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]
| Low-intensity pulsed ultrasound |
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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,[1] osteomies, or delayed healing. A 2017 review, however, found no trustworthy evidence for the use of low intensity pulsed ultrasound for bone healing, mostly based on the large pragmatic randomized controlled trial published in 2016.[7][8] An associated guideline issued a strong recommendation against its use in bone healing.[9] Evidence as of 2023 was insufficient to justify its use to prevent non healing of bone fractures.[10] Tentative evidence supports better healing with the use of the system in long bones that have not healed after three months.[11] Some reviews suggested inconclusive evidence of benefit.[12][10] One industry supported meta-analysis suggested it as a potential alternative to surgery for established nonunions.[13] 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.[14]
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
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