A Review of Therapeutic Ultrasound: Biophysical Effects

Almost 2 decades ago, it was pointed out that physical therapists tended to overlook the tenuous nature of the scientific basis for the use of therapeutic ultrasound. The purpose of this review is to examine the literature regarding the biophysical effects of therapeutic ultrasound to determine whether these effects may be considered sufficient to provide a reason (biological rationale) for the use of insonation for the treatment of people with pain and soft tissue injury. This review does not discuss articles that examined the clinical usefulness of ultrasound (see article by Robertson and Baker titled “A Review of Therapeutic Ultrasound: Effectiveness Studies” in this issue). The frequently described biophysical effects of ultrasound either do not occur in vivo under therapeutic conditions or have not been proven to have a clinical effect under these conditions. This review reveals that there is currently insufficient biophysical evidence to provide a scientific foundation for the clinical use of therapeutic ultrasound for the treatment of people with pain and soft tissue injury. [Baker KG, Robertson VJ, Duck FA. A review of therapeutic ultrasound: biophysical effects.

[1]  J. Saunders,et al.  Detection of acoustic emission from cavitation in tissue during clinical extracorporeal lithotripsy. , 1996, Ultrasound in medicine & biology.

[2]  S Daniels,et al.  Evidence for ultrasonically induced cavitation in vivo. , 1981, Physics in medicine and biology.

[3]  R. D. Hogan,et al.  The effect of ultrasound on microvascular hemodynamics in skeletal muscle: effect on arterioles , 1982 .

[4]  D. Hanahan,et al.  Patterns and Emerging Mechanisms of the Angiogenic Switch during Tumorigenesis , 1996, Cell.

[5]  J. Lehmann,et al.  Effect of therapeutic temperatures on tendon extensibility. , 1970, Archives of physical medicine and rehabilitation.

[6]  Linda Maxwell,et al.  Therapeutic Ultrasound: Its Effects on the Cellular and Molecular Mechanisms of Inflammation and Repair , 1992 .

[7]  D. Watmough,et al.  Imaging microbubbles and tissues using a linear focussed scanner operating at 20 MHz: possible implications for the detection of cavitation thresholds. , 1991, Ultrasonics.

[8]  M. Bullock,et al.  Therapeutic ultrasound: some historical background and development in knowledge of its effect on healing. , 1985, The Australian journal of physiotherapy.

[9]  Wyper Dj,et al.  Effects of some physiotherapeutic agents on skeletal muscle blood flow. , 1976 .

[10]  W. Harvey,et al.  Reduction of postoperative pain and swelling by ultrasound treatment: a placebo effect , 1988, Pain.

[11]  C. Enwemeka,et al.  The biomechanical effects of low-intensity ultrasound on healing tendons. , 1990, Ultrasound in medicine & biology.

[12]  M. Dyson,et al.  The effect of therapeutic ultrasound on angiogenesis. , 1990, Ultrasound in medicine & biology.

[13]  M C Ziskin,et al.  The sensitivity of biological tissue to ultrasound. , 1997, Ultrasound in medicine & biology.

[14]  E. Haker,et al.  A comparative study of continuous ultrasound, placebo ultrasound and rest in epicondylalgia. , 1988, Scandinavian journal of rehabilitation medicine.

[15]  A. Grant,et al.  Ultrasound and pulsed electromagnetic energy treatment for perineal trauma. A randomized placebo‐controlled trial , 1989, British journal of obstetrics and gynaecology.

[16]  A. R. Ward,et al.  Dangers in extrapolating in vitro uses of therapeutic ultrasound. , 1996, Physical therapy.

[17]  B. Rigby.  THE EFFECT OF MECHANICAL EXTENSION UPON THE THERMAL STABILITY OF COLLAGEN. , 1964, Biochimica et biophysica acta.

[18]  S. Robinson,et al.  Effect of continuous-wave ultrasound on blood flow in skeletal muscle. , 1995, Physical therapy.

[19]  N. Byl,et al.  Low-dose ultrasound effects on wound healing: a controlled study with Yucatan pigs. , 1992, Archives of physical medicine and rehabilitation.

[20]  R. H. Bickford,et al.  Influence of Ultrasonic Irradiation on Temperature and Blood Flow in Human Skeletal Muscle , 1953, Circulation research.

[21]  B. Starcher,et al.  The effect of ultrasound on collagen synthesis and fibroblast proliferation in vitro. , 1995, Medicine and science in sports and exercise.

[22]  J. Saunders,et al.  The cavitation threshold of human tissue exposed to 0.2-MHz pulsed ultrasound: preliminary measurements based on a study of clinical lithotripsy. , 1995, Ultrasound in medicine & biology.

[23]  M. Dyson,et al.  Stimulation of healing of varicose ulcers by ultrasound. , 1976, Ultrasonics.

[24]  D. Draper,et al.  Rate of temperature increase in human muscle during 1 MHz and 3 MHz continuous ultrasound. , 1995, The Journal of orthopaedic and sports physical therapy.

[25]  G. Raaphorst,et al.  Changes in muscle blood flow distribution during hyperthermia. , 1997, International journal of hyperthermia : the official journal of European Society for Hyperthermic Oncology, North American Hyperthermia Group.

[26]  The effects of ultrasound on chromosomes, nuclei and other structures of the cells in plant tissues. , 1954, Archives of physical medicine and rehabilitation.

[27]  J. Herrick,et al.  Certain physiologic and pathologic effects of microwaves , 1953, Electrical Engineering.

[28]  D. Kirkendall,et al.  A comparison of temperature rise in human calf muscles following applications of underwater and topical gel ultrasound. , 1993, The Journal of orthopaedic and sports physical therapy.

[29]  V. Rimer,et al.  Effects of ultrasound exposure in vitro on neuroblastoma cell membranes. , 1989, Ultrasound in medicine & biology.

[30]  R. D. Hogan,et al.  The effect of ultrasound on microvascular hemodynamics in skeletal muscle: effects during ischemia. , 1982, Microvascular research.

[31]  E. Everbach,et al.  Transient acoustic cavitation in gallstone fragmentation: a study of gallstones fragmented in vivo. , 1993, Ultrasound in medicine & biology.

[32]  P. Abraham,et al.  Diameter and blood velocity changes in the saphenous vein during thermal stress , 2004, European Journal of Applied Physiology and Occupational Physiology.

[33]  J. Lehmann,et al.  Comparative study of the efficiency of short-wave, microwave and ultrasonic diathermy in heating the hip joint. , 1959, Archives of physical medicine and rehabilitation.

[34]  P. Knipschild,et al.  A randomized clinical trial of ultrasound in the treatment of pressure ulcers. , 1996, Physical therapy.

[35]  T. Franklin,et al.  Acute effects of ultrasound on skeletal muscle oxygen tension, blood flow and capillary density. , 1990, Ultrasound in medicine & biology.

[36]  M. Kirsch‐Volders,et al.  In vitro effects of therapeutic ultrasound on the nucleus of human fibroblasts. , 1995, Physical therapy.

[37]  T. Ashikaga,et al.  The effects of heating with ultrasound on knee joint displacement. , 1997, The Journal of orthopaedic and sports physical therapy.

[38]  R E Apfel,et al.  Direct evidence of cavitation in vivo from diagnostic ultrasound. , 1996, Ultrasound in medicine & biology.

[39]  M. Nykänen.  Pulsed ultrasound treatment of the painful shoulder a randomized, double-blind, placebo-controlled study. , 1995, Scandinavian journal of rehabilitation medicine.

[40]  W. Harvey,et al.  Anti-inflammatory effects of ultrasound therapy: evidence for a major placebo effect. , 1986, British journal of rheumatology.

[41]  C. Enwemeka,et al.  The Effects of Therapeutic Ultrasound on Tendon Healing: A Biomechanical Study , 1989, American journal of physical medicine & rehabilitation.

[42]  L. Rowell,et al.  Interactions between local and reflex influences on human forearm skin blood flow. , 1976, Journal of applied physiology.

[43]  A. Rauth,et al.  Mechanism of ultrasound enhanced porphyrin cytotoxicity. Part I: A search for free radical effects. , 1997, Ultrasound in medicine & biology.

[44]  P. Edmonds,et al.  Evidence for free radical production by ultrasonic cavitation in biological media. , 1983, Ultrasound in medicine & biology.

[45]  S. Egginton,et al.  In vivo angiogenesis in adult rat skeletal muscle: early changes in capillary network architecture and ultrastructure , 1996, Cell and Tissue Research.