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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