Low-intensity pulsed ultrasound explained

Low-intensity pulsed ultrasound

Low-intensity pulsed ultrasound (LIPUS) is a technology that can be used for therapeutic purposes. It exploits low intensity and pulsed mechanical waves in order to induce regenerative and anti-inflammatory effects on biological tissues, such as bone,[1] cartilage, and tendon.[2] Even if the real mechanism underlying its effectiveness has not been understood yet, it is plausible that the treatment relies on non-thermal phenomena, such as microbubbles and microjets induced by cavitation, acoustic streaming, and mechanical stimulation.[3] [2]

Technique

LIPUS uses generally 1.5 MHz frequency pulses, with a pulse width of 200 μs, repeated at 1 kHz, at a spatial average and temporal average intensity of 30 mW/cm2.

Medical uses

Starting around the 1950s this technology was being used as a form of physical therapy for ailments such as tendinitis.[4]

As of 2009 research for the use of LIPUS to treat soft tissue injuries were in the early stages.[5] As of 2012 it was being studied for dental problems.[6]

Low intensity pulsed ultrasound has been proposed as a therapy to support bone healing after fractures,[1] osteomies, or delayed healing. A 2017 review, however, found no trustworthy evidence for the use of low intensity pulsed ultrasound for bone healing, mostly based on the large pragmatic randomized controlled trial published in 2016.[7] [8] An associated guideline issued a strong recommendation against its use in bone healing.[9] Evidence as of 2023 was insufficient to justify its use to prevent non healing of bone fractures.[10] Tentative evidence supports better healing with the use of the system in long bones that have not healed after three months.[11] Some reviews suggested inconclusive evidence of benefit.[12] One industry supported meta-analysis suggested it as a potential alternative to surgery for established nonunions.[13] Most studies suggesting benefit were funded by manufacturers of ultrasound devices.

In 2018, a study published in the journal Brain Stimulation, reported that experiments on mice showed that whole-brain LIPUS therapy markedly improved cognitive dysfunctions without serious side effects by enhancing specific cells related to dementia's pathology. Clinical trials are underway.[14]

In vitro experiments have confirmed the LIPUS capability to regulate cell proliferation and differentiation as well as the opening of cell membrane channels.[2]

Notes and References

  1. Book: https://books.google.com/books?id=K4xlDwAAQBAJ&q=%22LIPUS%22&pg=PA12. 9783319663234 . Tarek . El-Bialy . Eiji . Tanaka . Dror . Aizenbud. Springer. Mechanism of LIPUS on Dentofacial Bioengineering. Therapeutic Ultrasound in Dentistry: Applications for Dentofacial Repair, Regeneration, and Tissue Engineering. June 25, 2018 .
  2. Jiang. Xiaoxue. Savchenko. Oleksandra. Li. Yufeng. Qi. Shiang. Yang. Tianlin. Zhang. Wei. Chen. Jie. A Review of Low-Intensity Pulsed Ultrasound for Therapeutic Applications. IEEE Transactions on Biomedical Engineering. 66. 10. 2018. 2704–2718. 0018-9294. 10.1109/TBME.2018.2889669. 30596564. 58581708.
  3. Lin. Guiting. Reed-Maldonado. Amanda. Lin. Maofan. Xin. Zhongcheng. Lue. Tom. Effects and Mechanisms of Low-Intensity Pulsed Ultrasound for Chronic Prostatitis and Chronic Pelvic Pain Syndrome. International Journal of Molecular Sciences. 17. 7. 2016. 1057. 1422-0067. 10.3390/ijms17071057. 27376284. 4964433. free.
  4. Miller. Douglas. Smith. Nadine. Bailey. Michael. Czarnota. Gregory. Hynynen. Kullervo. Makin. Inder. April 2012. Overview of Therapeutic Ultrasound Applications and Safety Considerations. Journal of Ultrasound in Medicine. 31. 4. 623–634. 10.7863/jum.2012.31.4.623. 0278-4297. 3810427. 22441920.
  5. Khanna. A. Nelmes. RT. Gougoulias. N. Maffulli. N. Gray. J. The effects of LIPUS on soft-tissue healing: a review of literature.. British Medical Bulletin. 2009. 89. 169–82. 19011263. 10.1093/bmb/ldn040. free.
  6. 10.2174/1874210601206010220 . free. Current Status of Low Intensity Pulsed Ultrasound for Dental Purposes. The Open Dentistry Journal. 6. 220–5. 2012. Rego . E. B.. 23341848. 3547311.
  7. Schandelmaier. Stefan. Kaushal. Alka. Lytvyn. Lyubov. Heels-Ansdell. Diane. Siemieniuk. Reed A. C.. Agoritsas. Thomas. Guyatt. Gordon H.. Vandvik. Per O.. Couban. Rachel. Mollon. Brent. Busse. Jason W.. Low intensity pulsed ultrasound for bone healing: systematic review of randomized controlled trials. BMJ. 22 February 2017. 356. j656. 10.1136/bmj.j656. 28348110. 5484179. 1756-1833.
  8. Group. TRUST Investigators writing. Busse. Jason W.. Bhandari. Mohit. Einhorn. Thomas A.. Schemitsch. Emil. Heckman. James D.. Tornetta. Paul. Leung. Kwok-Sui. Heels-Ansdell. Diane. Makosso-Kallyth. Sun. Rocca. Gregory J. Della. 2016-10-25. Re-evaluation of low intensity pulsed ultrasound in treatment of tibial fractures (TRUST): randomized clinical trial. BMJ. en. 355. i5351. 10.1136/bmj.i5351. 1756-1833. 5080447. 27797787.
  9. Poolman. RW. Agoritsas. T. Siemieniuk. RA. Harris. IA. Schipper. IB. Mollon. B. Smith. M. Albin. A. Nador. S. Sasges. W. Schandelmaier. S. Lytvyn. L. Kuijpers. T. van Beers. LW. Verhofstad. MH. Vandvik. PO. Low intensity pulsed ultrasound (LIPUS) for bone healing: a clinical practice guideline.. BMJ (Clinical Research Ed.). 21 February 2017. 356. j576. 28228381. 10.1136/bmj.j576. free. 1765/98256. free.
  10. Searle . Henry Kc . Lewis . Sharon R. . Coyle . Conor . Welch . Matthew . Griffin . Xavier L. . 2023-03-03 . Ultrasound and shockwave therapy for acute fractures in adults . The Cochrane Database of Systematic Reviews . 2023 . 3 . CD008579 . 10.1002/14651858.CD008579.pub4 . 1469-493X . 9983300 . 36866917 .
  11. Higgins. A. Glover. M. Yang. Y. Bayliss. S. Meads. C. Lord. J. EXOGEN ultrasound bone healing system for long bone fractures with non-union or delayed healing: a NICE medical technology guidance.. Applied Health Economics and Health Policy. October 2014. 12. 5. 477–84. 25060830. 10.1007/s40258-014-0117-6. 4175405.
  12. Lou. S.. Lv. H.. Li. Z.. Zhang. L.. Tang. P. The effects of low-intensity pulsed ultrasound on fresh fracture: A meta-analysis. Medicine. 96. 1 September 2017. 39. e8181. 28953676 . 5626319. 10.1097/MD.0000000000008181.
  13. Leighton. R. . Watson . J.T . Giannoudis. P.. Papakostidis. C.. Harrison. A. . Steen. R.G. . Healing of fracture nonunions treated with low-intensity pulsed ultrasound (LIPUS): A systematic review and meta-analysis. Injury. 48 . May 2017. 7. 1339–1347. 28532896. 10.1016/j.injury.2017.05.016 . free.
  14. News: Whole-brain LIPUS therapy improves cognitive dysfunction in mice simulating dementia, Alzheimer's. 2018-07-20. News-Medical.net. 2018-07-20. en. mdy-all.

This article is licensed under the GNU Free Documentation License. It uses material from the Wikipedia article "Low-intensity pulsed ultrasound".

Except where otherwise indicated, Everything.Explained.Today is © Copyright 2009-2024, A B Cryer, All Rights Reserved. Cookie policy.