MedicineOrthopaedic SurgeryPhysiologyHeat TransferUltrasonographyUltrasoundMuscle MechanicsMusculoskeletal UltrasonographyMusculoskeletal UltrasoundThermal PhysiologyThermal StressesUltrasonicsHeat Transfer In TissuesScar Tissue EffectsScar Tissue MechanicsStretching DurationTemperature Effects On DecayTherapeutic Ultrasound TransducersThermal Tissue EffectsUltrasound Therapy
Researchers have determined that when therapeutic ultrasound vigorously heats connective tissue, it can be effective in increasing extensibility of collagen affected by scar tissue. These findings give credence to the use of continuous thermal ultrasound to heat tissue before stretching, exercise, or friction massage in an effort to decrease joint contractures and increase range of motion. Before our investigation, it was not known how long following an ultrasound treatment the tissue will remain at a vigorous heating level (>3 degrees C). We conducted this study to determine the rate of temperature decay following 3 MHz ultrasound, in order to determine the time period of optimal stretching. Twenty subjects had a 23-gauge hypodermic needle microprobe inserted 1.2 cm deep into the medial aspect of their anesthetized triceps surae muscle. Subjects then received a 3 MHz ultrasound treatment at 1.5 W/cm(2) until the tissue temperature was increased at least 5 degrees C. The mean baseline temperature before each treatment was 33.8 +/- 1.3 degrees C, and it peaked at 39.1 +/- 1.2 degrees C from the ultrasound. Immediately following the treatment, we recorded the rate at which the temperature dropped at 30-second intervals. We ran a stepwise nonlinear regression analysis to predict temperature decay as a function of time following ultrasound treatment. We found a significant nonlinear relationship between time and temperature decay. The average time it took for the temperature to drop each degree as expressed in minutes and seconds was: 1 degrees C = 1:20; 2 degrees C = 3:22; 3 degrees C = 5:50; 4 degrees C = 9:13; 5 degrees C = 14:55; 5.3 degrees C = 18:00 (baseline). We conclude that under similar circumstances where the tissue temperature is raised 5 degrees C, stretching will be effective, on average, for 3.3 minutes following an ultrasound treatment. To increase this stretching window, we suggest that stretching be applied during and immediately after ultrasound application.
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Effect of therapeutic temperatures on tendon extensibility.
Justus F. Lehmann, A J Masock, C. Gerald Warren et al. · PubMed · 1970 · 268 citations
Is therapeutic ultrasound effective in treating soft tissue lesions?
Allan Binder, G. Byron Hodge, Anna Greenwood et al. · BMJ · 1985 · 179 citations · Full text