ABSTRACT
Abstract Introduction : The therapeutic ultrasound is one of the main resources utilized on physical therapy to stimulate the healing due its thermal and mechanic effects. However, your application still not properly standardized. Objective :To analyze the presence of the collagens types I and III stimulated by the ultrasonic wave in continuous mode at the cutaneous injury local for first intention. Material and methods : It was utilized 90 Wistar rats, young adults, with average weight of 230g, divided in 3 groups of 30 animals: control group, treated with ultrasound off; group 1, treated with ultrasound 0.5 W/cm2 and group 2, treated with ultrasound 2.0 W/cm2. Each group was subdivided in 3 subgroups according with the healing phases, 3, 7 and 21 days of consecutive therapeutic sessions. The ultrasound therapy began 24 hours after the termination of the surgical act, at the dorsal region, applying frequency of 3 MHz and intensities 0.5 W/cm2 and 2.0 W/cm2 during 5 minutes under sliding technique. Later, the animals were sacrificed according to the healing phases for removal of incisional area and histological analyses. Conclusions : The results allowed conclude that the continuous mode of therapeutic ultrasound in the intensities 0.5 W/cm2 and 2.0 W/cm2promoted stimulus to formation of collagens types I and III in the lesion area for first intention.
Resumo Introdução : O ultrassom terapêutico é um dos principais recursos utilizados na fisioterapia para estimular a cicatrização devido aos seus efeitos térmicos e mecânicos. No entanto, sua aplicação ainda não está devidamente padronizada. Objetivo : Analisar a presença dos colágenos tipos I e III estimulados pela onda ultrassônica no modo contínuo no local da lesão cutânea por primeira intenção. Materiais e métodos : Foram utilizados 90 ratos Wistar, adulto-jovens, com peso médio de 230 g, divididos em 3 grupos de 30 animais: grupo controle, tratado com ultrassom desligado; grupo 1, tratado com ultrassom 0,5 W/cm² e grupo 2, tratado com ultrassom 2,0 W/cm². Cada grupo foi subdividido em 3 subgrupos de acordo com as fases de cicatrização 3, 7 e 21 dias de sessões terapêuticas consecutivas. A terapia ultrassônica teve início 24 horas após o término do ato cirúrgico, na região dorsal, aplicando frequência de 3 MHz e as intensidades 0,5 W/cm² e 2,0 W/cm² no tempo de 5 minutos sob a técnica de deslizamento. Posteriormente, os animais foram sacrificados de acordo com as fases de cicatrização para remoção da área incisional e análise histológica. Conclusão : Os resultados possibilitaram concluir que o modo contínuo do ultrassom terapêutico nas intensidades 0 W/cm² e 2,0 W/cm²promoveu estímulo para formação dos colágenos tipos I e III na área da lesão por primeira intenção.
ABSTRACT
OBJECTIVE: The aim of this placebo-controlled study was to evaluate the effects of pulsed and continuous ultrasound treatments combined with splint therapy on patients with mild and moderate idiopathic carpal tunnel syndrome. METHODS: The study included 46 carpal tunnel syndrome patients who were randomly divided into 3 groups. The first group (n = 15) received a 0 W/cm2 ultrasound treatment (placebo); the second group (n = 16) received a 1.0 W/cm2 continuous ultrasound treatment and the third group (n = 15) received a 1.0 W/cm2 1:4 pulsed ultrasound treatment 5 days a week for a total of 15 sessions. All patients also wore night splints during treatment period. Pre-treatment and post-treatment Visual Analogue Scale, Symptom Severity Scale and Functional Status Scale scores, median nerve motor conduction velocity and distal latency and sensory conduction velocities of the median nerve in the 2nd finger and palm were compared. Clinicaltrials.gov: NCT02054247. RESULTS: There were significant improvements in all groups in terms of the post-treatment Functional Status Scale score (p<0.05 for all groups), Symptom Severity Scale score (first group: p<0.05, second group: p<0.01, third group: p<0.001) and Visual Analogue Scale score (first and third groups: p<0.01, second group: p<0.001). Sensory conduction velocities improved in the second and third groups (p<0.01). Distal latency in the 2nd finger showed improvement only in the third group (p<0.01) and action potential latency in the palm improved only in the second group (p<0.05). CONCLUSION: The results of this study suggest that splinting therapy combined with placebo and pulsed or continuous ultrasound have similar effects on clinical improvement. Patients treated with continuous and pulsed ultrasound showed electrophysiological improvement; however, the results were not superior to those of the placebo. .