Gersten’s 1955 article on the effect of ultrasound on tendon extensibility began six decades of continuous published research, which has demonstrated the tried and true benefits of ultrasound. 1 These benefits include pain reduction, a high degree of patient comfort and acceptability, increased cellular microcirculation, relaxation of trigger points and improved collagen extensibility. All of these physiological benefits are dependent on proper dosage and application technique. Ultrasound can provide both mechanical and thermal effects. An effective, skilled ultrasound treatment requires the use of high-quality ultrasound equipment, evidence-based patient-specific parameters, the appropriate treatment area, proper transducer movement speed, and optimal incorporation of the treatment with other therapy procedures.
Shoulder range of motion, strength, and function are vital to self-care and everyday activities such as dressing, bathing, lifting and carrying items, and putting away groceries. With advanced age individuals may experience a variety of shoulder impairments including arthritis, rotator cuff tears, impingement, and fractures. These issues can result in pain, decreased motion, impaired strength, and reduced function.
Patient Information: Male, Age 50
Diagnosis: Below Knee Amputation
History: This gentleman was referred to a skilled nursing facility for physical and occupational therapy services after hospitalization due to a non-healing diabetic ulcer on the right foot resulting in a below the knee amputation. Prior to the amputation, he lived at home and was independent with walking and driving.
Indications: Combining ultrasound (US) with electrical stimulation (e-stim) is a treatment option to decrease acute and chronic musculoskeletal pain, decrease muscle tone-spasm, increase local circulation, and increase-maintain joint range of motion (ROM). This approach combines the physiological benefits of electrical stimulation with US and is often applied over motor or acupoints to optimize clinical outcomes. For post traumatic – post-surgical pain, consider using HVPC Sensory with subthermal US. For acute pain, LVPC Sensory or IFC - PREMOD Sensory with subthermal (pulsed) US are therapeutic options. To address chronic pain or limited ROM, consider using LVPC Motor with thermal US or IFC - PREMOD Motor with thermal US.
Posture affects an individual’s ability to balance in a seated or standing position, assess their surroundings, reach overhead, breathe, eat, and move safely. As one ages, posture generally declines, resulting in a more forward flexed position. When there is injury or neurologic impairment (such as CVA), further compromise to one’s posture and positioning can occur. Improved postural alignment of the neck, upper back and trunk with stretching, strengthening, and electrical stimulation can greatly impact an individual’s safety and quality of life.
Patient Information: Female, Age 77
Diagnosis: Hand Contracture / Stroke
History: This woman, a long-term skilled nursing facility resident, was referred to therapy for severely reduced range of motion (ROM) in the left hand resulting from a prior stroke. Previously, the woman’s caregivers were able to move her hand through full range of motion to provide care.