Low-intensity pulsed ultrasound

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Low-intensity pulsed ultrasound
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Low-intensity pulsed ultrasound (LIPUS) is a medical technology, generally using 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.[1] As of 2009 research for the use of LIPUS to treat soft tissue injuries were in the early stages.[1] As of 2012 it was being studied for dental problems.[2]

Medical uses

Starting around the 1950s this technology was being used as a form of physical therapy for ailments such as tendinitis.[3]

Low intensity pulsed ultrasound has been proposed as a therapy to support bone healing after fractures, osteotomies, or delayed healing. A 2017 review, however, found no trustworthy evidence for the use of low intensity pulsed ultrasound for bone healing.[4] An associated guideline issued a strong recommendation against its use in bone healing.[5] Evidence as of 2014 was insufficient to justify its use to prevent non healing of bone fractures.[6] Tentative evidence supports better healing with the use of the system in long bones that have not healed after three months.[7] Some reviews suggested inconclusive evidence of benefit.[8] One industry supported meta-analysis suggested it as a potential alternative to surgery for established nonunions.[9] Most studies suggesting benefit were funded by manufacturers of ultrasound devices.[4]

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.[10]

References

  1. ^ a b Khanna, A; Nelmes, RT; Gougoulias, N; Maffulli, N; Gray, J (2009). "The effects of LIPUS on soft-tissue healing: a review of literature". British Medical Bulletin. 89: 169–82. doi:10.1093/bmb/ldn040. PMID 19011263.
  2. ^ Rego, E. B. (2012). "Current Status of Low Intensity Pulsed Ultrasound for Dental Purposes". The Open Dentistry Journal. 6: 220–5. doi:10.2174/1874210601206010220. PMC 3547311. PMID 23341848.
  3. ^ 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. doi:10.7863/jum.2012.31.4.623. ISSN 0278-4297. PMC 3810427. PMID 22441920.
  4. ^ a b 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. (22 February 2017). "Low intensity pulsed ultrasound for bone healing: systematic review of randomized controlled trials". BMJ. 356: j656. doi:10.1136/bmj.j656 (inactive 2019-03-13). ISSN 1756-1833. PMC 5484179. PMID 28348110.
  5. ^ 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 (21 February 2017). "Low intensity pulsed ultrasound (LIPUS) for bone healing: a clinical practice guideline". BMJ (Clinical Research Ed.). 356: j576. doi:10.1136/bmj.j576. PMID 28228381.
  6. ^ Griffin, XL; Parsons, N; Costa, ML; Metcalfe, D (23 June 2014). "Ultrasound and shockwave therapy for acute fractures in adults". The Cochrane Database of Systematic Reviews (6): CD008579. doi:10.1002/14651858.CD008579.pub3. PMID 24956457.
  7. ^ Higgins, A; Glover, M; Yang, Y; Bayliss, S; Meads, C; Lord, J (October 2014). "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. 12 (5): 477–84. doi:10.1007/s40258-014-0117-6. PMC 4175405. PMID 25060830.
  8. ^ Lou, S.; Lv, H.; Li, Z.; Zhang, L.; Tang, P (1 September 2017). "The effects of low-intensity pulsed ultrasound on fresh fracture: A meta-analysis". Medecine (39): e8181. PMID 28953676.
  9. ^ Leighton, R.; Watson, J.T; Giannoudis, P.; Papakostidis, C.; Harrison, A.; Steen, R.G. (May 2017). "Healing of fracture nonunions treated with low-intensity pulsed ultrasound (LIPUS): A systematic review and meta-analysis". Injury (7): 1339–1347. PMID 28532896.
  10. ^ "Whole-brain LIPUS therapy improves cognitive dysfunction in mice simulating dementia, Alzheimer's". News-Medical.net. July 20, 2018. Retrieved July 20, 2018.
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