2021 Tutorial 2 Ultrasound dosages copy PDF

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Download 2021 Tutorial 2 Ultrasound dosages copy PDF

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SP2

Physiotherapy Studies 200

2021

Calculating ultrasound dosages

Tutorial 2

Aims of tutorial activity 1. To review the calculation of ultrasound dosages

Plan  



Complete the worksheet activity Make notes to support your answers. Be prepared to discuss your answers in detail with the rest of the class

Ac t i v i t y For each of the following case scenarios  Choose an appropriate dose of ultrasound (you will need to present the peak dose for each case study for a SATA machine)  Describe process of application (ie. Patient/therapist positioning)  Are there any specific contraindications or precautions to the use of ultrasound that you need to screen for?  What are you trying to achieve by using ultrasound in each of these cases? (i.e. what are the intended therapeutic effects ?)  What else may be part of your management plan?

1.

Mr Jones is 75 years old and has strained his calf muscle when he tripped on a step at home 3 weeks ago. He is slightly overweight, has a medical history of high blood pressure and has recently been diagnosed with peripheral vascular disease. Stage of healing: sub acute Depth: 1 cm Size: 1x transfuser head Precautions: peripheral vascular disease: heat problem BP interest but does not change anything due to size of transfuser head 1:4, 1Mhz

2.

Mrs Cohen is 65 and has chronic low back pain. As part of her presentation you identify that muscles adjacent her spine on the left side are tender and feel very tight on palpation. She is overweight, carrying a lot of weight around her mid section. Stage of healing: chronic Depth of lesion:

3.

Julie is 18 years of age and sprained her ankle playing netball 3 days ago.

Stage of healing: early Acute Depth of lesion: 1 cm Size: 1 transfuser head Location: concerned for superficial bone 1:9 due to being early acute to decrease heat Frequency: 3Mhz Intensity: 0.1 to 0.3: 0.1 w/cm2 Time: 2 min

0.14x 10= 1.4w/cm2 2x10= 20 min

Precautions to be taken: give her warning to not overdo exercises Watching out for skin cancer Inflammation optimizing: getting through inflammatory phase. Do gentle massage, put ice. Potentially using gait aid. Use strapping to support ankle

4.

Mr Rosenthall is 84 and had a TKR 5 years ago. His knee has been pretty good since then, but he strained it last week when trying to catch a ball that his great grand daughter threw. You think he has strained his quadriceps tendon. Depth of lesion: 0.5 Size: 1 transfuser head Location: quadriceps tendon (superficial) Mode: 1:4 Frequency: 3 Mhz Range: 0.1-0.3 = 0.2 0.24x5 = 1.2w/cm2 Time: 2 min 2X5=10

5. Jade is 45 and has a painful impinged supraspinatus tendon. It is very tender on palpation. Stage of healing: Acute Depth of lesion: 1 cm Size: 1 transfuser head Location: acromion(superficial bone) Mode: 1:9 Frequency: 3Mhz (Superficial) Range: 0.1 to 0.3 (0.1 cm)

0.14x10= 1.4 w/cm2

Time: 2 min

2x10=20 min

Precautions: be careful of bone, monitor as procedure goes through

6.

Lilian is 33 and has chronic tennis elbow on the right side (even though she has never played tennis in her life!). The extensor muscles are very tender just adjacent to the common extensor origin. Stage of healing: Chronic Depth: 0.5 Size: 1 transfuser head Time: 2 min Location: Extensor muscles near lateral epicondyle Mode: 1:1 Frequency 3Mhz(superficial) Range: 0.5-1.5 (0.6) 0.72x2= 1.44 2x2=2 min SATA: 0.72/0.5= 1.44 Precautions: a lot of superficial structures and make sure to stay in the affected region. First time so make sure she is okay and monitor her during procedure

7.

Anna is 40 and is a bit sick and tired of being overweight. She has started a walking program, and as she lives close to the beach loves to walk on the sand. However, she has noticed that she is getting pain in the plantar fascia of her left foot lately.

Stage of healing: Acute Depth: 0.5 cm

Size: 3 transfuser heads Location: muscle and fat. Look out for foot bones (calcaneus, tarsal and metatarsals) Mode: 1:4 Frequency:3Mhz Range: (0.1-0.3) 0.1 Time: 2x3=6 8.

0.12x5=0.6w/cm2 6x5=30

Louise is 38 and pregnant with her third child. However, her next to youngest is only two and has been very clingy lately, so Louise has been carrying her a lot resulting in an exacerbation of a long-standing problem with over-worked upper trapezius and levator scapulae muscles on the left side. She has been having quite a bit of neck pain and even headaches.

Stage of healing: Sub Acute Depth of lesion: 0.5 Size: 2 transfuser heads Location: Upper trapezius near insertion point and close to neck and not completely on neck to avoid cervical vertebrae Mode: 1:4 Frequency: 3Mhz Range: 0.3-0.5 (0.2)

0.24x5=1.2w/cm2

Time: 2min 2x2=4 4x5=20min SATA: 0.24/0.2=1.2 Recording: US to L upper traps & L levator scap, 3Mhz, pulsed 1:4, 0.24W/cm2; 20min

Dosage table 3MHz Depth of Lesion (cm) Intensity at Lesion (W (W/cm2) /cm2)

0.5

1

2

3

4

1

1.20

1.40

1.80

2.20

2.60

0.9

1.08

1.26

1.62

1.98

2.34

0.8

0.96

1.12

1.44

1.76

2.08

0.7

0.84

0.98

1.26

1.54

1.82

0.6

0.72

0.84

1.08

1.32

1.56

0.5

0.60

0.70

0.90

1.10

1.30

0.4

0.48

0.56

0.72

0.88

1.04

0.3

0.36

0.42

0.54

0.66

0.78

0.2

0.24

0.28

0.36

0.44

0.52

0.1

0.12

0.14

0.18

0.22

0.26

Dosage T Table able 1MHz Depth of Lesion (cm) Intensity at Lesion (W (W/cm2) /cm2)

0.5

1

2

3

4

5

6

1

1.13

1.25

1.50

1.75

2.00

2.25

2.50

0.9

1.01

1.13

1.35

1.58

1.80

2.03

2.25

0.8

0.90

1.00

1.20

1.40

1.60

1.80

2.00

0.7

0.79

0.88

1.05

1.23

1.40

1.58

1.75

0.6

0.68

0.75

0.90

1.05

1.20

1.35

1.50

0.5

0.56

0.63

0.75

0.88

1.00

1.13

1.25

0.4

0.45

0.50

0.60

0.70

0.80

0.90

1.00

0.3

0.34

0.38

0.45

0.53

0.60

0.68

0.75

0.2

0.23

0.25

0.30

0.35

0.40

0.45

0.50

0.1

0.11

0.13

0.15

0.18

0.20

0.23

0.25

Mode: Cont i nuous Ac ut e1 : 1 / 1 : 4 / 1 : 9 - St a geof he a l i ng - Adj a c e nt t i s s ue F r e que nc y 1 / 3MHz - De pt hof l e s i on - Adj a c e nt t i s s ue I nt e ns i t y: St a geof he a l i ng De pt hof l e s i on Ti me Si z eofl e s i on

1 : 4

1MHz

0 . 3 ; 0 . 7 0 . 5 2mi n...