortisone powder (1%)29 Hydrocortisone powder (10%)7 Eucerin cream0 Myoflex0 White petrolatum gel0
© 2005 – FA Davis Immersion Technique Used to treat irregularly shaped areas The limb is immersed in a tub of degassed water If tap water is used, increase the output intensity by 0.5 w/cm 2 Transducer is held appx. 1 from the body part Avoid the formation of air bubbles
© 2005 – FA Davis Pad (Bladder) Method A mass of conductive gel –Commercial pads –Self-made bladders Conforms to the treatment area Commercial pads help limit the size of the treatment area
© 2005 – FA Davis Output Parameters Output Frequency Duration Duty Cycle Output Intensity
© 2005 – FA Davis Output Frequency Determines the treatment depth 1 MHz Output –Deep (5 to 7 cm) tissues Rotator cuff, vastus intermedius, gastroc 3 MHz Output –Superficial (up to 3cm deep) tissues Patellar tendon, MCL, brachialis Remember that adipose tissue is transparent to ultrasound
© 2005 – FA Davis Treatment Duration Depends on: –Size of the treatment area –Output intensity –Therapeutic goals Vigorous heating –1 MHz output 10 to 12 minuts –3 MHz output 3 to 4 minutes Also see Output Intensity
© 2005 – FA Davis Duty Cycle Determine the proportion of thermal and nonthermal effects –High duty cycle: Predominantly thermal effects –Low duty cycle: Predominantly nonthermal effects Thermal effect used in subacute and chronic conditions Nonthermal effects may be beneficial in acute stages
© 2005 – FA Davis Output Intensity – 1 MHz At a 100% duty cycle 1.75 W/cm 2 output Approximately 4 min treatment is required to increase tissue temp 4°C
© 2005 – FA Davis Output Intensity – 3 MHz At a 100% duty cycle 1.5 W/cm 2 output Approximately 10 min treatment is required to increase tissue temp 4°C
© 2005 – FA Davis Ultrasound and Electrical Stimulation Combo Treatment
© 2005 – FA Davis US/Electrical Stimulation Theoretically combines the benefit of the two treatments Used to treat: –Trigger points –Muscle spasm Output parameters: –Thermal ultrasound –Motor level electrical stimulation
© 2005 – FA Davis Set-up and Application
© 2005 – FA Davis Contraindications Acute injuries (100% duty cycle) Ischemic areas Areas of impaired circulation including arterial disease Over areas of deep vein thrombosis Anesthetic areas Over cancerous tumors Over sites of active infection or sepsis Over the spinal cord or large nerve plexus in high doses Exposed metal that penetrates the skin (e.g., external fixation devices) Areas around the eyes, heart, skull, or genitals Over the thorax in the presence of an implanted pacemaker Pregnancy when used over the pelvic or lumbar areas Over a fracture site before healing is complete Stress fracture sites or sites of osteoporosis Over the pelvic or lumbar area in menstruating female patients
© 2005 – FA Davis Precautions Symptoms may increase after the initial treatments. Use caution when applying ultrasound around the spinal cord, especially after laminectomy. The use of ultrasound over metal implants is not contraindicated –Keep the sound head moving Use caution when applying ultrasound over epiphyseal plates of growing bone
© 2005 – FA Davis Instrumentation Duty cycle: Adjusts between continuous and pulsed ultrasound application Frequency: Selects the depth of penetration Gel warmer: Used to preheat the transmission gel, primarily for patient comfort Intensity: Adjusts the output intensity. –The WATT METER displays the output in either total watts or watts per square centimeter. Maximum head temperature: Prevents overheating in case the head is not properly coupled. Pause: Interrupts the treatment but retains the remaining amount of treatment time Power: Turns the unit ON or OFF Start-Stop: Initiates or terminates the production of ultrasound from the transducer. Timer: Sets the duration of the treatment. Watt meter: Displays the output of ultrasound in total watts or watts per square centimeter.
© 2005 – FA Davis Patient Preparation Establish that no contraindications are present Determine the method and mode of ultrasound application to be used Clean the area to be treated Determine the type of coupling method to be used Identify a treatment area that is 2 to 3 times the ERA For direct coupling: spread the gel over the area to be treated Explain the sensations to be expected during the treatment: –Mild to moderate warmth (but not pain or burning) for thermal treatments –No subcutaneous sensations during pulsed ultrasound For thermal treatments pre-heating with a moist heat pack will decrease the treatment time required to reach vigorous heating levels Advise the patient to report any adverse, unusual, or painful sensations during the treatment.
© 2005 – FA Davis Initiation of the Treatment Reduce the INTENSITY to zero before turning on the POWER. Select the appropriate mode for the output (CONTINUOUS or PULSED) Set the WATT METER to displays the appropriate output for the type of treatment Set the TIMER to the appropriate treatment duration Begin slowly moving the sound head over the medium –Press the START button to begin the treatment session –Units having low BNR may be moved at a slower rate than those with a higher BNR Slowly increase the INTENSITY –Keep the sound head moving Move the head at a moderate pace (4 cm per second or slower) Use firm, yet not strong, overlapping strokes If pain is experienced: –Move the sound head at a faster rate –Use a lower duty cycle –Use a lower the intensity If the gel begins to wear away or if the sound head begins sticking on the skin, depress the PAUSE button and apply more gel
© 2005 – FA Davis Phonophoresis Application Preheating the area to increase the absorption of the medication Use only approved ultrasound transmission media. –The direct coupling method is recommended –Efficacy of phonophoresis using the bladder method has not been established Ensure that the skin is well moistened; avoid areas of dry skin Position the extremity to encourage circulation. Use a continuous output to maximize the effect of phonophoresis –Unless the thermal effects of ultrasound are contraindicated Follow the procedures described in Initiation of the Treatment After treatment, cover the remaining medication with an occlusive dressing.
© 2005 – FA Davis Termination of the Treatment If the treatment is being terminated prematurely: –Reduce the intensity before removing the transducer Clean the remaining gel from the patients skin To ensure continuity of treatment sessions: –Record the treatment parameters Output frequency Intensity Duration Duty cycle Running count of ultrasound treatments given for this condition Immediately initiate any post-treatment stretching
© 2005 – FA Davis Maintenance Daily Maintenance Clean ultrasound head and transducer face as recommended by the manufacturer Monthly Maintenance Check all electrical cords for frays or kinks Check the sound head cable for frays or kinks Clean the transmitter face as recommended by the manufacturer. Federal regulations require that therapeutic ultrasound units be recalibrated annually by an authorized service technician
Therapeutic Ultrasound Chapter 7. © 2005 – FA Davis Description Acoustical energy (sound waves) above the range of human hearing Acoustical energy (sound.
Deep Heat Ultrasound & Diathermy. Ultrasound Ultrasound is the most commonly used deep heating modality in use today. Penetration is between 3-5 cm. Acoustical.
Chapter 15: Therapeutic Modalities. Therapeutic modalities can be an effective adjunct to various techniques of therapeutic exercise A variety of modalities.
Therapeutic Modalities and Injury Rehabilitation.
Therapeutic Modalities Sports Medicine 2 Lexington High School.
Unit 9. What are they? Therapeutic= something that promotes healing and injury repair Modality= the method of application of any therapeutic agent Many.
Principles of Electrical Currents. Electricity is an element of PT modalities most frightening and least understood. Understanding the basis principles.
Thermal Agents: Heat. Heat modalities: Superficial Heat Skin temperature rises but subQ tissue increase is minimal 1cm penetration depth of penetration.
Thermal Agents: Cryotherapy. Basics of Heat Heat: a term used to describe the energy that matter can store in the form of electronic, atomic, or molecular.
T.E.N.S. Trancutaneous Electrical Nerve Stimulation.
First Aid. Emergency Procedures Emergency care is defined as an unforeseen combination of circumstances and the resulting state that call for immediate.
Performance Enhancement. Introduction Improvement in the athletes condition is the factor most responsible for enhanced performance. Maximum physical.
1 WRBCS201B – PROVIDE MANICURE AND PEDICURE SERVICES Student name: Student ID:
EMERGENCY STATE. ADDICTION Introduction: Addiction has been defined as physical and physiological dependence on psychoactive substances (for example alcohol,
Bathy-2010PC CHIRP Subbottom Profiler / Deep Water Echo Sounder Overview Operation Installation Maintenance Applications.
Care of Patients Undergoing Chemotherapy MMC-ONCOLOGY CLINIC BONE MARROW TRANSPLANT UNIT CES PAJE, BSN, R.N.
Prevention and Treatment of Athletic Injuries Westfield High School Houston, Texas.
Merit Badge ID #8 Requirement #1 Boy Scout Requirements (33215) Revised: July 2008 Written by: J McNamara Tenderfoot - Second Class – First Class First.
Interferential Current - IFC. Interferential Current History: In 1950 Nemec used interference of electrical currents to achieve therapeutic benefits.
© 2009 McGraw-Hill Higher Education. All rights reserved. Chapter 16: Using Therapeutic Exercise in Rehabilitation.
Injury and the Healing Process. Introduction to Injury When an injury takes place some responses are predictable, but others are unexpected It is not.
Lesson 1 Providing First Aid Imagine that you are taking care of your neighbors son when he suddenly steps on a nail, which has punctured his foot. What.
SPA-KUR THERAPY DEVELOPMENT Calistoga California USA HYDROTHERAPY combined with MANUAL LYMPH DRAINAGE MASSAGE PRESENTED BY.
1 © Medtronic, Inc Medtronic Pain Therapies Referral Strategies for Managing Chronic Pain.
Mechanical Modalities Therapeutic Modalities in Athletic Rehabilitation.
1 VACCINE ADMINISTRATION VACCINE ADMINISTRATION “TECHNIQUES AND GUIDELINES “ from The Centers for Disease Control and Prevention.
1 Pacemaker Patient Follow-up Module 8. 2 Objectives List the steps for performing a pacemaker follow-up Locate threshold, sensing and impedance data.
Electromyography (EMG) Mark David S. Basco, PTRP Faculty Department of Physical Therapy College of Allied Medical Professions University of the Philippines.
SIH40111 Certificate IV in Hairdressing E-LEARNING MATERIAL & ASSESSMENTS SIHHCLS406A Solve complex colour problems DEMONSTRATION UNIT DELIVERY STYLE -
© 2016 SlidePlayer.com Inc. All rights reserved.