ultrasunetul.ppt
TRANSCRIPT
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Asist. Univ. Dr. Luana Macovei
ULTRASUNETUL
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Caracteristici
Definitie- vibratii acustice cu frecv mare, inaudibile,care determina efecte fiziologice termice si non-termice
US + diatermia = termoterapie profunda (3 cm)Frecv US terapeutic = 0,75-3 MHz; frecventa (nuintensitatea) este cea de care depinde profunzimea efectelor Parametrul de care se tine cont = W/cm2(=puterea/suprafata)Propagarea US in medii biologice se face in camp apropiat,sub forma unui manunchi cilindric de raze
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Modalitati de aplicare a radiatiei ultrasonice
1. In regim cu “unda continua”: ap emite energie ultrasonica in mod neintrerupt, pe toata S tegumentului2. In regim cu “impulsuri” (regim “iterativ”): efect= reduce ef termic (caloric) asupra tes=> permite utilizarea de radiatii de I mai mari, in scopul obtinerii unui ef mecanic si chimic mai important.3. Regimul “modulat”:se realizeaza o variatie in amplitudine a undelor
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ULTRASONOFOREZA= procedeul prin intermediul caruia se realizeaza patrunderea in org iradiat a unor substante farmaceutice (hidrocortizon, analgezice, anestezice locale)Doza de US = cant de energie absorbita intr-o unitate de timp, pe o unitatea de volum a obectului iradiat
Intensitati biologice- CLASIFICARE:
1.DOMENIUL I (0,1- 0,4 W/cm2) cu modificari fara imp, reversibile2.DOMENIUL II (0,5-0,6 W/cm2)cu act fizico-chimica maxima3.DOMENIUL III (≥0,8 W/cm2)modificari stabile si ireversibile
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EFECTE BIOLOGICE
a.Efect analgetic:dat ef mecanic si termic; ef pe rad nervoasa, ggl limfatici, muschi
b.Efect miorelaxant: prin ef mecanic (micromasaj); indicatii: contr musc primara (miopatii), contr musc secundara (discopatie); contraindicatii- contr musc analgica (sdr de NMC)
c.Efect metabolic: dat ef de cavitatie; doze 0,5-1 W/cm2; + medic ionizabile=> ultrasonoforeza
d.Efect rezorbtiv si fibrinolitic: doze de 1-2-3 W/cm2
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Metodologie de aplicare si prescriere a US:
I. TEHNICA DE IRADIEREa) Camp stationar: - cap radiant mic si imobil- aplicare ggl + efecte fibrinolitice (cicatrici cheloide, b Dupuytren);
aplicare radiculara paravertebralab) Camp semimobil:- cap radiant miscat f lin pe zone mici- aplicatii rad paravertebrale , trigger points, rezorbtia de calcar din
tendoane, stari posttraumatice cu edemc) Camp mobil:- cap radiant miscat lent pe zone mai mari, de-a lungul nerv
periferici
II. DOZAJUL:Doze mici: 0,05-0,5 W/cm2Doze medii: 0,5-1 W/cm2Doze mari: 1-2 W/cm2 (ef fibrinolitic, risc de osteoporoza)
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III. TIMPUL DE APLICARE:Std acut – 2-3 minute, cp stationarStd cronic – 4-10 minute, cp semimobil si mobil
IV. RITM DE APLICARE: zilnic sau la 2 zile
V. NR. SEDINTE: Std acut: 5-6 sedinteStd cronic : 10-12 sedinte
Precizari: dp fiecare sedinta repaus cel putin 3-0-40 minute; de preferat aplicarea tratamentului dp mese, in faza trofotropa!!!
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INDICATIIA.Boli reumatismale:- efect: scade durerea si det imbunatatire
functionala prin: cresterea mobilitatii str, cresterea elasticitatii str, scaderea spasmului musculaturii si a contracturii
- artroze, PR, SA, reum abarticularB. Modificari ale circ arteriale periferice
(doze mici)C. Sechele posttraumatice :- contuzii, algoneurodistrofie, hematoame,
stim formarea calusului- sportivi: sdr adductorilor (fotbalisti), schiori
(entorse de genunchi), epicondilite (juc de tenis)
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INDICATII-cont.D. Boli de piele:-ptr subtierea, inmuierea S, scaderea senzatiei de prurit si retractie, scaderea senz de tensiune-cicatrici cheloide, veruci, nevi pigmentari, ulcere cutanate, degeraturi cr recidivate, af cosmeticeE. Af ginecologice: anexite, endometrite, metrite, parametrite cronice, mastoza fibro-chistica cr, repermeabilizarea trompei uterine (sterilitate)F. Boli interne: terapie reflexa cuti-viscerala (astm bronsic, ulcer gastric si duodenal)G. Suferinte ale globului ocular
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INDICATII-cont.H. Indicatii speciale:1.Fracturi: -se pot aplica pe tije, pot scadea pana la ½ perioada de vindecare, ef mai semnificative cu cat calusul este mai superficial; - 0,1-0,2 W/cm2, cate 3 min, la 3 zile2.Boala Dupuytren: US in baie partiala mana 37-38 grade C, urmata de aplicatie paravertebrala cervicala relfexa3.Algoneurodistrofiile posttraumatice: in toate stadiile; cu cat std este mai acut, cu atat doza este mai mica4.Nevralgii, nevrite: aplicatii locale sau reflexe
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INDICATII-cont.5. PSH: aplicatii locale paravertebrale cervico-dorsale 0,05-0,1 W/cm2, apoi aplicatii in jurul articulatiilor(“V” deltoidian), apoi direct pe articulatia SPH6. Poliartrita reumatoida: -dupa puseul acut-efecte in PR: creste vascularizatia segm, metabolismul si mobilitatea7. Colagenoze: creste vascularizatia 8. Zona zoster: -daca exista eruptie: aplicatii reflexe (paravertebral)-dp vindecarea eruptiei: aplicatii mixte (locale si relfexe)-nevralgia post-zosteriana: 6-12 sedinte zilnice; aplicatie in impulsuri
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CONTRAINDICATII
1. Zona cartilagiului de crestere2. Hematoame3. Zone cu tulb de sensibilitate4. Zone cu tulb circulatorii5. Insuficienta venoasa cronica6. Tromboflebita acuta7. Ochi si organe genitale8. Zona pelvina si in timpul/imediat dp menstruatie9. Sarcina10.Pace-maker cardiac11.Neoplazii12.Infectii cutanate acute13.Artroplastii totale- se produce incalzirea cimentului, nu
a protezei; se poate folosi in zonele cu implanturi metalice (brose, tije)