Electrotherapy has been drifting in and out of fashion in the physiotherapy world for years.Old attitudes of a poor evidence base are slowly being challenged by new emerging evidence. At university we were taught by Tim Watson who is well known for his extensive work in this field. His own website is your best resource and can be found below. Your patients will ask you what electrotherapy you are using and how it works so familarise yourself with a condensed layman’s explaination.
A quick overview
Ultrasound is a form of mechanical energy where sound waves transmit through tissues. Parameters can be altered to achieve different physiological effects at different stages of tissue healing.
If used correctly US can :
- Increases cellular activity
- During the inflammatory phase, US has a stimulating effect on the mast cells, platelets, white cells with phagocytic roles and the macrophages (Nussbaum 1997, ter Haar 1999, Fyfe & Cahal 1982, Maxwell 1992, Watson 2008).
- Ultrasound applied to tissues enhances the functional capacity of the scar tissues (Nussbaum 1998, Huys et al 1993, Tsai et al 2006, Yeung et al 2006).
- Increases tensile strength and enhancing scar mobility (Nussbaum 1998, Wang 1998).
- US over the uterus during pregnancy
- Malignancy ( increases cellular activity in an area considered to be malignant may increase growth and reduce the patients prognosis)
- Over haemotoma/bruised tissue.
- Significant vascular abnormalities including deep vein thrombosis, emboli and severe arteriosclerosis / atherosclerosis.
- Haemophiliacs not covered by factor replacement
- Application over :
The stellate ganglion
The cardiac area in advanced heart disease & where pacemakers in situ
Active epiphyses in children (Ok to use US in children – critical question is whether the applied energy would reach the epiphysis)
- Always use the lowest intensity which produces a therapeutic response
- Ensure that the applicator is moved throughout the treatment (speed and direction not an issue)
- Caution is advised in the vicinity of a cardiac pacemaker or other implanted electronic device
- Continuous ultrasound is considered unwise over metal implants
- Superficial Ligament Damage
- Trochanteric Bursitis
- Facet Joint Inflammation
- Muscle Tears
- Fracture Healing
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