To all:
it is definitely an intersting conversation going on, and I have read the
studies in Physical Therapy about U/S showing no effect at all. Howver, I do
think that if we practiced EBM for everything, then perhaps we won't have
too much to use. Even a lot of our mobilisation techniques have not been
validated.
I still use U/S, but mainly on those patients who have been "trained" by
previous physio's or therapists and totally believe it is effective. I still
get old ladies who come in and say "my husband had that machine with the
gel, and it did miracles on his neck." Perhaps belief plays a big part as
well...
Henry***
>From: Geoff <[log in to unmask]>
>Reply-To: - for physiotherapists in education and practice
><[log in to unmask]>
>To: [log in to unmask]
>Subject: Re: ultrasound
>Date: Mon, 20 Aug 2001 18:55:34 -0700
>
>It is interesting that we put so much stock in a device that has never been
>shown to have a significant therapeutic benefit in any patient population.
>It is often very difficult for a profession to disgard any tool or idea
>that
>has long had a traditional place in it's repertoire, even when all evidence
>points to the uselessness of it.
>
>Sure, we can not just rely on research to make clinical judgments. We also
>cannot rely solely on poorly objective observations in the clinic. Someone
>is administered US and they feel relief of pain... was it from the US,
>another treatment, or the natural progression of the disease process? We
>can hardly justify charging for using US if the effects are purely placebo
>or incidental.
>
>As to the effects of energy in the tissues, I'm reminded of a research
>project a friend of mine designed at Sandia Laboratory. He applied US to
>muscle/bone models and thermographed them. He found that the attenuation
>of
>US energy in muscle was nearly zero at 1 and 3 MHz. The only area that
>showed appreciable energy absorption was at the surface of the bone. This
>may be great for someone with periosteum problems, but does little for a
>muscle strain.
>
>As for "non-thermal" effects, I am dubious as to any benefits. I would
>find
>much more credible the idea of compression, massage, and heat for moving
>things around in the tissues.
>
>Warm regards,
>Geoff Mosley, PT, NCS
>MRC
>Mt. Vernon, MO
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