1. THE USE OF ULTRASOUND IN PHYSIOTHERAPY
University of Split,

2. OUTLINE What is an ultrasound? History Tehnique of application
Therapeutic benefits and effects
Indications
Equipment

3. WHAT IS AN ULTRASOUND?
Ultrasound (sonography) is a method of stimulating the tissue beneath the skin's surface using very high frequency sound waves
It does not use ionizing radiation
The frequencies used in therapy are typically between 1.0 and 3.0 MHz (1MHz = 1 million cycles per second)

4. Vibrating source – a quartz or barium crystal
These crystals deform when subjected to varying potential difference – the piezo-electric effect
Piezoelectricity is a natural phenomenon; the crystal transforms mechanical energy into electrical energy and in reverse, electrical into mechanical

5. HISTORY
The first large scale application of ultrasound was around World War II
In 1938, Raimar Pohlman demonstrated the therapeutic effects of ultrasonic waves in human tissues
He suggested that the power of the transducer should be limited to 5 W/cm^2,

6. TEHNIQUE OF APPLICATION
Direct contact - ultrasound is applied using a transducer or applicator that is in direct contact with the patient's skin
Gel is used on all surfaces of the head to reduce friction and assist transmission of the ultrasonic waves
The treatment head of the transducer is moved in small concentric circles over the skin in order to avoid concentration at any point

8. Water bath – the bath is filled with distal water
Ordinary tap water presents the problem that gas bubbles dissociate out from the water
The technique of application is that the treatment head is held 1 cm from the skin and moved in small concentric circles

10. THERAPEUTIC BENEFITS AND EFFECTS
There are three primary benefits to ultrasound:
The first is the speeding up of the healing process from the increase in blood flow in the treated area
The second is the decrease in pain from the reduction of swelling and edema
The third is the gentle massage of muscles tendons and/ or ligaments in the treated area because no strain is added and any scar tissue is softened

11. The two types of effects are:
Thermal effects - due to the absorption of the sound waves
Non thermal effects – from cavitation, microstreaming and acoustic streaming
Cavitational effects are used to directly stimulate cell membranes therefore enhancing the cell-repair effects of the inflammatory response

12. Indications Soft tissue shortening Pain control
Surgical skin incisions
Tendon injuries
Resorption of calcium deposits
Bone fractures
Carpal tunnel syndrome

13. EQUIPMENT - outdated

14. EQUIPMENT - newer

15. CONCLUSION
Ultrasound is beneficial for its thermal and healing effects
Its usage dates to the early 1940’s
The safest and easiest method
Used mainly in cases of muscle, ligament and tendone injuries

16. THE END