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Martínez CM, LLontop P, Pérez-Sanz F, Asensio F, Montero de Espinosa F. Ultrasound Therapy With High-Pressure Pulses Is Effective to Reduce the Effects of Collagenase-Induced Tendinopathy in Rat's Achilles Tendon. ULTRASOUND IN MEDICINE & BIOLOGY 2024; 50:1415-1425. [PMID: 38879428 DOI: 10.1016/j.ultrasmedbio.2024.05.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/24/2023] [Revised: 04/18/2024] [Accepted: 05/21/2024] [Indexed: 08/06/2024]
Abstract
OBJECTIVE We propose an ultrasonic treatment for collagenase-induced tendinopathy in rat's Achilles tendon using pulses with a low number of cycles, high acoustic pressure and very low duty cycle. METHODS Twenty rats were used to perform the experiment. Four experimental groups of calcaneal tendons were studied: control (n = 6), sham (n = 4), collagenase-induced tendinopathy (n = 8) and ultrasound-treated collagenase-induced tendinopathy (n = 8). Surgical intervention was performed to expose the tendons prior to collagenase injection. A 1 MHz ultrasonic tansducer with a focusing lens was used. Ultrasonic treatments were used with an average total treatment time of 2.5 min, 20-cycle pulses, pressure amplitude p = 7 MPa, and 0.02% duty cycle. Histopathology of the samples was performed to evaluate nuclear density, acute inflammation, and signs of neovascularization. Collagen (types I and III), elastic fibers, and glycosaminoglycans were also analyzed. RESULTS No tendon involvement was found by the surgical process. Ultrasonic treatment is safe, as it does not affect healthy tendons. When collagenase infiltrated animals were treated with US, a clear predominance of type I collagen fibers and a similar collagen ratio profile to that observed in the control and sham groups was observed, with a higher density of elastic fibers compared to the control and sham groups and a significant increase in the density of glycosaminoglycans. CONCLUSION The ultrasound treatment proposed reduces the effects of the artificial collagenase lesion to reach the basal level after 45 d.
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Affiliation(s)
- Carlos M Martínez
- Biomedical Research Institute of Murcia "Pascual Parrilla", Murcia, Spain
| | - Pedro LLontop
- Experimental Medicine and Surgery Unit, Hospital General Universitario Gregorio Marañón, Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), Madrid, Spain
| | | | - Fernando Asensio
- Experimental Medicine and Surgery Unit, Hospital General Universitario Gregorio Marañón, Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), Madrid, Spain
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Luo Y, Rahmati M, Kazemi A, Liu W, Lee SW, Gyasi RM, López Sánchez GF, Koyanagi A, Smith L, Yon DK. Effects of therapeutic ultrasound in patients with knee osteoarthritis: A systematic review and meta-analysis. Heliyon 2024; 10:e30874. [PMID: 38803857 PMCID: PMC11128881 DOI: 10.1016/j.heliyon.2024.e30874] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2024] [Revised: 04/02/2024] [Accepted: 05/07/2024] [Indexed: 05/29/2024] Open
Abstract
Background Therapeutic ultrasound (US) is a treatment for knee osteoarthritis (KOA), but its efficacy and safety are unclear. The objective of this study is to quantify the effect of US on pain relief and function recovery in KOA, and to analyze the US treatment duration and parameters on treatment outcome. Methods We searched PubMed, MEDLINE, EMBASE, Google Scholar, Cochrane databases and ClinicalTrials.gov databases up to April 7, 2023. RCTs that compared the efficacy of therapeutic US with the control in KOA were included in the study, and the methodological quality of the trials was assessed using the Cochrane Risk of Bias tool. Results Twenty-one RCTs (1315 patients) were included. US had a positive effect on visual analog scale (VAS) (SMD = -0.64, 95 % CI [-0.88, -0.40], I2 = 71 %) and Western Ontario and McMaster Universities (WOMAC) total scale (SMD = -0.45, 95 % CI [-0.69, -0.20]; I2 = 67 %). Pulsed US with an intensity ≤2.5 W/cm2 reduced visual analog scale (VAS), and differed in sessions (24 sessions (SMD = -0.80, 95 % CI [-1.07, -0.53], I2 = 0 %) vs 10 sessions (SMD = -0.71, 95 % CI [-1.09, -0.33], I2 = 68 %)). For pulsed US, a duration of treatment of 4-8 weeks (SMD = -0.69, 95 % CI [-1.13, -0.25], I2 = 73 %) appeared to be superior to ≤4 weeks (SMD = -0.77, 95 % CI [-1.04, -0.49], I2 = 0 %) for reducing visual analog scale (VAS). No US treatment-related adverse events were reported. Conclusion Therapeutic US may be a safe and effective treatment for patients with KOA. The mode, intensity, frequency, and duration of US may affect the effectiveness of pain relief. Pulsed US with an intensity ≤2.5 W/cm2, 24 sessions, and a treatment duration of ≤4 weeks appears to have better pain relief.
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Affiliation(s)
- Yan Luo
- Clinical Medicine Eight-Year Program, Xiangya Hospital, Central South University, Changsha, China
| | - Masoud Rahmati
- CEReSS-Health Service Research and Quality of Life Center, Aix-Marseille University, Marseille, France
- Department of Physical Education and Sport Sciences, Faculty of Literature and Human Sciences, Lorestan University, Khoramabad, Iran
- Department of Physical Education and Sport Sciences, Faculty of Literature and Humanities, Vali-E-Asr University of Rafsanjan, Rafsanjan, Iran
| | - Abdolreza Kazemi
- Department of Physical Education and Sport Sciences, Faculty of Literature and Humanities, Vali-E-Asr University of Rafsanjan, Rafsanjan, Iran
| | - Wenbing Liu
- National Clinical Research Center for Ocular Diseases, Eye Hospital, WenZhou Medical University, Wenzhou, 325027, China
| | - Seung Won Lee
- Department of Precision Medicine, Sungkyunkwan University College of Medicine, Suwon, Republic of Korea
| | - Razak M. Gyasi
- African Population and Health Research Center, Nairobi, Kenya
- National Centre for Naturopathic Medicine, Faculty of Health, Southern Cross University, Lismore, New South Wales, Australia
| | - Guillermo F. López Sánchez
- Division of Preventive Medicine and Public Health, Department of Public Health Sciences, School of Medicine, University of Murcia, Murcia, Spain
| | - Ai Koyanagi
- Research and Development Unit, Parc Sanitari Sant Joan de Déu, Dr. Antoni Pujadas, 42, Sant Boi de Llobregat, 08830, Barcelona, Spain
| | - Lee Smith
- Centre for Health, Performance, and Wellbeing, Anglia Ruskin University, Cambridge, UK
| | - Dong Keon Yon
- Center for Digital Health, Medical Science Research Institute, Kyung Hee University Medical Center, Kyung Hee University College of Medicine, Seoul, Republic of Korea
- Department of Pediatrics, Kyung Hee University College of Medicine, Seoul, Republic of Korea
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Gherghel R, Onu I, Iordan DA, Antohe BA, Rezus II, Alexa O, Macovei LA, Rezus E. A New Approach to Postoperative Rehabilitation following Mosaicplasty and Bone Marrow Aspiration Concentrate (BMAC) Augmentation. Biomedicines 2024; 12:1164. [PMID: 38927371 PMCID: PMC11200487 DOI: 10.3390/biomedicines12061164] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2024] [Revised: 04/27/2024] [Accepted: 05/22/2024] [Indexed: 06/28/2024] Open
Abstract
BACKGROUND Chondral defects in the knee present a significant challenge due to their limited self-healing capacity, often leading to joint degeneration and functional disability. Current treatments, including surgical approaches like mosaicplasty and regenerative therapies such as bone marrow aspirate concentrate (BMAC) augmentation, aim to address these defects and improve patient outcomes. MATERIALS AND METHODS This study conducted a single-center, randomized controlled trial to evaluate the efficacy of different treatment approaches and rehabilitation protocols for chondral defects. Thirty-seven subjects presenting with symptomatic chondral or osteochondral defects (>3 cm2) in the weight-bearing region of the femoral condyle were partitioned into three groups, and underwent mosaicplasty with or without BMAC augmentation, followed by either a 6-week or 12-week rehabilitation program. Group 1 (n = 10) received mosaicplasty combined with BMAC augmentation and engaged in a twelve-week two-phase rehabilitation protocol. Group 2 (n = 15) underwent mosaicplasty alone and participated in the same twelve-week two-phase rehabilitation regimen. Meanwhile, Group 3 (n = 12) underwent mosaicplasty and underwent a shorter six-week one-phase rehabilitation program. Clinical assessments were performed using the visual analog scale (VAS) for pain, goniometry for the knee's range of motion (ROM), manual muscle testing (MMT) for quadricep strength, and the Western Ontario and McMaster University Arthritis Index (WOMAC) for functional evaluation in three test phases. RESULTS Significant differences in WOMAC scale scores were observed between the three groups at the intermediate (F(2, 34) = 5.24, p < 0.010) and final (F(2, 34) = 111, p < 0.000) stages, with post hoc Tukey tests revealing variations shared among all three groups. The between-group analysis of the VAS scale demonstrated no statistically significant difference initially (F(2, 34) = 0.18, p < 0.982), but significant differences emerged following the intermediate (F(2, 34) = 11.40, p < 0.000) and final assessments (F(2, 34) = 59.87, p < 0.000), with post hoc Tukey tests revealing specific group variations, notably between Group 1 and both Group 2 and Group 3, and also between Group 3 and Group 2. The between-group analysis of quadricep muscle strength using MMT scores revealed no statistically significant differences initially (F(2, 34) = 0.376, p < 0.689) or following the intermediate assessment (F(2, 34) = 2.090, p < 0.139). The one-way ANOVA analysis showed no significant difference in the knee ROM initially (F(2, 34) = 1.037, p < 0.366), but significant differences emerged following intermediate (F(2, 34) = 9.38, p < 0.001) and final assessments (F(2, 34) = 11.60, p < 0.000). Post hoc Tukey tests revealed significant differences between Groups 1 and 2, Groups 1 and 3, and Groups 2 and 3 at intermediate and final assessments. CONCLUSIONS The patients who received BMAC augmentation and completed a 12-week rehabilitation protocol had significantly better outcomes in pain relief, knee function, and ROM when compared to those who did not receive BMAC augmentation or those who completed a shorter rehabilitation period. Our findings suggest that combining mosaicplasty with BMAC augmentation and a comprehensive rehabilitation program can lead to superior clinical outcomes for patients with chondral defects in the knee.
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Affiliation(s)
- Robert Gherghel
- Department of Orthopedics and Trauma Surgery, Piatra Neamt Emergency Hospital, 700115 Piatra Neamt, Romania;
- Departments of Orthopedy and Physiotherapy, Medlife-Micromedica Clinic, 610119 Piatra Neamt, Romania
| | - Ilie Onu
- Departments of Orthopedy and Physiotherapy, Medlife-Micromedica Clinic, 610119 Piatra Neamt, Romania
- Department of Biomedical Sciences, Faculty of Medical Bioengineering, University of Medicine and Pharmacy “Grigore T. Popa” Iasi, 700454 Iasi, Romania
- Center of Physical Therapy and Rehabilitation, “Dunărea de Jos” University of Galati, 800008 Galati, Romania;
| | - Daniel Andrei Iordan
- Center of Physical Therapy and Rehabilitation, “Dunărea de Jos” University of Galati, 800008 Galati, Romania;
- Department of Individual Sports and Kinetotherapy, Faculty of Physical Education and Sport, “Dunarea de Jos” University of Galati, 800008 Galati, Romania
| | - Bogdan Alexandru Antohe
- Department of Physical and Occupational Therapy, “Vasile Alecsandri” University of Bacau, 600115 Bacau, Romania;
| | - Ioana-Irina Rezus
- Department of Dermatology, Faculty of Medicine, “Grigore T. Popa” University of Medicine and Pharmacy Iasi, 700115 Iasi, Romania;
| | - Ovidiu Alexa
- Department of Orthopaedic and Traumatology, Faculty of Medicine, “Grigore T. Popa” University of Medicine and Pharmacy of Iasi, 700115 Iasi, Romania;
| | - Luana Andreea Macovei
- Department of Rheumatology and Rehabilitation, Faculty of Medicine, “Grigore T. Popa” University of Medicine and Pharmacy Iasi, 700115 Iasi, Romania;
| | - Elena Rezus
- Department of Rheumatology and Rehabilitation, Faculty of Medicine, “Grigore T. Popa” University of Medicine and Pharmacy Iasi, 700115 Iasi, Romania;
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Zhou J, Ning E, Lu L, Zhang H, Yang X, Hao Y. Effectiveness of low-intensity pulsed ultrasound on osteoarthritis: molecular mechanism and tissue engineering. Front Med (Lausanne) 2024; 11:1292473. [PMID: 38695024 PMCID: PMC11061361 DOI: 10.3389/fmed.2024.1292473] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2023] [Accepted: 04/05/2024] [Indexed: 05/04/2024] Open
Abstract
Osteoarthritis (OA) is distinguished by pathological alterations in the synovial membrane, articular cartilage, and subchondral bone, resulting in physical symptoms such as pain, deformity, and impaired mobility. Numerous research studies have validated the effectiveness of low-intensity pulsed ultrasound (LIPUS) in OA treatment. The periodic mechanical waves generated by LIPUS can mitigate cellular ischemia and hypoxia, induce vibration and collision, produce notable thermal and non-thermal effects, alter cellular metabolism, expedite tissue repair, improve nutrient delivery, and accelerate the healing process of damaged tissues. The efficacy and specific mechanism of LIPUS is currently under investigation. This review provides an overview of LIPUS's potential role in the treatment of OA, considering various perspectives such as the synovial membrane, cartilage, subchondral bone, and tissue engineering. It aims to facilitate interdisciplinary scientific research and further exploration of LIPUS as a complementary technique to existing methods or surgery. Ongoing research is focused on determining the optimal dosage, frequency, timing, and treatment strategy of LIPUS for OA. Additional research is required to clarify the precise mechanism of action and potential impacts on cellular, animal, and human systems prior to its integration into therapeutic applications.
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Affiliation(s)
- Jing Zhou
- Orthopedics and Sports Medicine Center, The Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou, China
- Gusu School, Nanjing Medical University, Suzhou, China
| | - Eryu Ning
- Orthopedics and Sports Medicine Center, The Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou, China
- Gusu School, Nanjing Medical University, Suzhou, China
| | - Lingfeng Lu
- Orthopedics and Sports Medicine Center, The Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou, China
- Gusu School, Nanjing Medical University, Suzhou, China
| | - Huili Zhang
- Orthopedics and Sports Medicine Center, The Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou, China
- Gusu School, Nanjing Medical University, Suzhou, China
| | - Xing Yang
- Orthopedics and Sports Medicine Center, The Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou, China
- Gusu School, Nanjing Medical University, Suzhou, China
| | - Yuefeng Hao
- Orthopedics and Sports Medicine Center, The Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou, China
- Gusu School, Nanjing Medical University, Suzhou, China
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Volarić D, Žauhar G, Chen J, Jerbić Radetić AT, Omrčen H, Raič A, Pirović R, Cvijanović Peloza O. The Effect of Low-Intensity Pulsed Ultrasound on Bone Regeneration and the Expression of Osterix and Cyclooxygenase-2 during Critical-Size Bone Defect Repair. Int J Mol Sci 2024; 25:3882. [PMID: 38612693 PMCID: PMC11012169 DOI: 10.3390/ijms25073882] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2024] [Revised: 03/23/2024] [Accepted: 03/29/2024] [Indexed: 04/14/2024] Open
Abstract
Low-intensity pulsed ultrasound (LIPUS) is a form of ultrasound that utilizes low-intensity pulsed waves. Its effect on bones that heal by intramembranous ossification has not been sufficiently investigated. In this study, we examined LIPUS and the autologous bone, to determine their effect on the healing of the critical-size bone defect (CSBD) of the rat calvaria. The bone samples underwent histological, histomorphometric and immunohistochemical analyses. Both LIPUS and autologous bone promoted osteogenesis, leading to almost complete closure of the bone defect. On day 30, the bone volume was the highest in the autologous bone group (20.35%), followed by the LIPUS group (19.12%), and the lowest value was in the control group (5.11%). The autologous bone group exhibited the highest intensities of COX-2 (167.7 ± 1.1) and Osx (177.1 ± 0.9) expression on day 30. In the LIPUS group, the highest intensity of COX-2 expression was found on day 7 (169.7 ±1.6) and day 15 (92.7 ± 2.2), while the highest Osx expression was on day 7 (131.9 ± 0.9). In conclusion, this study suggests that LIPUS could represent a viable alternative to autologous bone grafts in repairing bone defects that are ossified by intramembranous ossification.
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Affiliation(s)
- Darian Volarić
- Department of Physical Medicine and Rehabilitation, Thalassotherapia Crikvenica—Special Hospital for Medical Rehabilitation, Gajevo Šetalište 21, 51260 Crikvenica, Croatia;
- Doctoral School of Biomedicine and Health, Faculty of Medicine, University of Rijeka, Braće Branchetta 20/1, 51000 Rijeka, Croatia
| | - Gordana Žauhar
- Department of Medical Physics and Biophysics, Faculty of Medicine, University of Rijeka, Braće Branchetta 20/1, 51000 Rijeka, Croatia
- Faculty of Physics, University of Rijeka, Radmile Matejčić 2, 51000 Rijeka, Croatia
| | - Jie Chen
- Department of Electrical and Computer Engineering, University of Alberta, Edmonton, AB T6G 2V4, Canada;
- Academy for Engineering and Technology, Fudan University, Shanghai 200433, China
| | - Ana Terezija Jerbić Radetić
- Department of Anatomy, Faculty of Medicine, University of Rijeka, Braće Branchetta 20/1, 51000 Rijeka, Croatia; (A.T.J.R.); (O.C.P.)
| | - Hrvoje Omrčen
- Department of Clinical Microbiology, Teaching Institute of Public Health of Primorsko-Goranska County, Krešimirova 52a, 51000 Rijeka, Croatia;
| | - Antonio Raič
- University Integrated Undergraduate and Graduate Study Programme of Medicine, Faculty of Medicine, University of Rijeka, Braće Branchetta 20/1, 51000 Rijeka, Croatia; (A.R.); (R.P.)
| | - Roko Pirović
- University Integrated Undergraduate and Graduate Study Programme of Medicine, Faculty of Medicine, University of Rijeka, Braće Branchetta 20/1, 51000 Rijeka, Croatia; (A.R.); (R.P.)
| | - Olga Cvijanović Peloza
- Department of Anatomy, Faculty of Medicine, University of Rijeka, Braće Branchetta 20/1, 51000 Rijeka, Croatia; (A.T.J.R.); (O.C.P.)
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Iliescu MG, Stanciu LE, Uzun AB, Cristea AE, Motoască I, Irsay L, Iliescu DM, Vari T, Ciubean AD, Caraban BM, Ciufu N, Azis O, Ciortea VM. Assessment of Integrative Therapeutic Methods for Improving the Quality of Life and Functioning in Cancer Patients-A Systematic Review. J Clin Med 2024; 13:1190. [PMID: 38592012 PMCID: PMC10931598 DOI: 10.3390/jcm13051190] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2023] [Revised: 02/13/2024] [Accepted: 02/15/2024] [Indexed: 04/10/2024] Open
Abstract
Background: Cancer rehabilitation represents a series of measures adopted for the recovery of psychological, emotional, social, and financial functioning in the case of cancer patients. The purpose of this study is to identify the main elements of therapeutic management in the field of medical rehabilitation, as well as integrative, complementary medicine and holistic approaches that can be performed on the oncological patient. Methods: This systematic literature review follows the methodology outlined in the "Preferred Reporting Items for Systematic Reviews and Meta-Analysis" ("PRISMA") statement, which is an internationally recognized and widely accepted standard. Results: Active rehabilitative therapies offer therapeutic options for improving the functioning and quality of life of oncological patients; these therapies comprehensively address both the physical and psychological aspects of the disease. This review also includes the latest novelties and nanotechnologies applied in oncological rehabilitation, for example, drugs (or supplements) inspired by nature. Conclusions: Physical and rehabilitation medicine, mostly using stimulating therapeutic methods, was recently added to the list of contraindications in the management of oncological patients, both as an approach to the pathological concept itself and as an approach to the main clinical consequences and functional aspects of oncological therapies. Integrative, complementary medicine presents an important therapeutic resource in the case of oncological patients. Advanced studies are needed in the future to further ascertain the role of these therapies.
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Affiliation(s)
- Mădălina Gabriela Iliescu
- Department of Physical Medicine and Rehabilitation, Faculty of Medicine, Ovidius University of Constanta, 1 University Alley, Campus-Corp B, 900470 Constanta, Romania
- Medical Doctoral School, Faculty of Medicine, Ovidius University of Constanta, 1 University Alley, Campus-Corp B, 900470 Constanta, Romania
| | - Liliana-Elena Stanciu
- Department of Physical Medicine and Rehabilitation, Faculty of Medicine, Ovidius University of Constanta, 1 University Alley, Campus-Corp B, 900470 Constanta, Romania
| | - Andreea-Bianca Uzun
- Department of Physical Medicine and Rehabilitation, Faculty of Medicine, Ovidius University of Constanta, 1 University Alley, Campus-Corp B, 900470 Constanta, Romania
- Medical Doctoral School, Faculty of Medicine, Ovidius University of Constanta, 1 University Alley, Campus-Corp B, 900470 Constanta, Romania
| | - Adelina-Elena Cristea
- Department of Physical Medicine and Rehabilitation, Faculty of Medicine, Ovidius University of Constanta, 1 University Alley, Campus-Corp B, 900470 Constanta, Romania
- Medical Doctoral School, Faculty of Medicine, Ovidius University of Constanta, 1 University Alley, Campus-Corp B, 900470 Constanta, Romania
| | - Irina Motoască
- Department of Rehabilitation Medicine, University of Medicine and Pharmacy "Iuliu Hatieganu", 8 Victor Babes Street, 400012 Cluj-Napoca, Romania
| | - Laszlo Irsay
- Department of Rehabilitation Medicine, University of Medicine and Pharmacy "Iuliu Hatieganu", 8 Victor Babes Street, 400012 Cluj-Napoca, Romania
| | - Dan Marcel Iliescu
- Department of Anatomy, Faculty of Medicine, Ovidius University of Constanta, 1 University Alley, Campus-Corp B, 900470 Constanta, Romania
| | - Titus Vari
- Department of Rehabilitation Medicine, University of Medicine and Pharmacy "Iuliu Hatieganu", 8 Victor Babes Street, 400012 Cluj-Napoca, Romania
| | - Alina Deniza Ciubean
- Department of Rehabilitation Medicine, University of Medicine and Pharmacy "Iuliu Hatieganu", 8 Victor Babes Street, 400012 Cluj-Napoca, Romania
| | - Bogdan Marian Caraban
- Department of Plastic Surgery, Faculty of Medicine, Ovidius University of Constanta, 1 University Alley, Campus-Corp B, 900470 Constanta, Romania
| | - Nicolae Ciufu
- Department of General Surgery, Faculty of Medicine, Ovidius University of Constanta, 1 University Alley, Campus-Corp B, 900470 Constanta, Romania
| | - Olgun Azis
- Department of Urology, Faculty of Medicine, Ovidius University of Constanta, 1 University Alley, Campus-Corp B, 900470 Constanta, Romania
| | - Viorela Mihaela Ciortea
- Department of Rehabilitation Medicine, University of Medicine and Pharmacy "Iuliu Hatieganu", 8 Victor Babes Street, 400012 Cluj-Napoca, Romania
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Chmielewska D, Malá J, Opala-Berdzik A, Nocuń M, Dolibog P, Dolibog PT, Stania M, Kuszewski M, Kobesova A. Acupuncture and dry needling for physical therapy of scar: a systematic review. BMC Complement Med Ther 2024; 24:14. [PMID: 38167051 PMCID: PMC10759514 DOI: 10.1186/s12906-023-04301-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2023] [Accepted: 12/10/2023] [Indexed: 01/05/2024] Open
Abstract
BACKGROUND There is a continuing interest in finding effective methods for scar treatment. Dry needling is gaining popularity in physiotherapy and is defined by Western medicine as a type of acupuncture. The terms acupuncture and dry needling have been used interchangeably so we have focused on the efficacy of dry needling or acupuncture in scar treatment. OBJECTIVE The aim of this systematic review was to determine the usefulness of dry needling or local acupuncture for scar treatment. In our search process, we used the terms 'acupuncture,' 'needling,' or 'dry needling' to identify all relevant scientific papers. We have focused on the practical aspects of local management of different scar types with dry needling or acupuncture. SEARCH STRATEGY The search strategy included different combinations of the following keywords: 'scar', 'keloid', 'dry needling', 'needling', 'acupuncture', 'treatment', 'physical therapy'. This systematic review was conducted in accordance with PRISMA guidelines. MEDLINE (PubMed, EBSCOHost and Ovid), EMBASE (Elsevier), and Web of Science databases were searched for relevant publications from inception through October 2023. INCLUSION CRITERIA The studies that investigated the effectiveness of dry needling or acupuncture for scar treatment were included. DATA EXTRACTION AND ANALYSIS The main extraction data items were: the needling technique; needle: diameter, length; needling locations; manual needling manipulation; number of sessions; settings; outcomes and results. RESULTS As a result of a comprehensive search, 11 manuscripts were included in the systematic review, of which eight were case reports, two were randomized trials and one study concerned case series. Two case reports scored 2-4 out of 8 points on the JBI checklist, five studies scored 5-7, and one study scored 8 points. The methodological quality of the two clinical trials was rated as good or fair on the PEDro scale. The case series study scored 7 of 10 points on the JBI checklist. A meta-analysis was not possible as only two randomized trials, eight case reports, and one case series were eligible for review; also, scar assessment scales and pain severity scales were highly heterogeneous. CONCLUSIONS The studies differed regarding the delivery of dry needling or local acupuncture for scar treatment. Differences included treatment frequency, duration, number of treatments, selection of needle insertion sites, number of needles used, angle of needle placement, and use of manual needling manipulation. SYSTEMATIC REVIEW REGISTRATION INPLASY no. 202310058.
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Affiliation(s)
- Daria Chmielewska
- Electromyography and Pelvic Floor Muscles Laboratory, Department of Physical Medicine, Institute of Physiotherapy and Health Sciences, Academy of Physical Education in Katowice, Mikołowska 72 street, Katowice, 40-065, Poland.
| | - Jitka Malá
- Physiotherapy Department, Faculty of Physical Education and Sport, Charles University in Prague, José Martího 31, Prague 6, 162 52, Czech Republic
| | - Agnieszka Opala-Berdzik
- Institute of Physiotherapy and Health Sciences, Department of Physiotherapy in Internal Diseases, Academy of Physical Education in Katowice, Mikołowska 72 street, Katowice, 40-065, Poland
| | - Magdalena Nocuń
- Students Scientific Association "IMPULSE" of the Institute of Electromyography and Pelvic Floor Muscles Laboratory, Department of Physical Medicine, Physiotherapy and Health Sciences, Academy of Physical Education in Katowice, Mikołowska 72 street, Katowice, 40-065, Poland
| | - Patrycja Dolibog
- Department of Medical Biophysics, Faculty of Medical Sciences, Medical University of Silesia, Medyków 18 street, 40-752, Katowice, Poland
| | - Paweł T Dolibog
- Department of Biophysics, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, Jordana 19 street, Zabrze, 41-808, Poland
| | - Magdalena Stania
- Institute of Sport Sciences, Academy of Physical Education in Katowice, Mikołowska 72 street, Katowice, 40-065, Poland
| | - Michał Kuszewski
- Institute of Physiotherapy and Health Sciences, Academy of Physical Education in Katowice, Mikołowska 72 street, Katowice, 40-065, Poland
| | - Alena Kobesova
- Department of Rehabilitation and Sports Medicine, 2nd Faculty of Medicine, Charles University and University Hospital Motol in Prague, V Úvalu 84, Prague 5, 150 06, Czech Republic
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Oliveira LFR, França FMG, Pereira WCA. A Data-Driven Approach for Estimating Temperature Variations Based on B-mode Ultrasound Images and Changes in Backscattered Energy. ULTRASONIC IMAGING 2024; 46:3-16. [PMID: 38041411 DOI: 10.1177/01617346231205810] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/03/2023]
Abstract
Thermal treatments that use ultrasound devices as a tool have as a key point the temperature control to be applied in a specific region of the patient's body. This kind of procedure requires caution because the wrong regulation can either limit the treatment or aggravate an existing injury. Therefore, determining the temperature in a region of interest in real-time is a subject of high interest. Although this is still an open problem, in the field of ultrasound analysis, the use of machine learning as a tool for both imaging and automated diagnostics are application trends. In this work, a data-driven approach is proposed to address the problem of estimating the temperature in regions of a B-mode ultrasound image as a supervised learning problem. The proposal consists in presenting a novel data modeling for the problem that includes information retrieved from conventional B-mode ultrasound images and a parametric image built based on changes in backscattered energy (CBE). Then, we compare the performance of classic models in the literature. The computational results presented that, in a simulated scenario, the proposed approach that a Gradient Boosting model would be able to estimate the temperature with a mean absolute error of around 0.5°C, which is acceptable in practical environments both in physiotherapic treatments and high intensity focused ultrasound (HIFU).
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Affiliation(s)
- Luiz F R Oliveira
- Program Systems Engineering and Computer Science Program, COPPE, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Felipe M G França
- Program Systems Engineering and Computer Science Program, COPPE, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
- Telecommunications Institute, University of Porto, Porto, Portugal
| | - Wagner C A Pereira
- Biomedical Engineering Program, COPPE, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
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9
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Kim H, Choi Y, Kim SY, Pahk KJ. Increased intracellular diffusivity of macromolecules within a mammalian cell by low-intensity pulsed ultrasound. ULTRASONICS SONOCHEMISTRY 2023; 100:106644. [PMID: 37844347 PMCID: PMC10587770 DOI: 10.1016/j.ultsonch.2023.106644] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/21/2023] [Revised: 10/05/2023] [Accepted: 10/07/2023] [Indexed: 10/18/2023]
Abstract
Whilst a number of studies have demonstrated that low-intensity pulsed ultrasound (LIPUS) is a promising therapeutic ultrasound technique that can be used for delivering mild mechanical stimuli to target tissue non-invasively, the underlying biophysical mechanisms still remain unclear. Most mechanism studies have focused explicitly on the effects of LIPUS on the cell membrane and mechanosensitive receptors. In the present study, we propose an additional mechanism by which LIPUS propagation through living cells may directly impact intracellular dynamics, particularly the diffusion transport of biomolecules. To support our hypothesis, human epithelial-like cells (SaOS-2 and HeLa) seeded on a confocal dish placed on a microscope stage were exposed to LIPUS with various exposure conditions (ultrasound frequencies of 0.5, 1 and 3 MHz, peak acoustic pressure of 200 and 400 kPa, a pulse repetition frequency of 1 kHz and a 20 % duty cycle), and the diffusivities of various sizes of biomolecules in the cytoplasm area were measured using fluorescence recovery after photobleaching (FRAP). Furthermore, giant unilamellar vesicles (GUVs) filled with macromolecules were used to examine the physical causal relationship between LIPUS and molecular diffusion changes. Nucleocytoplasmic transport coefficients were also measured by modified FRAP that bleaches the whole cell nuclear region. Extracellular signal-regulated kinases (ERK) activity (the phosphorylation dynamics) was monitored using fluorescence resonance energy transfer (FRET) microscopy. All the measurements were taken during, before and after the LIPUS exposure. Our experimental results clearly showed that the diffusion coefficients of macromolecules within the cell increased with acoustic pressure by 12.1 to 33.5 % during the sonication, and the increments were proportional to their molecular sizes regardless of the ultrasound frequency used. This observation in living cells was consistent with the GUVs exposed to the LIPUS, which indicated that the diffusivity increase was a passive physical response to the acoustic energy of LIPUS. Under the 1 MHz LIPUS exposure with 400 kPa, the passive nucleocytoplasmic transport of enhanced green fluorescent protein (EGFP) was accelerated by 21.4 %. With the same LIPUS exposure condition, both the diffusivity and phosphorylation of ERK induced by EGF treatment were significantly elevated simultaneously, which implied that LIPUS could also modify the kinase kinetics in the signal transduction process. Taken together, this study is the first attempt to uncover the physical link between LIPUS and the dynamics of intracellular macromolecules and related biological processes that LIPUS can possibly increase the diffusivity of intracellular macromolecules, leading to the changes in the basic cellular processes: passive nucleocytoplasmic transport and ERK. Our findings can provide a novel perspective that the mechanotransduction process that the intracellular region, in addition to the cell membrane, can convert the acoustic stimuli of LIPUS to biochemical signals.
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Affiliation(s)
- Hyojun Kim
- LAAS-CNRS, University of Toulouse, CNRS, Toulouse, France
| | - Yeonho Choi
- Department of Bioengineering, Korea University, Seoul, Republic of Korea
| | - So Yeon Kim
- Chemical and Biological Integrative Research Center, Biomedical Research Division, Korea Institute of Science and Technology (KIST), Seoul, Republic of Korea; Division of Bio-Medical Science and Technology, KIST School, Korea University of Science and Technology (UST), Seoul 02792, Republic of Korea.
| | - Ki Joo Pahk
- Department of Biomedical Engineering, Kyung Hee University, Yongin 17104, Republic of Korea.
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10
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Rabie GM, Shokry KE, Alsharnoubi J. Short-term effects of low-level laser versus ultrasound therapy on children's neck posture after long-term use of electronic devices. Lasers Med Sci 2023; 38:235. [PMID: 37831223 PMCID: PMC10575798 DOI: 10.1007/s10103-023-03895-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2023] [Accepted: 09/25/2023] [Indexed: 10/14/2023]
Abstract
The purpose of the study was to compare the effect of low-level laser therapy (LLLT), ultrasound therapy (US), and strengthening and stretching exercise in children diagnosed with cervical straightening caused by long-term use of electronic devices. A total of 60 patients from 12 to 18 years of both gender diagnosed with straight neck syndrome which is losing the normal C shape of cervical vertebrae. Patients were randomized into three groups. In group A, patients received LLLT plus exercise, while in group B, they received US plus exercise, and group C received exercise. In group A and B, Cobb angle and VAS showed a significant improvement (more significant in group A) with P < 0.001, while in group C P = 0.006. LLLT, US, and exercise improved the cervical straight curve, and reduced pain with maximum effect was done by LLLT.
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Affiliation(s)
| | - Kamal Elsayed Shokry
- Department of Pediatric Physical Therapy Faculty of Physical Therapy, Cairo University, Cairo, Egypt
| | - Jehan Alsharnoubi
- Department of Pediatrics, National Institute of Laser Enhanced Sciences (NILES), Cairo University, Giza, Egypt.
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11
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Li Y, Li W, Liu X, Liu X, Zhu B, Guo S, Wang C, Wang D, Li S, Zhang Z. Effects of Low-Intensity Pulsed Ultrasound in Tendon Injuries. JOURNAL OF ULTRASOUND IN MEDICINE : OFFICIAL JOURNAL OF THE AMERICAN INSTITUTE OF ULTRASOUND IN MEDICINE 2023; 42:1923-1939. [PMID: 37079603 DOI: 10.1002/jum.16230] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/16/2022] [Revised: 03/16/2023] [Accepted: 03/22/2023] [Indexed: 05/03/2023]
Abstract
Tendon injuries are the most common soft tissue injuries, caused by tissue overuse and age-related degeneration. However, the tendon repair process is slow and inefficient due to the lack of cellular structure and blood vessels in the tendon. Low-intensity pulsed ultrasound (LIPUS) has received increasing attention as a non-invasive, simple, and safe way to promote tendon healing. This review summarizes the effects and underlying mechanisms of LIPUS on tendon injury by comprehensively examining the published literature, including in vitro, in vivo, and clinical studies. This review reviewed 24 studies, with 87.5% showing improvement. The application of LIPUS in tendon diseases is a promising field worthy of further study.
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Affiliation(s)
- Yujie Li
- Institute of Physical Education, Southwest Medical University, Luzhou, Sichuan, China
| | - Wei Li
- Orthopaedics Department, Hejiang County People's Hospital, Luzhou, Sichuan, China
| | - Xinyue Liu
- Institute of Physical Education, Southwest Medical University, Luzhou, Sichuan, China
| | - Xueli Liu
- Institute of Physical Education, Southwest Medical University, Luzhou, Sichuan, China
| | - Bin Zhu
- Institute of Physical Education, Southwest Medical University, Luzhou, Sichuan, China
| | - Sheng Guo
- Spinal Surgery Department, The Affiliated Traditional Chinese Medicine Hospital of Southwest Medical University, Luzhou, Sichuan, China
| | - Chenglong Wang
- Spinal Surgery Department, The Affiliated Traditional Chinese Medicine Hospital of Southwest Medical University, Luzhou, Sichuan, China
| | - Dingxuan Wang
- Institute of Physical Education, Southwest Medical University, Luzhou, Sichuan, China
| | - Sen Li
- Spinal Surgery Department, The Affiliated Traditional Chinese Medicine Hospital of Southwest Medical University, Luzhou, Sichuan, China
| | - Zhongfa Zhang
- Orthopaedics Department, Hejiang County People's Hospital, Luzhou, Sichuan, China
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12
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Dabbagh A, Ziebart C, MacDermid JC, Packham T, Grewal R. The effectiveness of biophysical agents in the treatment of carpal tunnel syndrome- an umbrella review. BMC Musculoskelet Disord 2023; 24:645. [PMID: 37563725 PMCID: PMC10416372 DOI: 10.1186/s12891-023-06778-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/30/2023] [Accepted: 08/03/2023] [Indexed: 08/12/2023] Open
Abstract
BACKGROUND Our objective was to summarize, synthesize, and integrate the evidence evaluating the effectiveness of biophysical agents compared to other conservative treatments, for the management of carpal tunnel syndrome (CTS). METHODS This was an overview of systematic reviews (SRs). We searched several online databases and obtained SRs relating to managing CTS using biophysical agents. Two independent researchers screened and appraised the quality of the SRs using the A MeaSurement Tool to Assess systematic Reviews-2 appraisal tool. We extracted information related to study characteristics as well as the effectiveness of biophysical agents for CTS, the effect sizes, and between-group significances. We categorized the information based on the type of biophysical agent. We also performed a citation mapping and calculated the corrected covered area index. RESULTS We found 17 SRs addressing 12 different biophysical agents. The quality of the SRs was mainly critically low (n = 16) or low (n = 1). The evidence was inconclusive for the effectiveness of Low-level Laser therapy and favorable for the short-term efficacy of non-thermal ultrasound in improving symptom severity, function, pain, global rating of improvement, satisfaction with treatment, and other electrophysiological measures compared to manual therapy or placebo. Evidence was inconclusive for Extracorporeal Shockwave therapy, and favorable for the short-term effectiveness of Shortwave and Microwave Diathermy on pain and hand function. The corrected covered area index was lower than 35% indicating a low overlap of the SRs. CONCLUSIONS The findings were based on low-quality primary studies, with an unclear or high risk of bias, small sample sizes, and short follow-ups. Therefore, no recommendations can be made for the long-term effectiveness of any biophysical agents. High-quality evidence is needed to support evidence-based recommendations on the use of biophysical agents in the management of CTS. PROSPERO REGISTRATION NUMBER CRD42022319002, registered on 17/04/2022.
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Affiliation(s)
- Armaghan Dabbagh
- Department of Rehabilitation Sciences, Faculty of Health Sciences, Elborn College, Western University, London, ON, Canada.
| | - Christina Ziebart
- Department of Rehabilitation Sciences, Faculty of Health Sciences, Elborn College, Western University, London, ON, Canada
- KITE-UHN, University of Toronto, Toronto, ON, Canada
| | - Joy C MacDermid
- Department of Physical Therapy, Faculty of Health Sciences, Western University, London, ON, Canada
- Roth McFarlane Hand and Upper Limb Centre, St. Joseph's Hospital, London, ON, Canada
| | - Tara Packham
- School of Rehabilitation Science, McMaster University, Hamilton, ON, Canada
| | - Ruby Grewal
- Department of Surgery, Western University, London, ON, Canada
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13
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Ji X, Duan H, Wang S, Chang Y. Low-intensity pulsed ultrasound in obstetrics and gynecology: advances in clinical application and research progress. Front Endocrinol (Lausanne) 2023; 14:1233187. [PMID: 37593351 PMCID: PMC10431596 DOI: 10.3389/fendo.2023.1233187] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/01/2023] [Accepted: 07/17/2023] [Indexed: 08/19/2023] Open
Abstract
In the past decade, research on ultrasound therapy in obstetrics and gynecology has rapidly developed. Currently, high-intensity ultrasound has been widely used in clinical practice, while low-intensity ultrasound has gradually emerged as a new trend of transitioning from pre-clinical research to clinical applications. Low-intensity pulsed ultrasound (LIPUS), characterized by a non-invasive low-intensity pulse wave stimulation method, employs its non-thermal effects to achieve safe, economical, and convenient therapeutic outcomes. LIPUS converts into biochemical signals within cells through pathways such as cavitation, acoustic flow, and mechanical stimulation, regulating molecular biological mechanisms and exerting various biological effects. The molecular biology mechanisms underlying the application of LIPUS in obstetrics and gynecology mainly include signaling pathways, key gene expression, angiogenesis, inflammation inhibition, and stem cell differentiation. LIPUS plays a positive role in promoting soft tissue regeneration, bone regeneration, nerve regulation, and changes in cell membrane permeability. LIPUS can improve the treatment benefit of premature ovarian failure, pelvic floor dysfunction, nerve damage caused by intrauterine growth restriction, ovariectomized osteoporosis, and incomplete uterine involution through the above biological effects, and it also has application value in the adjuvant treatment of malignant tumors such as ovarian cancer and cervical cancer. This study outlines the biological mechanisms and applications of LIPUS in treating various obstetric and gynecologic diseases, aiming to promote its precise application and provide a theoretical basis for its use in the field.
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Affiliation(s)
| | - Hua Duan
- Department of Minimally Invasive Gynecology, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing Maternal and Child Health Care Hospital, Beijing, China
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14
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Mahran HG. Shockwave versus ultrasound therapy in the enhancement of Aloe vera in cutaneous wound healing. J Wound Care 2023; 32:cxxxix-cxlv. [PMID: 37405969 DOI: 10.12968/jowc.2023.32.sup7a.cxxxix] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/07/2023]
Abstract
OBJECTIVE To investigate the healing efficacy of topical Aloe vera enhanced by shockwave or ultrasound therapy on wounds in rats and compare both effects. METHOD A total of 75 male albino rats were randomly divided into equal groups A, B, C, D and E. Under anaesthesia, a wound (6cm2) was created on the back of each rat. Group A received topical Aloe vera under occlusive dressing followed by shockwave therapy with the following parameters: 600 shocks, four pulses/second and 0.11mJ/mm2. Group B received topical Aloe vera under occlusive dressing followed by therapeutic ultrasound with the following parameters: pulsed mode, 2:8 duty cycle, 1MHz and 0.5 W/cm2. Group C received the same treatment as group A but in a reversed sequence-the shockwave therapy followed by the Aloe vera gel. Group D received the same treatment as group B but in a reversed sequence-therapeutic ultrasound followed by the Aloe vera gel. And control group E only received topical Aloe vera under occlusive dressing. Each group received three sessions per week, for two weeks. Wound extent and shrinkage rates were measured at study initiation and at the end of each week. RESULTS There were significant wound reductions in groups A and B compared to C and D, respectively, and in group A compared to group B. CONCLUSION Shockwaves and ultrasound were found to amplify the effect of the Aloe vera on the wound, and there was improved wound healing in the shockwave group A compared to the ultrasound group B.
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Affiliation(s)
- Hesham Galal Mahran
- Department of Physical Therapy for Surgery, Faculty of Physical Therapy, Cairo University, Giza, Egypt
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15
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Ashar H, Ranjan A. Immunomodulation and targeted drug delivery with high intensity focused ultrasound (HIFU): Principles and mechanisms. Pharmacol Ther 2023; 244:108393. [PMID: 36965581 DOI: 10.1016/j.pharmthera.2023.108393] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2022] [Revised: 03/04/2023] [Accepted: 03/20/2023] [Indexed: 03/27/2023]
Abstract
High intensity focused ultrasound (HIFU) is a non-invasive and non-ionizing sonic energy-based therapeutic technology for inducing thermal and non-thermal effects in tissues. Depending on the parameters, HIFU can ablate tissues by heating them to >55 °C to induce denaturation and coagulative necrosis, improve radio- and chemo-sensitizations and local drug delivery from nanoparticles at moderate hyperthermia (~41-43 °C), and mechanically fragment cells using acoustic cavitation (also known as histotripsy). HIFU has already emerged as an attractive modality for treating human prostate cancer, veterinary cancers, and neuromodulation. Herein, we comprehensively review the role of HIFU in enhancing drug delivery and immunotherapy in soft and calcified tissues. Specifically, the ability of HIFU to improve adjuvant treatments from various classes of drugs is described. These crucial insights highlight the opportunities and challenges of HIFU technology and its potential to support new clinical trials and translation to patients.
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Affiliation(s)
- Harshini Ashar
- Department of Physiological Sciences, College of Veterinary Medicine, Oklahoma State University, Stillwater, OK 74078, United States of America
| | - Ashish Ranjan
- Department of Physiological Sciences, College of Veterinary Medicine, Oklahoma State University, Stillwater, OK 74078, United States of America.
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16
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Uysal B, Özkuk K, Şahin N, Ökmen BM, Sezer R, Ateş Z. Comparison of the effectiveness of high-intensity laser and ultrasound therapies in adhesive capsulitis: A randomized controlled study. J Back Musculoskelet Rehabil 2023; 36:227-236. [PMID: 35964170 DOI: 10.3233/bmr-220026] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
BACKGROUND Adhesive capsulitis (AC) is a common musculoskeletal disease characterized with shoulder pain, limitation of range of motion (ROM) and disability. Although physical therapy is used in the treatment of AC, studies on its effectiveness are continuing. OBJECTIVE This study aimed to assess the effectiveness of ultrasound (US) and high-intensity laser therapy (HILT) in the treatment of AC. METHODS Sixty patients were randomized into two groups. Group I received US (15 sessions) and Group II received HILT (9 sessions) for 3 weeks. In addition, all patients received physical therapy program (hot pack, TENS and exercises). Assessments were made using VAS-pain, Shoulder Pain and Disability Index (SPADI), range of motion (ROM) at baseline and in post-treatment 3rd, 8th and 24th weeks. RESULTS There was no statistically significant difference between the groups in terms of all pre-treatment values. In intragroup assessment, statistically significant difference was identified in all the values of Groups 1 and 2 in all assessment periods compared with the pre-treatment values (p< 0.05). There was no significant difference between groups in all assessment periods. CONCLUSION According to results, US therapy and HILT were effective on the improvement of pain, ROM and functional conditions of patients in the treatment of AC.
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Affiliation(s)
- Bilal Uysal
- Department of Physical Medicine and Rehabilitation, Faculty of Medicine, Balikesir University, Balikesir, Turkey
| | - Kağan Özkuk
- Department of Medical Ecology and Hydroclimatology, Faculty of Medicine, Usak University, Usak, Turkey
| | - Nilay Şahin
- Department of Physical Medicine and Rehabilitation, Faculty of Medicine, Balikesir University, Balikesir, Turkey
| | - Burcu M Ökmen
- Department of Physical Medicine and Rehabilitation, Saglik Bilimleri University Bursa Yuksek Ihtisas Training and Research Hospital, Bursa, Turkey
| | - Refia Sezer
- Department of Physical Medicine and Rehabilitation, İzzet Baysal Physical Medicine and Rehabilitation Training and Research Hospital, Bolu, Turkey
| | - Zeynep Ateş
- Department of Physical Medicine and Rehabilitation, İzzet Baysal Physical Medicine and Rehabilitation Training and Research Hospital, Bolu, Turkey
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The role of anti-tumor immunity of focused ultrasound for the malignancies: depended on the different ablation categories. Int J Clin Oncol 2022; 27:1543-1553. [PMID: 35943643 DOI: 10.1007/s10147-022-02219-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2022] [Accepted: 07/07/2022] [Indexed: 11/05/2022]
Abstract
Improving anti-tumor immunity has promising outcomes in eradicating malignant tumors. Tumor cells can escape from immune surveillance and killing; therefore, various strategies are continuously developing to inhibit immune escape. Focused ultrasound (FUS) has recently emerged to play an important role in immune modulation. After FUS therapy, various tumor antigens and related signals are released. The non-thermal effect of FUS strengthens the blood and lymph circulation, increases cell permeability, and helps in crossing the physical barrier like the blood-brain barrier and blood-tumor barrier. However, the different ablation of FUS is proposed to have a different anti-tumor immune effect. Therefore, we categorized the FUS ablation into thermal and non-thermal ablation and summarized possible anti-tumor immunity mechanisms.
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Xue H, Zhang X, Guo X, Tu J, Zhang D. Optimization of a random linear ultrasonic therapeutic array based on a genetic algorithm. ULTRASONICS 2022; 124:106751. [PMID: 35512579 DOI: 10.1016/j.ultras.2022.106751] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/24/2022] [Revised: 04/01/2022] [Accepted: 04/18/2022] [Indexed: 06/14/2023]
Abstract
Given their advantage of suppressing grating lobes, randomly arranged linear arrays have potential for use in ultrasonic treatment. The current work proposes a method based on genetic algorithm to optimize the random arrangement of array elements, so that the suppression effect of grating lobes can be significantly improved with reduced calculating time. The maximum and average kerfs of array elements are used as genes, and the ratio of the maximum to the secondary maximum sound pressure at the focal plane is used as the optimized target. Typically, the calculation requirements of the current method can be reduced to ∼ 25% of the traversing method. We further discuss how the kerf width, the effective ratio of element areas and the ratio of focal distance to array aperture affect the suppression of grating lobes. For a typical linear array with 32 elements (1-MHz operating frequency, 1.5-mm element width and 150-mm focal distance), the results suggest that the grating lobes are suppressed well when (1) the ratio of maximum width to average width of the element is between 5 and 8, (2) the ratio of the effective element area to the area of the whole array is between 0.5 and 0.9, and (3) the ratio of the effective emission aperture to the actual emission aperture of the array is as large as possible. Based on optimized parameters, an experimental array was fabricated and the measured results of corresponding sound field were entirely consistent with the simulated results (Given her role as an Associate Editor of this journal, Juan Tu had no involvement in the peer-review of articles for which she was an author and had no access to information regarding the peer-review. Full responsibility for the peer-review process for this article was delegated to another Editor of this journal.).
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Affiliation(s)
- Honghui Xue
- Key Laboratory of Modern Acoustics (MOE), School of Physics, Collaborative Innovation Center of Advanced Microstructure, Nanjing University, Nanjing 210093, China
| | - Xin Zhang
- Key Laboratory of Modern Acoustics (MOE), School of Physics, Collaborative Innovation Center of Advanced Microstructure, Nanjing University, Nanjing 210093, China
| | - Xiasheng Guo
- Key Laboratory of Modern Acoustics (MOE), School of Physics, Collaborative Innovation Center of Advanced Microstructure, Nanjing University, Nanjing 210093, China
| | - Juan Tu
- Key Laboratory of Modern Acoustics (MOE), School of Physics, Collaborative Innovation Center of Advanced Microstructure, Nanjing University, Nanjing 210093, China; The State Key Laboratory of Acoustics, Chinese Academy of Science, Beijing 10080, China.
| | - Dong Zhang
- Key Laboratory of Modern Acoustics (MOE), School of Physics, Collaborative Innovation Center of Advanced Microstructure, Nanjing University, Nanjing 210093, China; The State Key Laboratory of Acoustics, Chinese Academy of Science, Beijing 10080, China.
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19
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Ultrasound triggered organic mechanoluminescence materials. Adv Drug Deliv Rev 2022; 186:114343. [PMID: 35580814 DOI: 10.1016/j.addr.2022.114343] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2022] [Revised: 04/05/2022] [Accepted: 05/09/2022] [Indexed: 11/23/2022]
Abstract
Ultrasound induced organic mechanoluminescence materials have become one of the focal topics in wireless light sources since they exhibit high spatiotemporal resolution, biocompatibility and excellent tissue penetration depth. These properties promote great potential in ultrahigh sensitive bioimaging with no background noise and noninvasive nanodevices. Recent advances in chemistry, nanotechnology and biomedical research are revolutionizing ultrasound induced organic mechanoluminescence. Herein, we try to summarize some recent researches in ultrasound induced mechanoluminescence that use various materials design strategies based on the molecular conformational changes and cycloreversion reaction. Practical applications, like noninvasive bioimaging and noninvasive optogenetics, are also presented and prospected.
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Effectiveness of High Power Laser Therapy on Pain and Isokinetic Peak Torque in Athletes with Proximal Hamstring Tendinopathy: A Randomized Trial. BIOMED RESEARCH INTERNATIONAL 2022; 2022:4133883. [PMID: 35647184 PMCID: PMC9142273 DOI: 10.1155/2022/4133883] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/27/2022] [Revised: 04/12/2022] [Accepted: 04/20/2022] [Indexed: 11/18/2022]
Abstract
Athletes such as long-distance runners, sprinters, hockey, and/or football players may have proximal hamstring tendinopathy (PHT). Laser therapy has been shown to be effective in tendinopathies. High power laser therapy (HPLT) is used for the treatment of several musculoskeletal conditions; however, its efficacy on PHT has not been investigated. This study is aimed at examining the effects of HPLT on pain and isokinetic peak torque (IPT) in athletes with PHT. The two-arm comparative pretest-posttest experimental design was used with random allocation of 36 athletes aged 18-35 years into two groups (experimental and conventional group). The experimental group included the application of HPLT for 3 weeks. The conventional group included treatment with a conventional physiotherapy program including ultrasound therapy, moist heat pack, and home exercises for a total of 3 weeks. Pain and IPT of the hamstring muscle were measured before and after the application of the intervention. Pain score decreased, and IPT increased significantly (p < 0.05) after application of HPLT, by 61.26% and 13.18%, respectively. In the conventional group, a significant difference (p < 0.05) was observed in pain scores only, which decreased by 41.14%. No significant difference (p > 0.05) was observed in IPT in the conventional group. When HPLT was compared with conventional physiotherapy, a significant difference was found in pain scores only. HPLT for 3 weeks was found to be effective in improving pain in athletes with PHT. However, no significant difference was found between HPLT and conventional physiotherapy (US, moist heat, and home exercises) in improving the IPT of the hamstring muscle.
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Portilla Tuesta G, Montero de Espinosa F. System and method for applying physiotherapeutic focused ultrasound. ULTRASONICS 2022; 121:106693. [PMID: 35093669 DOI: 10.1016/j.ultras.2022.106693] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/24/2021] [Revised: 01/18/2022] [Accepted: 01/19/2022] [Indexed: 06/14/2023]
Abstract
Despite many years of clinical use of ultrasound, the results of different reviews of controlled trials on the efficacy of ultrasound physical therapy for different musculoskeletal injuries continue to question its efficacy. However, "in vitro" experiments with well-controlled cell cultures and experiments with animal models show positive results. The question is whether the commercial systems used by physiotherapists can deliver the required ultrasonic dose to the exact location on the body. The object of this work is the design, realization and testing of a new concept of ultrasound system for Physiotherapy capable of focusing the ultrasound beam to apply the required ultrasonic energy dose at the point targeted by the physiotherapist. The system is designed for non-thermal effects Physiotherapy. The system consists of conceptually new piezocomposite arrays with a metallic delay line, multi-pulser electronics for emission focusing, parallel robots for mechanical steering and positioning of the array transducers, and linear and angular encoders to allow the physiotherapist to direct the focus to the target. The multi-pulser and parallel robot angulation are controlled by the computer, using a graphical interface software.
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Affiliation(s)
- G Portilla Tuesta
- ITEFI-CSIC, Spanish High Research Council, Serrano 144, Madrid, Spain
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Sun Z, Chen S, Liu W, Sun G, Liu J, Wang J, Wang W, Zheng Y, Fan C. Efficacy of ultrasound therapy for the treatment of lateral elbow tendinopathy (the UCICLET Trial): study protocol for a three-arm, prospective, multicentre, randomised controlled trial. BMJ Open 2022; 12:e057266. [PMID: 35039305 PMCID: PMC8765018 DOI: 10.1136/bmjopen-2021-057266] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
INTRODUCTION Lateral elbow tendinopathy (LET) is a highly prevalent disease among the middle-aged population, with no consensus on optimal management. Non-operative treatment is generally accepted as the first-line intervention. Ultrasound (US) therapy has been reported to be beneficial for various orthopaedic diseases, including tendinopathy. The purpose of this study is to investigate the efficacy of US for LET treatment. METHODS AND ANALYSIS This protocol entails a three-arm, prospective, multicentre, randomised controlled trial. Seventy-two eligible participants with clinically confirmed LET will be assigned to either (1) US, (2) corticosteroid injections or (3) control group. All participants will receive exercise-based therapy as a fundamental intervention. The primary outcome is Patient-rated Tennis Elbow Evaluation. The secondary outcomes include Visual Analogue Scale for pain, shortened version of the Disabilities of the Arm, Shoulder and Hand for upper limb disability, pain free/maximum grip strength, Work Limitations Questionnaire-25 for functional limitations at work, EuroQol-5D for general health, Hospital Anxiety and Depression Scale for mental status, Global Rating of Change for treatment success and recurrence rate, and Mahomed Scale for the participant's satisfaction. Adverse events will be recorded. Intention-to-treat analyses will be used. ETHICS AND DISSEMINATION Ethics committees of all clinical centres have approved this study. The leading centre is Shanghai Sixth People's Hospital, whose approval number is 2021-153. New versions with appropriate amendments will be submitted to the committee for further approval. Final results will be published in peer-reviewed journals and presented at local, national and international conferences. TRIAL REGISTRATION NUMBER ChiCTR2100050547.
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Affiliation(s)
- Ziyang Sun
- Department of Orthopedics, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, China
- Shanghai Engineering Research Center for Orthopaedic Material Innovation and Tissue Regeneration, Shanghai, China
| | - Shuai Chen
- Department of Orthopedics, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, China
- Shanghai Engineering Research Center for Orthopaedic Material Innovation and Tissue Regeneration, Shanghai, China
| | - Weixuan Liu
- Department of Orthopedics, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, China
- Shanghai Engineering Research Center for Orthopaedic Material Innovation and Tissue Regeneration, Shanghai, China
| | - Guixin Sun
- Department of Orthopaedics, Shanghai East Hospital, Tongji University School of Medicine, Shanghai, China
| | - Junjian Liu
- Department of Orthopedics, Shanghai Tenth People's Hospital, School of Medicine, Tongji University, Shanghai, China
| | - Jian Wang
- Department of Orthopaedics, Pudong New Area People's Hospital, Shanghai, China
| | - Wei Wang
- Department of Orthopedics, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, China
- Shanghai Engineering Research Center for Orthopaedic Material Innovation and Tissue Regeneration, Shanghai, China
| | - Yuanyi Zheng
- Department of Ultrasound in Medicine, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, China
| | - Cunyi Fan
- Department of Orthopedics, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, China
- Shanghai Engineering Research Center for Orthopaedic Material Innovation and Tissue Regeneration, Shanghai, China
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Abstract
PURPOSE The aim of this systematic review was to evaluate studies reporting on the effects of therapeutic ultrasound on the physis. SUMMARY OF KEY POINTS Eight studies were included in the final analysis, all of which were animal studies. At higher doses, studies found skin and bone necrosis and inhibition of growth, while in lower doses some studies found that ultrasound had a transient stimulatory effect on growth, increased thickness of the hypertrophic zone, and increased thickness of the whole growth plate. Overall, experimental evidence in animal models suggests that therapeutic ultrasound, even at low doses, might induce microscopic changes to the histology of the growth plate. CONCLUSION While we found no reports of growth disturbance in humans, given the histological changes found in animal studies, the current limited literature seems to support the recommendation that the application of therapeutic ultrasound around the physis should be avoided.
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Orloff LA, Noel JE, Stack BC, Russell MD, Angelos P, Baek JH, Brumund KT, Chiang FY, Cunnane MB, Davies L, Frasoldati A, Feng AY, Hegedüs L, Iwata AJ, Kandil E, Kuo J, Lombardi C, Lupo M, Maia AL, McIver B, Na DG, Novizio R, Papini E, Patel KN, Rangel L, Russell JO, Shin J, Shindo M, Shonka DC, Karcioglu AS, Sinclair C, Singer M, Spiezia S, Steck JH, Steward D, Tae K, Tolley N, Valcavi R, Tufano RP, Tuttle RM, Volpi E, Wu CW, Abdelhamid Ahmed AH, Randolph GW. Radiofrequency ablation and related ultrasound-guided ablation technologies for treatment of benign and malignant thyroid disease: An international multidisciplinary consensus statement of the American Head and Neck Society Endocrine Surgery Section with the Asia Pacific Society of Thyroid Surgery, Associazione Medici Endocrinologi, British Association of Endocrine and Thyroid Surgeons, European Thyroid Association, Italian Society of Endocrine Surgery Units, Korean Society of Thyroid Radiology, Latin American Thyroid Society, and Thyroid Nodules Therapies Association. Head Neck 2021; 44:633-660. [PMID: 34939714 DOI: 10.1002/hed.26960] [Citation(s) in RCA: 91] [Impact Index Per Article: 30.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2021] [Accepted: 12/02/2021] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND The use of ultrasound-guided ablation procedures to treat both benign and malignant thyroid conditions is gaining increasing interest. This document has been developed as an international interdisciplinary evidence-based statement with a primary focus on radiofrequency ablation and is intended to serve as a manual for best practice application of ablation technologies. METHODS A comprehensive literature review was conducted to guide statement development and generation of best practice recommendations. Modified Delphi method was applied to assess whether statements met consensus among the entire author panel. RESULTS A review of the current state of ultrasound-guided ablation procedures for the treatment of benign and malignant thyroid conditions is presented. Eighteen best practice recommendations in topic areas of preprocedural evaluation, technique, postprocedural management, efficacy, potential complications, and implementation are provided. CONCLUSIONS As ultrasound-guided ablation procedures are increasingly utilized in benign and malignant thyroid disease, evidence-based and thoughtful application of best practices is warranted.
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Affiliation(s)
- Lisa A Orloff
- Department of Otolaryngology - Head & Neck Surgery, Stanford University School of Medicine, Stanford, California, USA
| | - Julia E Noel
- Department of Otolaryngology - Head & Neck Surgery, Stanford University School of Medicine, Stanford, California, USA
| | - Brendan C Stack
- Department of Otolaryngology - Head & Neck Surgery, Southern Illinois University School of Medicine, Springfield, Illinois, USA
| | - Marika D Russell
- Department of Otolaryngology - Head & Neck Surgery, San Francisco School of Medicine, University of California, San Francisco, California, USA
| | - Peter Angelos
- Department of Surgery, University of Chicago, Chicago, Illinois, USA
| | - Jung Hwan Baek
- Department of Radiology, Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
| | - Kevin T Brumund
- Division of Otolaryngology - Head and Neck Surgery, Department of Surgery, University of California, San Diego, San Diego, California, USA
| | - Feng-Yu Chiang
- Department of Otolaryngology - Head and Neck Surgery, E-Da Hospital, School of Medicine, College of Medicine, I-Shou University, Kaohsiung, Taiwan
| | - Mary Beth Cunnane
- Department of Radiology, Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, Massachusetts, USA
| | - Louise Davies
- The Section of Otolaryngology, The Dartmouth Institute for Health Policy and Clinical Practice, Geisel School of Medicine at Dartmouth, Hanover, New Hampshire, USA
| | - Andrea Frasoldati
- Department of Endocrinology and Metabolism, Arcispedale Santa Maria Nuova IRCCS-ASL, Reggio Emilia, Italy
| | - Anne Y Feng
- Department of Otolaryngology - Head and Neck Surgery, Brigham & Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Laszlo Hegedüs
- Department of Endocrinology and Metabolism, Odense University Hospital, Odense, Denmark
| | - Ayaka J Iwata
- Department of Otolaryngology - Head & Neck Surgery, Kaiser Permanente, Santa Clara, California, USA
| | - Emad Kandil
- Department of Surgery, Tulane University School of Medicine, New Orleans, Louisiana, USA
| | - Jennifer Kuo
- Department of Surgery, Columbia University Irving Medical Center, New York, New York, USA
| | - Celestino Lombardi
- Division of Endocrine and Metabolic Surgery, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Mark Lupo
- Thyroid & Endocrine Center of Florida, Sarasota, Florida, USA
| | - Ana Luiza Maia
- Unidade de Tireoide, Hospital de Clínicas de Porto Alegre, Faculdade de Medicina, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Bryan McIver
- Department of Head and Neck-Endocrine Oncology, H. Lee Moffitt Cancer Center, Research Institute, Tampa, Florida, USA
| | - Dong Gyu Na
- Department of Radiology, Gangneung Asan Hospital, University of Ulsan College of Medicine, Gangneung, South Korea
| | | | - Enrico Papini
- Department of Endocrinology and Metabolism, Regina Apostolorum Hospital, Rome, Italy
| | - Kepal N Patel
- Department of Surgery, New York University, New York, New York, USA
| | - Leonardo Rangel
- Division of Otorhinolaryngology - Head and Neck Surgery, State University of Rio de Janeiro, Rio de Janiero, Brazil
| | - Jonathon O Russell
- Department of Otolaryngology - Head and Neck Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Jennifer Shin
- Department of Otolaryngology - Head and Neck Surgery, Brigham & Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Maisie Shindo
- Department of Otolaryngology - Head and Neck Surgery, Oregon Health and Science University, Portland, Oregon, USA
| | - David C Shonka
- Department of Otolaryngology - Head and Neck Surgery, University of Virginia Health System, Charlottesville, Virginia, USA
| | - Amanda S Karcioglu
- Division of Otolaryngology - Head and Neck Surgery, Department of Surgery, NorthShore University Health System, Evanston, Illinois, USA.,Clinician Educator, Pritzker School of Medicine, Chicago, Illinois, USA
| | - Catherine Sinclair
- Department of Otolaryngology - Head and Neck Surgery, Mount Sinai West Hospital, New York, New York, USA
| | - Michael Singer
- Department of Otolaryngology - Head and Neck Surgery, Henry Ford Health System, Detroit, Michigan, USA
| | - Stefano Spiezia
- Endocrine Surgery, Ospedale del Mare, ASL NA1 Centro, Naples, Italy
| | - Jose Higino Steck
- Department of Otorhinolaryngology - Head and Neck Surgery, University of Campinas, Campinas, Brazil
| | - David Steward
- Department of Otolaryngology - Head and Neck Surgery, University of Cincinnati, Cincinnati, Ohio, USA
| | - Kyung Tae
- Department of Otolaryngology - Head and Neck Surgery, College of Medicine, Hanyang University, Seoul, South Korea
| | - Neil Tolley
- Hammersmith Hospital, Imperial College NHS Healthcare Trust, London, UK
| | | | - Ralph P Tufano
- Department of Otolaryngology - Head and Neck Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - R Michael Tuttle
- Endocrine Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | - Erivelto Volpi
- Oncology Center, Oswaldo Cruz German Hospital, Sao Paulo, Brazil
| | - Che Wei Wu
- Department of Otolaryngology - Head and Neck Surgery, Kaohsiung Medical University Hospital, Faculty of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Amr H Abdelhamid Ahmed
- Department of Otolaryngology - Head and Neck Surgery, Division of Thyroid and Parathyroid Endocrine Surgery, Massachusetts Eye & Ear Infirmary, Harvard Medical School, Boston, Massachusetts, USA
| | - Gregory W Randolph
- Department of Otolaryngology - Head and Neck Surgery, Division of Thyroid and Parathyroid Endocrine Surgery, Massachusetts Eye & Ear Infirmary, Harvard Medical School, Boston, Massachusetts, USA
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Hodgetts C, Walker B. Epidemiology, common diagnoses, treatments and prognosis of shoulder pain: A narrative review. INT J OSTEOPATH MED 2021. [DOI: 10.1016/j.ijosm.2021.10.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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GÜN N, KARABOCE B, YURDALAN U. INVESTIGATION OF THERAPEUTIC ULTRASOUND DOSE ON MUSCLE PHANTOM: AN EXPERIMENTAL STUDY. CLINICAL AND EXPERIMENTAL HEALTH SCIENCES 2021. [DOI: 10.33808/clinexphealthsci.950896] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
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Dantas LO, Osani MC, Bannuru RR. Therapeutic ultrasound for knee osteoarthritis: A systematic review and meta-analysis with grade quality assessment. Braz J Phys Ther 2021; 25:688-697. [PMID: 34535411 PMCID: PMC8721076 DOI: 10.1016/j.bjpt.2021.07.003] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/04/2020] [Revised: 07/01/2021] [Accepted: 07/30/2021] [Indexed: 01/04/2023] Open
Abstract
BACKGROUND Therapeutic ultrasound (US) is a widely used intervention in physical therapy to manage pain and to aid in the healing of soft tissue. OBJECTIVE This systematic review aimed to determine the effects of therapeutic US on knee osteoarthritis (KOA) symptoms. METHODS PubMed, MEDLINE, EMBASE, Google Scholar, and the Cochrane databases were searched from inception to April 2019. Randomized controlled trials (RCTs) involving adults with symptomatic KOA that compared therapeutic US with a sham or other control were included. The methodological quality of the trials was assessed at the study level using the Cochrane Risk of Bias tool. The quality of evidence at the outcome level- and overall- was assessed using GRADE methodology. Meta-analyses were conducted using random effects models, and heterogeneity was assessed using the I2 statistic. RESULTS Four studies (N = 234 participants) were eligible for inclusion in our primary analyses assessing therapeutic US versus sham. The methodological quality of the included RCTs ranged from moderate to very low. Treatment with therapeutic US resulted in small, statistically significant benefits for pain (approximate 9.6% improvement on a 0-100 visual analog scale [95% confidence interval: 2, 17.4%]) and self-reported measures of function (approximate 12.8% improvement on a 0-100 visual analog scale [0.4, 25.2%]). The overall quality of the evidence was very low. No adverse events were reported in any of the included studies. CONCLUSIONS The use of therapeutic US may provide additional benefits to physical therapy regimens in terms of symptom relief in individuals with KOA. However, it is not possible to make any meaningful recommendations for clinical practice due to the small number of applicable RCTs and the low methodological quality of the RCTs deemed eligible for this study.
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Affiliation(s)
- Lucas Ogura Dantas
- Division of Rheumatology, Tufts Medical Center, Boston, MA, USA; Physical Therapy Department, Universidade Federal de São Carlos, São Carlos, São Paulo, Brazil
| | - Mikala C Osani
- Center for Treatment Comparison and Integrative Analysis, Division of Rheumatology, Tufts Medical Center, Boston, MA, USA
| | - Raveendhara R Bannuru
- Center for Treatment Comparison and Integrative Analysis, Division of Rheumatology, Tufts Medical Center, Boston, MA, USA; Center for Complementary and Integrative Medicine, Division of Rheumatology, Tufts Medical Center, Boston, MA, USA.
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Snehota M, Vachutka J, Dolezal L, Balazova K, Trneckova M, Kolarova H. Far field during sonication experiments in vitro - Is it really far enough? ULTRASONICS 2021; 115:106461. [PMID: 34000664 DOI: 10.1016/j.ultras.2021.106461] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/21/2020] [Revised: 05/02/2021] [Accepted: 05/03/2021] [Indexed: 06/12/2023]
Abstract
In many in vitro experiments studying ultrasound bioeffects the sonicated samples are placed to far field with intention of exposing them to as uniform ultrasound field as possible. The main aim of this work is to assess whether the sonicated samples really experience what they are believed to. Also we would like to suggest basic rules for construction of sonication vessels. We used 3.5 MHz and 7 MHz ultrasound transducers for measurements. We measured ultrasound field inside and behind common culture plates and special 3D printed plates placed to last axial maximum in water sonication tank with use of a needle hydrophone. Our results show that even though the sonication vessels with sonicated samples are placed into far field, the sonicated samples are actually exposed to some kind of a near field pattern which develops due to the interaction between ultrasound and well of culture plate. The variability of local acoustic intensity can reach up to several hundreds of percent. Our results are also supported by theoretical calculation and software for simulation of ultrasound fields. Even though the sonicated samples may have actually been exposed to some kind of near field pattern in many past studies, the whole phenomenon of creation of near field pattern can be controlled to some extent for future studies. Thus, we suggest that the sonication vessel should always be designed for particular ultrasound transducer.
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Affiliation(s)
- Martin Snehota
- Department of Medical Biophysics, Faculty of Medicine and Dentistry, Palacký University Olomouc, Hnevotinska 3, Olomouc 775 15, Czech Republic
| | - Jaromir Vachutka
- Department of Medical Biophysics, Faculty of Medicine and Dentistry, Palacký University Olomouc, Hnevotinska 3, Olomouc 775 15, Czech Republic.
| | - Ladislav Dolezal
- Department of Medical Biophysics, Faculty of Medicine and Dentistry, Palacký University Olomouc, Hnevotinska 3, Olomouc 775 15, Czech Republic
| | - Klara Balazova
- Department of Medical Biophysics, Faculty of Medicine and Dentistry, Palacký University Olomouc, Hnevotinska 3, Olomouc 775 15, Czech Republic
| | - Marketa Trneckova
- Department of Medical Biophysics, Faculty of Medicine and Dentistry, Palacký University Olomouc, Hnevotinska 3, Olomouc 775 15, Czech Republic; Department of Computer Science, Faculty of Science, Palacký University Olomouc, 17. listopadu 12, Olomouc 771 46, Czech Republic
| | - Hana Kolarova
- Department of Medical Biophysics, Faculty of Medicine and Dentistry, Palacký University Olomouc, Hnevotinska 3, Olomouc 775 15, Czech Republic
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Effects of Non-thermal Ultrasound on a Fibroblast Monolayer Culture: Influence of Pulse Number and Pulse Repetition Frequency. SENSORS 2021; 21:s21155040. [PMID: 34372277 PMCID: PMC8347617 DOI: 10.3390/s21155040] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/10/2021] [Revised: 07/09/2021] [Accepted: 07/19/2021] [Indexed: 11/25/2022]
Abstract
Despite the use of therapeutic ultrasound in the treatment of soft tissue pathologies, there remains some controversy regarding its efficacy. In order to develop new treatment protocols, it is a common practice to carry out in vitro studies in cell cultures before conducting animal tests. The lack of reproducibility of the experimental results observed in the literature concerning in vitro experiments motivated us to establish a methodology for characterizing the acoustic field in culture plate wells. In this work, such acoustic fields are fully characterized in a real experimental configuration, with the transducer being placed in contact with the surface of a standard 12-well culture plate. To study the non-thermal effects of ultrasound on fibroblasts, two different treatment protocols are proposed: long pulse (200 cycles) signals, which give rise to a standing wave in the well with the presence of cavitation (ISPTP max = 19.25 W/cm2), and a short pulse (five cycles) of high acoustic pressure, which produces a number of echoes in the cavity (ISPTP = 33.1 W/cm2, with Pmax = 1.01 MPa). The influence of the acoustic intensity, the number of pulses, and the pulse repetition frequency was studied. We further analyzed the correlation of these acoustic parameters with cell viability, population, occupied surface, and cell morphology. Lytic effects when cavitation was present, as well as mechanotransduction reactions, were observed.
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Li S, Xu Z, Wang Z, Xiang J, Zhang T, Lu H. Acceleration of Bone-Tendon Interface Healing by Low-Intensity Pulsed Ultrasound Is Mediated by Macrophages. Phys Ther 2021; 101:6131760. [PMID: 33561257 DOI: 10.1093/ptj/pzab055] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/21/2020] [Revised: 10/15/2020] [Accepted: 01/04/2021] [Indexed: 11/13/2022]
Abstract
OBJECTIVE Low-intensity pulsed ultrasound (LIPUS) has been proven to facilitate bone-tendon interface (BTI) healing and regulate some inflammatory cytokines. However, the role of macrophages, a key type of inflammatory cell, during treatment remains unknown. This study aimed to investigate the role of macrophages in the treatment of BTI injury with LIPUS in a rotator cuff tear animal model. METHODS In this experimental and comparative study, a total of 160 C57BL/6 mature male mice that underwent supraspinatus tendon detachment and repair were randomly assigned to 4 groups: daily ultrasonic treatment and liposomal clodronate (LIPUS+LC), daily ultrasonic treatment and liposomes (LIPUS), daily mock sonication and liposomal clodronate (LC), and daily mock sonication and liposomes (control [CTL]). LIPUS treatment was initiated immediately postoperatively and continued daily until the end of the experimental period. RESULTS The failure load and stiffness of the supraspinatus tendon-humerus junction were significantly higher in the LIPUS group than in the other groups at postoperative weeks 2 and 4, whereas those in the LIPUS+LC and LC groups were lower than those in the CTL group at postoperative week 4. The LIPUS, LIPUS+LC, and LC groups exhibited significantly more fibrocartilage than the CTL group at 2 weeks. Only the LIPUS group had more fibrocartilage than the CTL group at 4 weeks. Micro-computed tomography results indicated that LIPUS treatment could improve the bone quality of the attachment site after both 2 and 4 weeks. When macrophages were depleted by LC, the bone quality-promoting effect of LIPUS treatment was significantly reduced. CONCLUSION The enhancement of BTI healing by LIPUS might be mediated by macrophages. IMPACT In our study, LIPUS treatment appeared to accelerate BTI healing, which was associated with macrophages based on our murine rotator cuff repair model. The expressions of macrophage under LIPUS treatment may offer a potential mechanism to explain BTI healing and the effects of LIPUS on BTI healing.
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Affiliation(s)
- Shengcan Li
- Department of Sports Medicine, Xiangya Hospital, Central South University, Changsha, Hunan, PR China.,Key Laboratory of Organ Injury, Aging and Regenerative Medicine of Hunan Province, Changsha, Hunan, PR China
| | - Zihan Xu
- Department of Sports Medicine, Xiangya Hospital, Central South University, Changsha, Hunan, PR China.,Key Laboratory of Organ Injury, Aging and Regenerative Medicine of Hunan Province, Changsha, Hunan, PR China
| | - Zhanwen Wang
- Department of Sports Medicine, Xiangya Hospital, Central South University, Changsha, Hunan, PR China.,Key Laboratory of Organ Injury, Aging and Regenerative Medicine of Hunan Province, Changsha, Hunan, PR China
| | - Jie Xiang
- Department of Sports Medicine, Xiangya Hospital, Central South University, Changsha, Hunan, PR China.,Key Laboratory of Organ Injury, Aging and Regenerative Medicine of Hunan Province, Changsha, Hunan, PR China
| | - Tao Zhang
- Department of Sports Medicine, Xiangya Hospital, Central South University, Changsha, Hunan, PR China.,Key Laboratory of Organ Injury, Aging and Regenerative Medicine of Hunan Province, Changsha, Hunan, PR China
| | - Hongbin Lu
- Department of Sports Medicine, Xiangya Hospital, Central South University, Changsha, Hunan, PR China.,Key Laboratory of Organ Injury, Aging and Regenerative Medicine of Hunan Province, Changsha, Hunan, PR China
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Al Onazi MM, Yurick JL, Harris C, Nishimura K, Suderman K, Pituskin E, Chua N, McNeely ML. Therapeutic Ultrasound for Chemotherapy-Related Pain and Sensory Disturbance in the Hands and Feet in Patients With Colorectal Cancer: A Pilot Randomized Controlled Trial. J Pain Symptom Manage 2021; 61:1127-1138. [PMID: 33137422 DOI: 10.1016/j.jpainsymman.2020.10.028] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/24/2020] [Revised: 10/23/2020] [Accepted: 10/26/2020] [Indexed: 12/15/2022]
Abstract
CONTEXT This proof-of-concept trial was undertaken as a first step in exploring the clinical benefit of therapeutic ultrasound for pain and sensory disturbance in patients with colorectal cancer. OBJECTIVES The aim of this study was to determine the feasibility and preliminary efficacy of adding therapeutic ultrasound to a home-based therapeutic exercise program (current standard of care) for patients presenting with oxaliplatin-related pain and sensory disturbance in the hands and feet. METHODS Thirty-one colorectal cancer patients with presenting symptoms of peripheral sensory neuropathy, based on a physician-rated grade 1, 2, or 3 on the National Cancer Institute Common Terminology Criteria for Adverse Events for sensory and motor neuropathy, were enrolled in the trial. Patients were randomized to either 10 sessions of ultrasound therapy intervention over two-week period (continuous ultrasound at an intensity of 0.7 to 0.8 w/cm2, and frequency of 3 MHz for 5 minutes) plus standard care (n = 16) or to standard care alone (n = 15). The feasibility of therapeutic ultrasound was determined by the recruitment rate, participants' adherence to the intervention, and the study completion rates. Assessments of pain, sensory disturbance, sensation, and balance were conducted at baseline, two and six weeks. RESULTS We achieved a recruitment rate of 84%, an adherence rate of 100% to the intervention, and a completion rate of 100%. Adding therapeutic ultrasound to standard care resulted in a statistically and clinically significant improvement in symptoms of pain and sensory disturbance (P = 0.003) at two weeks; however, no significance difference between the groups was found at the six-week follow-up. CONCLUSIONS The findings of this proof-of-concept study support the feasibility of the therapeutic ultrasound in addition to standard care as an intervention for colorectal cancer patients with oxaliplatin-related pain and sensory disturbance in the hands and feet. The findings warrant a large-scale placebo-controlled trial.
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Affiliation(s)
- Mona M Al Onazi
- Faculty of Rehabilitation Medicine, Department of Physical Therapy, University of Alberta, Edmonton, Alberta, Canada
| | - Janice L Yurick
- Department of Rehabilitation Medicine, Cross Cancer Institute, Alberta Health Services, Edmonton, Alberta, Canada
| | - Claire Harris
- Faculty of Rehabilitation Medicine, Department of Physical Therapy, University of Alberta, Edmonton, Alberta, Canada
| | - Kacy Nishimura
- Faculty of Rehabilitation Medicine, Department of Physical Therapy, University of Alberta, Edmonton, Alberta, Canada
| | - Kirsten Suderman
- Faculty of Rehabilitation Medicine, Department of Physical Therapy, University of Alberta, Edmonton, Alberta, Canada
| | - Edith Pituskin
- Faculty of Nursing, University of Alberta, Edmonton, Alberta, Canada; Department of Oncology, Cross Cancer Institute, Alberta Health Services, Edmonton, Alberta, Canada
| | - Neil Chua
- Department of Oncology, Cross Cancer Institute, Alberta Health Services, Edmonton, Alberta, Canada
| | - Margaret L McNeely
- Faculty of Rehabilitation Medicine, Department of Physical Therapy, University of Alberta, Edmonton, Alberta, Canada; Department of Rehabilitation Medicine, Cross Cancer Institute, Alberta Health Services, Edmonton, Alberta, Canada.
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Wei P, Cornel EJ, Du J. Ultrasound-responsive polymer-based drug delivery systems. Drug Deliv Transl Res 2021; 11:1323-1339. [PMID: 33761101 PMCID: PMC7989687 DOI: 10.1007/s13346-021-00963-0] [Citation(s) in RCA: 62] [Impact Index Per Article: 20.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/11/2021] [Indexed: 02/06/2023]
Abstract
Ultrasound-responsive polymeric materials have received a tremendous amount of attention from scientists for several decades. Compared to other stimuli-responsive materials (such as UV-, thermal-, and pH-responsive materials), these smart materials are more applicable since they allow more efficient drug delivery and targeted treatment by fairly non-invasive means. This review describes the recent advances of such ultrasound-responsive polymer-based drug delivery systems and illustrates various applications. More specifically, the mechanism of ultrasound-induced drug delivery, typical formulations, and biomedical applications (tumor therapy, disruption of blood-brain barrier, fighting infectious diseases, transdermal drug delivery, and enhanced thrombolysis) are summarized. Finally, a perspective on the future research directions for the development of ultrasound-responsive polymeric materials to facilitate a clinical translation is given.
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Affiliation(s)
- Ping Wei
- Department of Polymeric Materials, School of Materials Science and Engineering, Key Laboratory of Advanced Civil Engineering Materials of Ministry of Education, Tongji University, 4800 Caoan Road, Shanghai, 201804, China
| | - Erik Jan Cornel
- Department of Polymeric Materials, School of Materials Science and Engineering, Key Laboratory of Advanced Civil Engineering Materials of Ministry of Education, Tongji University, 4800 Caoan Road, Shanghai, 201804, China
| | - Jianzhong Du
- Department of Polymeric Materials, School of Materials Science and Engineering, Key Laboratory of Advanced Civil Engineering Materials of Ministry of Education, Tongji University, 4800 Caoan Road, Shanghai, 201804, China. .,Department of Orthopedics, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai, 200072, China.
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ÖZMEN T, KOPARAL SS, KARATAŞ Ö, ESER F, ÖZKURT B, GAFUROĞLU Ü. Comparison of the clinical and sonographic effects of ultrasound therapy, extracorporeal shock wave therapy, and Kinesio taping in lateral epicondylitis. Turk J Med Sci 2021; 51:76-83. [PMID: 32682361 PMCID: PMC7991874 DOI: 10.3906/sag-2001-79] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2020] [Accepted: 07/18/2020] [Indexed: 11/03/2022] Open
Abstract
Background/aim The aim of this study was to compare the clinical and sonographic effects of the ultrasound (US) therapy, extracorporeal shock wave therapy (ESWT), and Kinesio taping (KT) in the lateral epicondylitis (LE). Materials and methods A total of 40 patients with LE were included in the present study. The patients were randomly assigned to 3 treatment groups: US (n = 13), ESWT (n = 14), and KT (n = 13) groups. Results The visual analog scale (VAS) scores significantly decreased in all groups (P < 0.05). Grip strength significantly increased after 8 weeks in only the KT group (P < 0.05). The Patient-Rated Tennis Elbow Evaluation Scale (PRTEE) scores significantly decreased after 2 weeks and after 8 weeks in the US group and ESWT groups, and after 8 weeks in the KT group (P < 0.05). Common extensor tendon (CET) thicknesses significantly decreased after 8 weeks in only the ESWT group (P < 0.05). Conclusion The US therapy, KT, and ESWT are effective in reducing pain and improving functionality. However, none of these treatment methods were found to be superior to others in reducing the pain and improving functionality.
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Affiliation(s)
- Tarık ÖZMEN
- Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Karabük University, KarabükTurkey
| | - Salih Süha KOPARAL
- Department of Radiology, Ankara Numune Training and Research Hospital, AnkaraTurkey
| | - Özlem KARATAŞ
- Department of Physical Medicine and Rehabilitation, University of Health Sciences, Antalya Training and Research Hospital, AntalyaTurkey
| | - Filiz ESER
- Department of Physical Medicine and Rehabilitation, Ankara Numune Training and Research Hospital, AnkaraTurkey
| | - Bülent ÖZKURT
- Department of Orthopedics, Ankara Numune Training and Research Hospital, AnkaraTurkey
| | - Ümit GAFUROĞLU
- Department of Physical Medicine and Rehabilitation, Ankara Numune Training and Research Hospital, AnkaraTurkey
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Perrucini PDDO, Oliveira RFD, Medeiros FBPD, Bertin LD, Pires-Oliveira DADA, Frederico RCP. Ultrasonic therapy modulates the expression of genes related to neovascularization and inflammation in fibroblasts. FISIOTERAPIA EM MOVIMENTO 2021. [DOI: 10.1590/fm.2021.34112] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Abstract Introduction: In the rehabilitation of musculoskeletal injuries, ultrasound is widely used in clinical practice. Objective: To evaluate the effects of pulsed ultrasonic therapy on the viability and modulation of genes involved in inflammation (IL-6) and neovascularization (VEGF) processes of L929 fibroblast cells. Methods: For irradiation with ultrasound the cells were subdivided into groups: G1 (without irradiation), G2 (0.3 W/cm2-20%) and G3 (0.6 W/cm2-20%), with periods of treatment at 24, 48 and 72 hours. The cell viability assay was analyzed by the MTT method and gene modulation was analyzed by RT-qPCR method. Results: After the comparative analysis between groups, only G2 and G3 (48-hour) presented statistically significant differences in relation to the control. In relation to the gene expression, the selection of the groups analyzed was delimited according to the comparative analysis of the values obtained by the MTT test. After the achievement of RT-qPCR, it could be observed that in G2 the amount of VEGF gene transcripts increased by 1.125-fold compared to endogenous controls, and increased 1.388-fold in G3. The IL-6 gene, on the other hand, had its transcripts reduced in both G2 (5.64x10-9) and G3 (1.91x10-6). Conclusion: Pulsed ultrasound in L929 fibroblasts showed a significant biostimulatory effect in the 48-hour period, with increased cell viability, and the same effect in the modulation of gene expression related the neovascularization and inflammation, mediating the acceleration of the tissue repair cascade.
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Xu M, Wang L, Wu S, Dong Y, Chen X, Wang S, Li X, Zou C. Review on experimental study and clinical application of low-intensity pulsed ultrasound in inflammation. Quant Imaging Med Surg 2021; 11:443-462. [PMID: 33392043 DOI: 10.21037/qims-20-680] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
Low-intensity pulsed ultrasound (LIPUS), as physical therapy, is widely used in both research and clinical settings. It induces multiple bioeffects, such as alleviating pain, promoting tissue repair, and shortening disease duration. LIPUS can also mediate inflammation. This paper reviews the application of LIPUS in inflammation and discusses the underlying mechanism. In basic experiments, LIPUS can regulate inflammatory responses at the cellular level by affecting some signaling pathways. In a clinical trial, LIPUS has been shown to alleviate inflammatory responses efficiently. As a cheap, safe, and convenient physical method, LIPUS is promising as anti-inflammatory therapy.
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Affiliation(s)
- Maosheng Xu
- Department of Ultrasonography, The Second Affiliated Hospital, and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, China
| | - Liang Wang
- Department of Ultrasonography, The Second Affiliated Hospital, and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, China
| | - Senmin Wu
- Department of Ultrasonography, The Second Affiliated Hospital, and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, China
| | - Yanyan Dong
- Department of Ultrasonography, The Second Affiliated Hospital, and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, China
| | - Xiu Chen
- Department of Ultrasonography, The Second Affiliated Hospital, and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, China
| | - Shijia Wang
- Department of Ultrasonography, The Second Affiliated Hospital, and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, China
| | - Xiuyun Li
- Department of Ultrasonography, The Second Affiliated Hospital, and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, China
| | - Chunpeng Zou
- Department of Ultrasonography, The Second Affiliated Hospital, and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, China
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Liao YH, Chen WS, Jee SH. The additive efficacy of therapeutic low-intensity pulsed ultrasound in the treatment of vitiligo: A randomized, left-right comparison clinical trial. Dermatol Ther 2020; 34:e14648. [PMID: 33296553 DOI: 10.1111/dth.14648] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2020] [Revised: 11/19/2020] [Accepted: 12/01/2020] [Indexed: 11/28/2022]
Abstract
Repigmentation of vitiligo relies on the proliferation and migration of melanoblasts from hair follicles to the epidermis to replenish epidermal melanin. Our previous study has demonstrated low-intensity pulsed ultrasound (LIPUS) can stimulate melanoblast migration in vitro. We sought to evaluate the potential additive efficacy and safety of LIPUS for repigmentation of vitiligo. Twenty-seven adult patients with stable generalized vitiligo on the face or trunk were recruited in this randomized, open, left-right comparison study. In each patient, two symmetric lesional sites were randomly selected; one was assigned as the target lesion, which was treated with add-on LIPUS twice weekly for 24 weeks, and the other as the control lesion, which was administrated with sham sonification. The primary outcome was the difference of repigmentation degree between the target and control lesions at week 24, based on the 7-point physician global assessment score. At the end of study, 23 patients with vitiligo on the face (n = 10) or trunk (n = 13) completed the 24-week treatment course. Enhanced repigmentation for vitiligo receiving LIPUS as compared to sham sonification was observed in 38.5% (5/13) of the patients with truncal vitiligo, but none of those with facial vitiligo. Truncal vitiligo (P = .046) and higher intensity of LIPUS administered (P = .01) were statistically significantly associated with the effectiveness of additive LIPUS treatment. The LIPUS treatment was well-tolerated without remarkable adverse effects. This pilot study showed that LIPUS could provide therapeutic benefits and could be considered as a treatment adjunct for truncal vitiligo.
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Affiliation(s)
- Yi-Hua Liao
- Department of Dermatology, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan
| | - Wen-Shiang Chen
- Department of Physical Medicine and Rehabilitation, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan
| | - Shiou-Hwa Jee
- Department of Dermatology, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan.,Department of Dermatology, Cathay General Hospital, Taipei, Taiwan
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Ebadi S, Henschke N, Forogh B, Nakhostin Ansari N, van Tulder MW, Babaei-Ghazani A, Fallah E. Therapeutic ultrasound for chronic low back pain. Cochrane Database Syst Rev 2020; 7:CD009169. [PMID: 32623724 PMCID: PMC7390505 DOI: 10.1002/14651858.cd009169.pub3] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
BACKGROUND This is an update of a Cochrane Review published in 2014. Chronic non-specific low back pain (LBP) has become one of the main causes of disability in the adult population around the world. Although therapeutic ultrasound is not recommended in recent clinical guidelines, it is frequently used by physiotherapists in the treatment of chronic LBP. OBJECTIVES The objective of this review was to determine the effectiveness of therapeutic ultrasound in the management of chronic non-specific LBP. A secondary objective was to determine the most effective dosage and intensity of therapeutic ultrasound for chronic LBP. SEARCH METHODS We performed electronic searches in CENTRAL, MEDLINE, Embase, CINAHL, PEDro, Index to Chiropractic Literature, and two trials registers to 7 January 2020. We checked the reference lists of eligible studies and relevant systematic reviews and performed forward citation searching. SELECTION CRITERIA We included randomised controlled trials (RCTs) on therapeutic ultrasound for chronic non-specific LBP. We compared ultrasound (either alone or in combination with another treatment) with placebo or other interventions for chronic LBP. DATA COLLECTION AND ANALYSIS Two review authors independently assessed the risk of bias of each trial and extracted the data. We performed a meta-analysis when sufficient clinical and statistical homogeneity existed. We determined the certainty of the evidence for each comparison using the GRADE approach. MAIN RESULTS We included 10 RCTs involving a total of 1025 participants with chronic LBP. The included studies were carried out in secondary care settings in Turkey, Iran, Saudi Arabia, Croatia, the UK, and the USA, and most applied therapeutic ultrasound in addition to another treatment, for six to 18 treatment sessions. The risk of bias was unclear in most studies. Eight studies (80%) had unclear or high risk of selection bias; no studies blinded care providers to the intervention; and only five studies (50%) blinded participants. There was a risk of selective reporting in eight studies (80%), and no studies adequately assessed compliance with the intervention. There was very low-certainty evidence (downgraded for imprecision, inconsistency, and limitations in design) of little to no difference between therapeutic ultrasound and placebo for short-term pain improvement (mean difference (MD) -7.12, 95% confidence interval (CI) -17.99 to 3.75; n = 121, 3 RCTs; 0-to-100-point visual analogue scale (VAS)). There was also moderate-certainty evidence (downgraded for imprecision) of little to no difference in the number of participants achieving a 30% reduction in pain in the short term (risk ratio 1.08, 95% CI 0.81 to 1.44; n = 225, 1 RCT). There was low-certainty evidence (downgraded for imprecision and limitations in design) that therapeutic ultrasound has a small effect on back-specific function compared with placebo in the short term (standardised mean difference -0.29, 95% CI -0.51 to -0.07 (MD -1.07, 95% CI -1.89 to -0.26; Roland Morris Disability Questionnaire); n = 325; 4 RCTs), but this effect does not appear to be clinically important. There was moderate-certainty evidence (downgraded for imprecision) of little to no difference between therapeutic ultrasound and placebo on well-being (MD -2.71, 95% CI -9.85 to 4.44; n = 267, 2 RCTs; general health subscale of the 36-item Short Form Health Survey (SF-36)). Two studies (n = 486) reported on overall improvement and satisfaction between groups, and both reported little to no difference between groups (low-certainty evidence, downgraded for serious imprecision). One study (n = 225) reported on adverse events and did not identify any adverse events related to the intervention (low-certainty evidence, downgraded for serious imprecision). No study reported on disability for this comparison. We do not know whether therapeutic ultrasound in addition to exercise results in better outcomes than exercise alone because the certainty of the evidence for all outcomes was very low (downgraded for imprecision and serious limitations in design). The estimate effect for pain was in favour of the ultrasound plus exercise group (MD -21.1, 95% CI -27.6 to -14.5; n = 70, 2 RCTs; 0-to-100-point VAS) at short term. Regarding back-specific function (MD - 0.41, 95% CI -3.14 to 2.32; n = 79, 2 RCTs; Oswestry Disability Questionnaire) and well-being (MD -2.50, 95% CI -9.53 to 4.53; n = 79, 2 RCTs; general health subscale of the SF-36), there was little to no difference between groups at short term. No studies reported on the number of participants achieving a 30% reduction in pain, patient satisfaction, disability, or adverse events for this comparison. AUTHORS' CONCLUSIONS The evidence from this systematic review is uncertain regarding the effect of therapeutic ultrasound on pain in individuals with chronic non-specific LBP. Whilst there is some evidence that therapeutic ultrasound may have a small effect on improving low back function in the short term compared to placebo, the certainty of evidence is very low. The true effect is likely to be substantially different. There are few high-quality randomised trials, and the available trials were very small. The current evidence does not support the use of therapeutic ultrasound in the management of chronic LBP.
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Affiliation(s)
- Safoora Ebadi
- Department of Physical Medicine and Rehabilitation, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
- Neuromusculoskeletal Research Center, Iran University of Medical Sciences, Tehran, Iran
| | | | - Bijan Forogh
- Department of Physical Medicine and Rehabilitation, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
- Neuromusculoskeletal Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Noureddin Nakhostin Ansari
- Department of Physiotherapy, Faculty of Rehabilitation, Tehran University of Medical Sciences, Tehran, Iran
| | - Maurits W van Tulder
- Department of Health Sciences, Faculty of Earth and Life Sciences, VU University Amsterdam, Amsterdam, Netherlands
| | - Arash Babaei-Ghazani
- Department of Physical Medicine and Rehabilitation, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
- Neuromusculoskeletal Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Ehsan Fallah
- Department of Orthopedics, School of Medicine, AJA University of Medical Sciences, Tehran, Iran
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Bock M, Eisenschenk A, Lorenzen H, Lautenbach M. Study of Medical Ultrasound for Rhizarthrosis (SUR): study protocol for a randomized controlled single-center pilot-trial. Trials 2020; 21:450. [PMID: 32487163 PMCID: PMC7268749 DOI: 10.1186/s13063-020-04375-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2020] [Accepted: 05/05/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Rhizarthrosis (trapeziometacarpal osteoarthritis) is the second most common site of osteoarthritis in the hand affecting 10-30% of adults over the age of 50. Up to four times as many women as men have rhizarthrosis. Clinical symptoms include functional disability of the thumb, pain, joint swelling, and reduced strength. The first carpometacarpal joint is pivotal in the opposition of the thumb and allows a high degree in flexibility to humans. Current therapies focus mainly on surgical strategies, which should be considered in advanced, therapy-resistant stages to relieve pain and improve function. However, conservative treatment methods are urgently required in presurgical stages. The efficacy of conservative treatment options for rhizarthrosis, which are intended to preserve function, joint integrity and to relieve pain, has not been adequately studied. In the clinical study protocol presented here, we investigate the efficacy of multimodal hand therapy versus therapeutic ultrasound versus combination therapy with both hand therapy and therapeutic ultrasound. METHODS This study is a single-center, randomized, controlled, parallel-group pilot trial. One hundred fifty patients with rhizarthrosis and current disease activity will be randomized to one of three conservative interventions over 6 months. Interventions are (1) multimodal hand therapy (2) therapeutic ultrasound, and (3) combination therapy with both hand therapy and ultrasound therapy. The primary outcome measure is the Disabilities of the Arm, Shoulder, and Hand (DASH) questionnaire score after 6 months. Secondary endpoints are changes in pain, quality of life, disability progression, and changes of hand function. Safety will also be assessed. DISCUSSION Clinical data suggest that multimodal hand therapy may improve functionality and reduce pain in rhizarthrosis. Clinical data regarding therapeutic ultrasound are not available. Clinical evidence is lacking. This study is the first clinical study investigating the effects of multimodal hand therapy in direct comparison to therapeutic ultrasound and to a combination therapy with both hand therapy and ultrasound therapy for rhizarthrosis. TRIAL REGISTRATION ClinicalTrials.gov; NCT04115085; Registered on September 30, 2019.
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Affiliation(s)
- Markus Bock
- Department of Hand Surgery, Upper Extremity and Foot Surgery, Center for Orthopedics and Trauma Surgery, Hospital Waldfriede, Argentinische Allee 40, 14163, Berlin, Germany.
- Institute of Biochemistry, University Medicine Berlin - Charité, Charitéplatz 1, 10117, Berlin, Germany.
- Department of Neurology, University Medical Center of the Johannes-Gutenberg University Mainz, Langenbeckstr. 1, 55131, Mainz, Germany.
| | - Andreas Eisenschenk
- Department of Hand and Functional Microsurgery, University Medicine Greifswald, Ferdinand-Sauerbruch-Str. 1, 17475, Greifswald, Germany
- Department of Hand, Replantation and Microsurgery, Unfallkrankenhaus Berlin, Warener Str. 7, 12683, Berlin, Germany
| | - Heiko Lorenzen
- Department of Hand Surgery, Upper Extremity and Foot Surgery, Center for Orthopedics and Trauma Surgery, Hospital Waldfriede, Argentinische Allee 40, 14163, Berlin, Germany
- Practice for Occupational Therapy, Argentinische Allee 40, 14163, Berlin, Germany
| | - Martin Lautenbach
- Department of Hand Surgery, Upper Extremity and Foot Surgery, Center for Orthopedics and Trauma Surgery, Hospital Waldfriede, Argentinische Allee 40, 14163, Berlin, Germany
- Department of Hand and Functional Microsurgery, University Medicine Greifswald, Ferdinand-Sauerbruch-Str. 1, 17475, Greifswald, Germany
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Effect of acoustic standing waves on cellular viability and metabolic activity. Sci Rep 2020; 10:8493. [PMID: 32444830 PMCID: PMC7244593 DOI: 10.1038/s41598-020-65241-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2019] [Accepted: 04/28/2020] [Indexed: 11/08/2022] Open
Abstract
Acoustic standing wave devices offer excellent potential applications in biological sciences for drug delivery, cell manipulation and tissue engineering. However, concerns have been raised about possible destructive effects on cells due to the applied acoustic field, in addition to other produced secondary factors. Here, we report a systematic study employing a 1D resonant acoustic trapping device to evaluate the cell viability and cell metabolism for a healthy cell line (Human Dermal Fibroblasts, HDF) and a cervical cancer cell line (HeLa), as a function of time and voltages applied (4-10 Vpp) under temperature-controlled conditions. We demonstrate that high cell viability can be achieved reliably when the device is operated at its minimum trapping voltage and tuned carefully to maximise the acoustic standing wave field at the cavity resonance. We found that cell viability and reductive metabolism for both cell lines are kept close to control levels at room temperature and at 34 °C after 15 minutes of acoustic exposure, while shorter acoustic exposures and small changes on temperature and voltages, had detrimental effects on cells. Our study highlights the importance of developing robust acoustic protocols where the operating mode of the acoustic device is well defined, characterized and its temperature carefully controlled, for the application of acoustic standing waves when using live cells and for potential clinical applications.
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Pinkaew D, Kiattisin K, Wonglangka K, Awoot P. Phonophoresis of Phyllanthus amarus nanoparticle gel improves functional capacity in individuals with knee osteoarthritis: A randomized controlled trial. J Bodyw Mov Ther 2020; 24:15-18. [PMID: 31987536 DOI: 10.1016/j.jbmt.2019.04.013] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2019] [Revised: 04/22/2019] [Accepted: 04/26/2019] [Indexed: 10/26/2022]
Abstract
OBJECTIVE This study examined the effects of treatment with Phyllanthus amarus nanoparticle gel applied by phonophoresis (PP) and ultrasound therapy (UT) in patients with symptomatic knee osteoarthritis (OA) using a randomized, double-blind, controlled trial. METHODS Patients with knee OA (n = 40; mean age ± SD, 64.30 ± 9.71 years), who had visual analogue scale (VAS) scores for knee pain intensity of 68.00 ± 9.58 (UT group) and 71.00 ± 8.74 (PP group, respectively) before treatment, were randomly allocated into two groups. Both groups were treated with an ultrasound program in continuous mode, 1.0 W/cm2, 10 min per session, for 10 sessions. Nanoparticles of P. amarus were used in the PP group, whereas a nondrug coupling gel was used in the UT group. The 6-min walk test (6-MWT) was performed to evaluate functional capacity. The VAS and the 6-MWT were evaluated before and after 10 treatment sessions in both groups using a double-blind procedure. RESULTS VAS and 6-MWT showed significant improvement after treatment in both groups (p < 0.05). The PP group showed more significant effects than the UT group, in terms of both reducing the VAS pain score (p < 0.05) and improving 6-MWT (p < 0.05). CONCLUSIONS PP is suggested as an effective method for the treatment of symptomatic knee OA for reducing pain and improving functional capacity.
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Affiliation(s)
- Decha Pinkaew
- Department of Physical Therapy, Faculty of Associated Medical Sciences, Chiang Mai University, Chiang Mai, Thailand.
| | - Kanokwan Kiattisin
- Department of Pharmaceutical Sciences. Faculty of Pharmacy, Chiang Mai University, Chiang Mai, Thailand
| | - Khanittha Wonglangka
- Department of Physical Therapy, Faculty of Associated Medical Sciences, Chiang Mai University, Chiang Mai, Thailand
| | - Pisittawoot Awoot
- Department of Community Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
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Dedes V, Tzirogiannis K, Polikandrioti M, Dede AM, Mitseas A, Panoutsopoulos GI. Comparison of radial extracorporeal shockwave therapy with ultrasound therapy in patients with lateral epicondylitis. J Med Ultrason (2001) 2020; 47:319-325. [PMID: 31912320 DOI: 10.1007/s10396-019-01002-9] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2019] [Accepted: 12/04/2019] [Indexed: 10/25/2022]
Abstract
PURPOSE Patients suffering from lateral epicondylitis exhibit diminished mobility due to pain. The aim of the study was to compare the efficacy of both shockwave and ultrasound therapies in patients with lateral epicondylitis. METHODS The shockwave group consisted of 117 patients, 63 patients constituted the ultrasound group, and 18 patients made up the control group. The "University of Peloponnese Pain, Functionality and Quality of Life Questionnaire" was used for the evaluation of pain, functionality, and quality of life on a five-point Likert scale, pre-treatment, post-treatment, and at 4-week follow-up. RESULTS The pain was reduced and the functionality and quality of life were improved in both the shockwave and ultrasound groups post-treatment (p < 0.001) and at 4-week follow-up (p < 0.001), but the results in the ultrasound group were not as pronounced as in the shockwave group (p < 0.001). CONCLUSION Both radial shockwave and ultrasound therapies were significantly effective in patients with lateral epicondylitis. However, ultrasound therapy was less effective than shockwave therapy.
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Affiliation(s)
- Vasileios Dedes
- Laboratory of Physiology-Pharmacology, Department of Nursing, Faculty of Human Movement and Quality of Life Sciences, University of Peloponnese, Efstathiou and Stamatikis Valioti and Plateon, 23 100, Sparta, Greece
| | - Konstantinos Tzirogiannis
- Laboratory of Physiology-Pharmacology, Department of Nursing, Faculty of Human Movement and Quality of Life Sciences, University of Peloponnese, Efstathiou and Stamatikis Valioti and Plateon, 23 100, Sparta, Greece
| | - Maria Polikandrioti
- Department of Nursing, Faculty of Health and Caring Professions, University of West Attica, Athens, Greece
| | - Ariadni Maria Dede
- Engineering in Biotechnology Department, Absalon University College, Kalundborg, Sjelland, Denmark
| | | | - Georgios I Panoutsopoulos
- Laboratory of Physiology-Pharmacology, Department of Nursing, Faculty of Human Movement and Quality of Life Sciences, University of Peloponnese, Efstathiou and Stamatikis Valioti and Plateon, 23 100, Sparta, Greece.
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Rubira APFDA, Rubira MC, Rubira LDA, Comachio J, Magalhães MO, Marques AP. Comparison of the effects of low-level laser and pulsed and continuous ultrasound on pain and physical disability in chronic non-specific low back pain: a randomized controlled clinical trial. Adv Rheumatol 2019; 59:57. [PMID: 31847915 DOI: 10.1186/s42358-019-0099-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2019] [Accepted: 11/18/2019] [Indexed: 01/01/2023] Open
Abstract
OBJECTIVE To compare the short-term effects of pulsed laser and pulsed and continuous ultrasound on pain and functional disability in women with chronic non-specific low back pain. METHODS The sample was composed of 100 volunteers randomly allocated into four groups: The Pulsed Laser Group (n = 26) was treated with 3 J/cm2; the Pulsed Ultrasound Group (n = 24; 3 MHz) was treated with 1 W/cm2; the Continuous Ultrasound Group (n = 26; 1 MHz) was treated with 1 W/cm2; and a Control Group (n = 24), where the patients were still waiting for treatment. Before and after 10 sessions of treatment, the intensity of pain was assessed using the visual analogue scale (VAS), the quality of pain was evaluated using the McGill pain questionnaire and functional disability was investigated using the Roland-Morris questionnaire. RESULTS The three treated groups exhibited a decrease in pain (p < 0.001); the Pulsed Laser Group showed the greater relative gain (91.2%), Meanwhile, the Control Group exhibited a worsening of - 5.8%. The three treated groups demonstrated improvement in the quality of pain (McGill) in the total, sensory and affective dimensions (p < 0.005; p < 0.002; p < 0.013, respectively). All treated groups showed a decrease in functional disability (p < 0.001), but the Pulsed Ultrasound Group showed the highest relative gain (83.3%). CONCLUSIONS The three modalities have significant effects to decreasing low back pain and improving functional disability in women with non-specific chronic low back pain, but the pulsed low-level laser had the best results on pain while the pulsed ultrasound had the best results on improve the functional disability. TRIAL REGISTRATION ClinicalTrials.gov: NCT02150096.
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Affiliation(s)
- Ana Paula Fernandes De Angelis Rubira
- Physical Therapy, Speech and Occupational Therapy Department, School of Medicine, University of Sao Paulo, Cipotânea, n 51, Cidade Universitária, Sao Paulo, Brazil
| | | | | | - Josielli Comachio
- Physical Therapy, Speech and Occupational Therapy Department, School of Medicine, University of Sao Paulo, Cipotânea, n 51, Cidade Universitária, Sao Paulo, Brazil.
| | - Maurício Oliveira Magalhães
- Physical Therapy, Speech and Occupational Therapy Department, School of Medicine, University of Sao Paulo, Cipotânea, n 51, Cidade Universitária, Sao Paulo, Brazil
| | - Amélia Pasqual Marques
- Physical Therapy, Speech and Occupational Therapy Department, School of Medicine, University of Sao Paulo, Cipotânea, n 51, Cidade Universitária, Sao Paulo, Brazil
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Hauck M, da Silva Paulitsch F, Cruz JM, Martins CN, Oliveira MR, Puntel GO, Vargas da Silva AM, Signori LU. Intensity-dependent effect of pulsed and continuous therapeutic ultrasound on endothelial function: a randomised crossover clinical trial. INTERNATIONAL JOURNAL OF THERAPY AND REHABILITATION 2019. [DOI: 10.12968/ijtr.2018.0049] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Background/Aims The aim of this study was to evaluate the effects of different intensities and waveforms of therapeutic ultrasound on endothelial function in typically healthy participants. Methods A total of 15 participants were evaluated over 2 consecutive days. Different intensities of continuous and pulsed (20% duty cycle) 1-MHz ultrasound were applied to the brachial artery for 5 minutes each. Endothelial function was measured using flow-mediated dilation technique before and immediately after ultrasound was applied. Results Compared to baseline values, endothelium-dependent vasodilation increased with both continuous (2.8%) and pulsed (1.6%) ultrasound at an intensity of 0.4 W/cm2SPTA. At 1.2 W/cm2SPTA, endothelium-dependent vasodilation was 4.1% above baseline for pulsed and 5.3% above baseline for continuous waveforms. There was no additional increase in vasodilation at intensities above 1.2 W/cm2SPTA. The percentage of endothelium-dependent vasodilation was similar for the all of the different waveforms studied. Conclusions Both continuous and pulsed ultrasound waveforms promote endothelium-dependent vasodilation. There was a dose-dependent increase in vasodilation at intensities from 0.4 W/cm2SPTA to 1.2 W/cm2SPTA. Pulsed is more efficient than continuous ultrasound because it produces the same effect on endothelium-dependent vasodilation while employing 20% of the energy applied with continuous ultrasound.
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Affiliation(s)
- Melina Hauck
- Faculty of Medicine, Graduate Programme in Health Sciences, Federal University of Rio Grande, Rio Grande, Brazil
| | - Felipe da Silva Paulitsch
- Faculty of Medicine, Graduate Programme in Health Sciences, Federal University of Rio Grande, Rio Grande, Brazil
| | - Jeferson Mendez Cruz
- Faculty of Medicine, Graduate Programme in Health Sciences, Federal University of Rio Grande, Rio Grande, Brazil
| | - Cassio Noronha Martins
- Faculty of Medicine, Graduate Programme in Health Sciences, Federal University of Rio Grande, Rio Grande, Brazil
| | - Murilo Rezende Oliveira
- Physiotherapy and Rehabilitation Department, Postgraduate Programme in Functional Rehabilitation, Federal University of Santa Maria, Santa Maria, Brazil
| | - Gustavo Orione Puntel
- Physiotherapy and Rehabilitation Department, Postgraduate Programme in Functional Rehabilitation, Federal University of Santa Maria, Santa Maria, Brazil
| | - Antônio Marcos Vargas da Silva
- Physiotherapy and Rehabilitation Department, Postgraduate Programme in Functional Rehabilitation, Federal University of Santa Maria, Santa Maria, Brazil
| | - Luis Ulisses Signori
- Physiotherapy and Rehabilitation Department, Postgraduate Programme in Functional Rehabilitation, Federal University of Santa Maria, Santa Maria, Brazil
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Jiang X, Savchenko O, Li Y, Qi S, Yang T, Zhang W, Chen J. A Review of Low-Intensity Pulsed Ultrasound for Therapeutic Applications. IEEE Trans Biomed Eng 2019; 66:2704-2718. [DOI: 10.1109/tbme.2018.2889669] [Citation(s) in RCA: 74] [Impact Index Per Article: 14.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
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Analysis of Cell Viability and Gene Expression After Continuous Ultrasound Therapy in L929 Fibroblast Cells. Am J Phys Med Rehabil 2019; 98:369-372. [DOI: 10.1097/phm.0000000000001103] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Almekkawy M, Chen J, Ellis MD, Haemmerich D, Holmes DR, Linte CA, Panescu D, Pearce J, Prakash P, Zderic V. Therapeutic Systems and Technologies: State-of-the-Art Applications, Opportunities, and Challenges. IEEE Rev Biomed Eng 2019; 13:325-339. [PMID: 30951478 PMCID: PMC7341980 DOI: 10.1109/rbme.2019.2908940] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
In this review, we present current state-of-the-art developments and challenges in the areas of thermal therapy, ultrasound tomography, image-guided therapies, ocular drug delivery, and robotic devices in neurorehabilitation. Additionally, intellectual property and regulatory aspects pertaining to therapeutic systems and technologies are addressed.
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geçgelen cesur M, Onal T, Bilgin MD, Sirin FB, Inan S, Koken EC, Alkan A, Cesur G. Histological and biochemical investigation of the effects of low intensity pulsed ultrasound on orthodontic tooth movement. KONURALP TIP DERGISI 2019. [DOI: 10.18521/ktd.510808] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Carina V, Costa V, Sartori M, Bellavia D, De Luca A, Raimondi L, Fini M, Giavaresi G. Adjuvant Biophysical Therapies in Osteosarcoma. Cancers (Basel) 2019; 11:cancers11030348. [PMID: 30871044 PMCID: PMC6468347 DOI: 10.3390/cancers11030348] [Citation(s) in RCA: 35] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2019] [Revised: 02/28/2019] [Accepted: 03/08/2019] [Indexed: 12/22/2022] Open
Abstract
Osteosarcoma (OS) is a primary bone sarcoma, manifesting as osteogenesis by malignant cells. Nowadays, patients’ quality of life has been improved, however continuing high rates of limb amputation, pulmonary metastasis and drug toxicity, remain unresolved issues. Thus, effective osteosarcoma therapies are still required. Recently, the potentialities of biophysical treatments in osteosarcoma have been evaluated and seem to offer a promising future, thanks in this field as they are less invasive. Several approaches have been investigated such as hyperthermia (HT), high intensity focused ultrasound (HIFU), low intensity pulsed ultrasound (LIPUS) and sono- and photodynamic therapies (SDT, PDT). This review aims to summarize in vitro and in vivo studies and clinical trials employing biophysical stimuli in osteosarcoma treatment. The findings underscore how the technological development of biophysical therapies might represent an adjuvant role and, in some cases, alternative role to the surgery, radio and chemotherapy treatment of OS. Among them, the most promising are HIFU and HT, which are already employed in OS patient treatment, while LIPUS/SDT and PDT seem to be particularly interesting for their low toxicity.
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Affiliation(s)
- Valeria Carina
- IRCCS-Istituto Ortopedico Rizzoli, via Di Barbiano 1/10, 40136 Bologna, Italy.
| | - Viviana Costa
- IRCCS-Istituto Ortopedico Rizzoli, via Di Barbiano 1/10, 40136 Bologna, Italy.
| | - Maria Sartori
- IRCCS-Istituto Ortopedico Rizzoli, via Di Barbiano 1/10, 40136 Bologna, Italy.
| | - Daniele Bellavia
- IRCCS-Istituto Ortopedico Rizzoli, via Di Barbiano 1/10, 40136 Bologna, Italy.
| | - Angela De Luca
- IRCCS-Istituto Ortopedico Rizzoli, via Di Barbiano 1/10, 40136 Bologna, Italy.
| | - Lavinia Raimondi
- IRCCS-Istituto Ortopedico Rizzoli, via Di Barbiano 1/10, 40136 Bologna, Italy.
| | - Milena Fini
- IRCCS-Istituto Ortopedico Rizzoli, via Di Barbiano 1/10, 40136 Bologna, Italy.
| | - Gianluca Giavaresi
- IRCCS-Istituto Ortopedico Rizzoli, via Di Barbiano 1/10, 40136 Bologna, Italy.
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Immediate Effects of Simultaneous Application of Transcutaneous Electrical Nerve Stimulation and Ultrasound Phonophoresis on Active Myofascial Trigger Points: A Randomized Controlled Trial. Am J Phys Med Rehabil 2019; 97:332-338. [PMID: 29206666 DOI: 10.1097/phm.0000000000000876] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE The aim of the study was to investigate the efficacy of phonophoresis with combined therapy on active myofascial trigger points. PARTICIPANTS One hundred participants with acute mechanical neck pain and at least one active myofascial trigger point in the upper trapezius were randomly assigned into four equal groups. INTERVENTION Groups consisted of diclofenac phonophoresis with combined therapy, diclofenac phonophoresis, ultrasound (US) with coupling gel, and sham US and applied for 10 mins over myofascial trigger points. MEASUREMENTS Measurements included pressure pain threshold and active cervical lateral flexion. RESULTS There were statistically significant improvements in postintervention pressure pain threshold and range of motion values in treatment groups (P < 0.0001). As for the sham US, no significant difference was found between the preintervention and postintervention values (P > 0.05). Bonferroni correction test revealed that there was a significant difference between all the four groups in pressure pain threshold values (P < 0.0001); however, it was nonsignificant (P > 0.05) for range of motion. CONCLUSIONS Diclofenac phonophoresis with combined therapy, phonophoresis, and US were all effective in increasing pressure pain threshold values and range of motion. In addition, phonophoresis with combined therapy was shown to be superior over phonophoresis, and phonophoresis was superior over US in terms of reducing pain sensitivity. However, none of the treatment groups were found to be superior over the other in increasing range of motion.
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Dey J, Ghosh R, Das Mahapatra R. Self-Assembly of Unconventional Low-Molecular-Mass Amphiphiles Containing a PEG Chain. LANGMUIR : THE ACS JOURNAL OF SURFACES AND COLLOIDS 2019; 35:848-861. [PMID: 29923405 DOI: 10.1021/acs.langmuir.8b00779] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
The design and synthesis of biocompatible surfactants are important for a wide range of applications in cosmetics, personal care products, and nanomedicine. This feature article summarizes our studies over the past 8 years on the design, synthesis, surface activity, and self-assembly of a series of unconventional low-molecular-mass amphiphiles containing a poly(ethylene glycol) (PEG) tail or spacer and different ionic or zwitterionic headgroups, including carboxylate, sulfonate, and quaternary ammonium salts. Despite having a so-called polar PEG chain as a tail or spacer, these ionic amphiphiles are found to have a tendency to adsorb at the air/water interface and self-assemble in pH 7.0 buffers at 298 K in the same way that conventional hydrocarbon tail surfactants do. However, they are observed to be relatively less surface-active compared to hydrocarbon tail surfactants. Although these amphiphilic molecules have less surface activity, they do self-assemble in aqueous buffer at 298 K, producing a range of microstructures, including spherical micelles, disclike micelles, and vesicles. In fact, our group is the first to report the self-assembly of PEG-tailed ionic amphiphiles in water at room temperature. Some of these molecules are also found to gel various organic liquids on heat-cool treatment or by ultrasound irradiation. We think that the present article will arouse general interest among researchers working toward the development of new biocompatible amphiphiles and soft materials.
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Affiliation(s)
- Joykrishna Dey
- Department of Chemistry , Indian Institute of Technology Kharagpur , Kharagpur 721302 , India
| | - Rita Ghosh
- Department of Chemistry , Indian Institute of Technology Kharagpur , Kharagpur 721302 , India
| | - Rita Das Mahapatra
- Department of Chemistry , Indian Institute of Technology Kharagpur , Kharagpur 721302 , India
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