Ultrasound therapy is one type of heat therapy.

the method of treatment uses sound waves to

stimulate damaged tissue

Ultrasound therapy (AS) is one type of therapy in the field of Physical Medicine and Rehabilitation
that uses sound / ultrasonic waves with frequency of sound waves that cannot be heard by the
human ear with a frequency of 20,000 times per second / Hertz (Hz) for therapeutic purposes in the
field musculoskeletal rehabilitation. Ultrasound therapy can reach a depth of 2-5 cm from the
surface of the body.

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

• Vigorous heating
– 1 MHz output
• 10 to 12 minuts
– 3 MHz output
3 to 4 minutes
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

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)
• 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

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/cm2
• Transducer is held appx. 1” from the body part
• Avoid the formation of air bubbles

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
CONTRAINDICATIONS :
Do not expose either the embryo or foetus to therapeutic levels of ultrasound by treating over the
uterus during pregnancy
Malignancy (history of malignancy is NOT a contraindication – DO NOT treat over tissue that is, or
considered to be malignant)
Tissues in which bleeding is occurring or could reasonably be expected (usually within 4-6 hours of
injury but may be longer in some instances and for some patients)
Significant vascular abnormalities including deep vein thrombosis, emboli and severe
arteriosclerosis / atherosclerosis (if increase in local blood flow demanded by the treatment can not
reasonably be delivered)
Patients with Haemophilia not covered by factor replacement
Application over : o The eye o The stellate ganglion o The cardiac area in advanced heart disease &
where pacemakers in situ o The gonads o Active epiphyses in children (Ok to use US in children –
critical question is whether the applied energy would reach the epiphysis whilst it is active

Patient Preparation
1. Use clothes that are loose and comfortable.
2. The doctor or therapist will re-examine the area to be given therapy and conduct an interview
again about the abnormalities suffered and possible contraindications for the provision of therapy
and a history of allergies to certain substances that are applied. Doctors and therapists will explain
once again the purpose of ultrasound therapy according to the condition and condition of a person,
each individual is different.
3. The doctor or therapist will clean the area to be treated from oil or dirt that sticks to the skin,
including from lotions or rubbing drugs that were used previously using cotton cotton or cotton that
is given water. If you have sensitive and very dry skin, it is best to tell your doctor or therapist that
alcohol will not be used which can sometimes cause skin irritation.
4. The doctor or therapist will position the parts that will be treated as comfortably as possible.
5. The doctor or therapist will adjust the dosage of the ultrasound device.
6. The doctor or therapist will give a gel over the skin to be treated or certain topical drugs mixed
with ultrasound gel on Ultrasound Phonophoresis therapy, then start doing therapy with circular
probe motion or back and forth in the area. When the therapy is carried out if the desired thermal
effect, it will feel warm in the treated area, if the mechanical or non-thermal effects are desired then
nothing will feel just the movement of the ultrasound probe. Therapy will last for 7-10 minutes
depending on the goal of therapy. (The probe is a device that emits ultrasound waves on ultrasound
therapy such as a hand shower).
7. If you feel pain or excessive heat during therapy, immediately tell your doctor or therapist.
8. After completing therapy, the doctor or therapist will clean the remaining gel or topical drugs that
are still remaining in the treated area and will stretch the area several times.
9. The doctor or therapist will return to the examination and interview regarding the effects that are
felt after finishing therapy.
Effect

In general, ultrasound therapy is very rarely cause side effects, if side effects occur, are reversible or
can return to perfect after therapy is stopped or within 2-3 days. Side effects that can occur:
1. Heat that can cause redness on the skin and feels sore.
2. Increased pain if the intensity of therapy given is too large and the technique of giving ultrasound
therapy is stationary or immovable.
3. On giving Ultrasound Phonophoresis therapy using certain topical drugs can cause an allergic
reaction in the form of itching and redness on the skin.