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'''Low-intensity pulsed ultrasound''' ('''LIPUS''') is a technology that can be used for therapeutic purposes. It exploits low intensity and pulsed [[mechanical wave]]s in order to induce regenerative and anti-inflammatory effects on biological tissues, such as bone, cartilage, and tendon<ref name="JiangSavchenko2018">{{cite journal|last1=Jiang|first1=Xiaoxue|last2=Savchenko|first2=Oleksandra|last3=Li|first3=Yufeng|last4=Qi|first4=Shiang|last5=Yang|first5=Tianlin|last6=Zhang|first6=Wei|last7=Chen|first7=Jie|title=A Review of Low-Intensity Pulsed Ultrasound for Therapeutic Applications|journal=IEEE Transactions on Biomedical Engineering|year=2018|pages=1–1|issn=0018-9294|doi=10.1109/TBME.2018.2889669}}</ref>. Even if the real mechanism underlying its effectiveness has not been understood yet, it is plausible that the treatment relies on non-thermal phenomena, such as microbubbles and microjets induced by [[cavitation]], acoustic streaming, and mechanical stimulation<ref name="LinReed-Maldonado2016">{{cite journal|last1=Lin|first1=Guiting|last2=Reed-Maldonado|first2=Amanda|last3=Lin|first3=Maofan|last4=Xin|first4=Zhongcheng|last5=Lue|first5=Tom|title=Effects and Mechanisms of Low-Intensity Pulsed Ultrasound for Chronic Prostatitis and Chronic Pelvic Pain Syndrome|journal=International Journal of Molecular Sciences|volume=17|issue=7|year=2016|pages=1057|issn=1422-0067|doi=10.3390/ijms17071057}}</ref><ref name="JiangSavchenko2018"/>.
'''Low-intensity pulsed ultrasound''' ('''LIPUS''') is a technology that can be used for therapeutic purposes. It exploits low intensity and pulsed [[mechanical wave]]s in order to induce regenerative and anti-inflammatory effects on biological tissues, such as bone,<ref name="">{{cite book|url=https://books.google.it/books?id=K4xlDwAAQBAJ&pg=PA12&dq=%22LIPUS%22&hl=it&sa=X&ved=0ahUKEwj329Tg4r7iAhXFalAKHVQsDmcQ6AEIKjAA#v=onepage&q=%22LIPUS%22&f=false||isbn=9783319663234 |first2= Tarek |last1=El-Bialy |first2=Eiji |last2=Tanaka |first3=Dror |last3=Aizenbud|doi= |publisher=Springer|chapter=Mechanism of LIPUS on Dentofacial Bioengineering|title=Therapeutic Ultrasound in Dentistry: Applications for Dentofacial Repair, Regeneration, and Tissue Engineering}}</ref> cartilage, and tendon<ref name="JiangSavchenko2018">{{cite journal|last1=Jiang|first1=Xiaoxue|last2=Savchenko|first2=Oleksandra|last3=Li|first3=Yufeng|last4=Qi|first4=Shiang|last5=Yang|first5=Tianlin|last6=Zhang|first6=Wei|last7=Chen|first7=Jie|title=A Review of Low-Intensity Pulsed Ultrasound for Therapeutic Applications|journal=IEEE Transactions on Biomedical Engineering|year=2018|pages=1–1|issn=0018-9294|doi=10.1109/TBME.2018.2889669}}</ref>. Even if the real mechanism underlying its effectiveness has not been understood yet, it is plausible that the treatment relies on non-thermal phenomena, such as microbubbles and microjets induced by [[cavitation]], acoustic streaming, and mechanical stimulation<ref name="LinReed-Maldonado2016">{{cite journal|last1=Lin|first1=Guiting|last2=Reed-Maldonado|first2=Amanda|last3=Lin|first3=Maofan|last4=Xin|first4=Zhongcheng|last5=Lue|first5=Tom|title=Effects and Mechanisms of Low-Intensity Pulsed Ultrasound for Chronic Prostatitis and Chronic Pelvic Pain Syndrome|journal=International Journal of Molecular Sciences|volume=17|issue=7|year=2016|pages=1057|issn=1422-0067|doi=10.3390/ijms17071057}}</ref><ref name="JiangSavchenko2018"/>.


== Technique==
== Technique==

Revision as of 17:47, 28 May 2019

Low-intensity pulsed ultrasound

Low-intensity pulsed ultrasound (LIPUS) is a technology that can be used for therapeutic purposes. It exploits low intensity and pulsed mechanical waves in order to induce regenerative and anti-inflammatory effects on biological tissues, such as bone,[1] cartilage, and tendon[2]. Even if the real mechanism underlying its effectiveness has not been understood yet, it is plausible that the treatment relies on non-thermal phenomena, such as microbubbles and microjets induced by cavitation, acoustic streaming, and mechanical stimulation[3][2].

Technique

LIPUS uses generally 1.5 MHz frequency pulses, with a pulse width of 200 μs, repeated at 1 kHz, at a spatial average and temporal average intensity of 30 mW/cm2.[4]

Medical uses

Starting around the 1950s this technology was being used as a form of physical therapy for ailments such as tendinitis.[5]

As of 2009 research for the use of LIPUS to treat soft tissue injuries were in the early stages.[4] As of 2012 it was being studied for dental problems.[6]

Low intensity pulsed ultrasound has been proposed as a therapy to support bone healing after fractures, osteomies, or delayed healing. A 2017 review, however, found no trustworthy evidence for the use of low intensity pulsed ultrasound for bone healing.[7] An associated guideline issued a strong recommendation against its use in bone healing.[8] Evidence as of 2014 was insufficient to justify its use to prevent non healing of bone fractures.[9] Tentative evidence supports better healing with the use of the system in long bones that have not healed after three months.[10] Some reviews suggested inconclusive evidence of benefit.[11] One industry supported meta-analysis suggested it as a potential alternative to surgery for established nonunions.[12] Most studies suggesting benefit were funded by manufacturers of ultrasound devices.[7]

In 2018, a study published in the journal Brain Stimulation, reported that experiments on mice showed that whole-brain LIPUS therapy markedly improved cognitive dysfunctions without serious side effects by enhancing specific cells related to dementia's pathology. Clinical trials are underway.[13]

In vitro experiments have confirmed the LIPUS capability to regulate cell proliferation and differentiation as well as the opening of cell membrane channels[2].

References

  1. ^ El-Bialy; Tanaka, Eiji; Aizenbud, Dror. "Mechanism of LIPUS on Dentofacial Bioengineering". Therapeutic Ultrasound in Dentistry: Applications for Dentofacial Repair, Regeneration, and Tissue Engineering. Springer. ISBN 9783319663234. {{cite book}}: Cite has empty unknown parameter: |1= (help)
  2. ^ a b c Jiang, Xiaoxue; Savchenko, Oleksandra; Li, Yufeng; Qi, Shiang; Yang, Tianlin; Zhang, Wei; Chen, Jie (2018). "A Review of Low-Intensity Pulsed Ultrasound for Therapeutic Applications". IEEE Transactions on Biomedical Engineering: 1–1. doi:10.1109/TBME.2018.2889669. ISSN 0018-9294.
  3. ^ Lin, Guiting; Reed-Maldonado, Amanda; Lin, Maofan; Xin, Zhongcheng; Lue, Tom (2016). "Effects and Mechanisms of Low-Intensity Pulsed Ultrasound for Chronic Prostatitis and Chronic Pelvic Pain Syndrome". International Journal of Molecular Sciences. 17 (7): 1057. doi:10.3390/ijms17071057. ISSN 1422-0067.{{cite journal}}: CS1 maint: unflagged free DOI (link)
  4. ^ a b Khanna, A; Nelmes, RT; Gougoulias, N; Maffulli, N; Gray, J (2009). "The effects of LIPUS on soft-tissue healing: a review of literature". British Medical Bulletin. 89: 169–82. doi:10.1093/bmb/ldn040. PMID 19011263.
  5. ^ Miller, Douglas; Smith, Nadine; Bailey, Michael; Czarnota, Gregory; Hynynen, Kullervo; Makin, Inder (April 2012). "Overview of Therapeutic Ultrasound Applications and Safety Considerations". Journal of Ultrasound in Medicine. 31 (4): 623–634. doi:10.7863/jum.2012.31.4.623. ISSN 0278-4297. PMC 3810427. PMID 22441920.
  6. ^ Rego, E. B. (2012). "Current Status of Low Intensity Pulsed Ultrasound for Dental Purposes". The Open Dentistry Journal. 6: 220–5. doi:10.2174/1874210601206010220. PMC 3547311. PMID 23341848.
  7. ^ a b Schandelmaier, Stefan; Kaushal, Alka; Lytvyn, Lyubov; Heels-Ansdell, Diane; Siemieniuk, Reed A. C.; Agoritsas, Thomas; Guyatt, Gordon H.; Vandvik, Per O.; Couban, Rachel; Mollon, Brent; Busse, Jason W. (February 22, 2017). "Low intensity pulsed ultrasound for bone healing: systematic review of randomized controlled trials". BMJ. 356: j656. doi:10.1136/bmj.j656 (inactive March 13, 2019). ISSN 1756-1833. PMC 5484179. PMID 28348110.{{cite journal}}: CS1 maint: DOI inactive as of March 2019 (link)
  8. ^ Poolman, RW; Agoritsas, T; Siemieniuk, RA; Harris, IA; Schipper, IB; Mollon, B; Smith, M; Albin, A; Nador, S; Sasges, W; Schandelmaier, S; Lytvyn, L; Kuijpers, T; van Beers, LW; Verhofstad, MH; Vandvik, PO (February 21, 2017). "Low intensity pulsed ultrasound (LIPUS) for bone healing: a clinical practice guideline". BMJ (Clinical Research Ed.). 356: j576. doi:10.1136/bmj.j576. PMID 28228381.
  9. ^ Griffin, XL; Parsons, N; Costa, ML; Metcalfe, D (June 23, 2014). "Ultrasound and shockwave therapy for acute fractures in adults". The Cochrane Database of Systematic Reviews (6): CD008579. doi:10.1002/14651858.CD008579.pub3. PMID 24956457.
  10. ^ Higgins, A; Glover, M; Yang, Y; Bayliss, S; Meads, C; Lord, J (October 2014). "EXOGEN ultrasound bone healing system for long bone fractures with non-union or delayed healing: a NICE medical technology guidance". Applied Health Economics and Health Policy. 12 (5): 477–84. doi:10.1007/s40258-014-0117-6. PMC 4175405. PMID 25060830.
  11. ^ Lou, S.; Lv, H.; Li, Z.; Zhang, L.; Tang, P (September 1, 2017). "The effects of low-intensity pulsed ultrasound on fresh fracture: A meta-analysis". Medecine (39): e8181. PMID 28953676.
  12. ^ Leighton, R.; Watson, J.T; Giannoudis, P.; Papakostidis, C.; Harrison, A.; Steen, R.G. (May 2017). "Healing of fracture nonunions treated with low-intensity pulsed ultrasound (LIPUS): A systematic review and meta-analysis". Injury (7): 1339–1347. PMID 28532896.
  13. ^ "Whole-brain LIPUS therapy improves cognitive dysfunction in mice simulating dementia, Alzheimer's". News-Medical.net. July 20, 2018. Retrieved July 20, 2018.
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