Dear Ruth,
I would like to suggest that you should read the book titled "Physical
Agents: Theroy and Practice for the Physical Therapist Assistant. page
105. The authors, Barbara J Behrens and Susan L Michlovitz, say
The contraindication to treatment over epiphyseal plates in children
has been passed on as part of the tradition of ultrasound. These plates
give rise to new bone cells. The original work that gave rise to concern
was done on legs of dogs at very low frequency (0.8 MHz) and high
intensity (0.5 - 3.0 W/cm2 SA) using a stationary transducer. These
characteristics would have caused high absorption and intense heating of
bone. Subsequent work on animal bone by Dyson and others suggests that
healing fractures in fact that benefit from ultrasound at low dose. In
view of the adverse treatment characteristics of the early work and
advantages found in recent work, treatment over epiphyseal plates in
children is not considered a contraindication at the present time. It is
suggested that low treatment intensity be used and that the course of
treatment should not be prolonged.
In another book titled Thermal Agents in Rehabilitation, written by
Susan L. Micholovitz, page 164.
Epiphysial areas (growth areas of bone) in children should be exposed
to ultrasound only minimally. Literature in the field suggests that
intensities used therapeutically would be safe. But at intensities
greater than 3.0 W/cm2, there is some evidence of demineralization of
bone, damage to epiphyseal plates, and retardation of bone growth when
using a stationary transducer for periods of 3 minutes or more. There
are no reasons to avoid ultrasound application over fracture sites,
unless sensation to the area is impaired. In fact, recent animal studies
by Dyson and Brookes have demonstrated that pulsed ultrasound may
accelerate fracture healing. Certainly, this subject warrants further
investigation.
I hope this helps.
Sincerely,
hal berda wrote:
>
> Hello,
> What do you think to the use of ultrasound over epiphyseal plates in the
> under 16's? How about over fractured calcaneums??? in adults.
>
> We are having some disagreements with our consultants at present.
>
> Thanks
> Ruth.
--
Chung-hwi Yi, Ph.D., PT, Associate professor, Chairperson, Dept. of
Rehabilitation Therapy,
College of Health Science, Yonsei University#234 Hungob-myun, Wonju
City, Kangwon-do, Republic of Korea
220-710 Tel: 82-371-760-2429, Fax: 82-371-760-2496 email:
[log in to unmask]
%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%
|