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健康志愿者前臂对治疗性超声的短期感觉和皮肤血管反应。

Short-term sensory and cutaneous vascular responses to therapeutic ultrasound in the forearms of healthy volunteers.

作者信息

Shaik Shaguftha Sultana, MacDermid Joy C, Birmingham Trevor, Grewal Ruby, Farooq Baseer

机构信息

Faculty of Health Sciences, Department of Health and Rehabilitation Sciences, Physical Therapy Field, Western University, London, ON N6G 1H1, Canada.

Faculty of Health Sciences, Department of Health and Rehabilitation Sciences, Physical Therapy Field, Western University, London, ON N6G 1H1, Canada ; Hand and Upper Limb Centre, Clinical Research Laboratory, St. Joseph's Health Centre, London, ON N6A 4 V2, Canada ; School of Rehabilitation Science, McMaster University, Hamilton, ON L8S4L8, Canada.

出版信息

J Ther Ultrasound. 2014 Jun 2;2:10. doi: 10.1186/2050-5736-2-10. eCollection 2014.

Abstract

BACKGROUND

Therapeutic ultrasound (US) is used for a variety of clinical pathologies and is thought to accelerate tissue repair and help with pain reduction via its thermal and nonthermal effects. The evidence on physiological effects of US on both sensory and vascular functions in humans is incomplete. Hence, the purpose of this study was to determine the short-term impact of two doses of US (3 MHz, 1:4, 0.25 W/cm(2), 5 min; 1 MHz, continuous, 0.8 W/cm(2), 3 min), on sensory and vascular responses in the healthy forearms.

METHODS

Twenty healthy subjects were recruited (mean age, 29.6 ± 8.8 years) for the study. Superficial blood flow (SBF) in the distal forearms was determined using the tissue viability imaging system. Sensory perception thresholds (SPT) were determined from ring finger (C7, C8) to assess A-beta (at 2,000 Hz) and C fiber function (at 5 Hz), using a Neurometer CPT/C device. Subject's two hands were randomly allocated to group order (AB/BA). Scores were obtained before and immediately after the application of US and control. Differences in these were analyzed using repeated measures.

RESULTS

Both 3 MHz pulsed US and 1 MHz continuous US showed small to moderate (effect size = 0.12 to 0.68), statistically significant reductions in SBF (3 MHz, mean change = 2.8 AU and 1 MHz, mean change = 3.9 AU, p < 0.05 respectively), skin temperature (2.5°C and 1.1°C, p < 0.05), and SPT at 5 Hz (1.3 and 1 mA, p < 0.05) across time. SPT at 2,000 Hz remained unaltered by all three conditions (p > 0.05). Age and gender also had no effect on all outcome measures (p > 0.05).

CONCLUSION

This study demonstrated minor reductions in skin blood flow, skin temperatures, and C fiber perception thresholds immediately after 3 MHz, and 1 MHz US. The responses observed may have been due to a thermo-cooling effect of the gel or due to the direct effect of US on C fibers of median and ulnar nerves. US had a negligible effect on A-beta fibres. This would suggest that future studies looking at physiological effects of US should move towards investigating larger dosages and study the effects in patient populations.

摘要

背景

治疗性超声(US)用于多种临床病症,被认为可通过其热效应和非热效应加速组织修复并减轻疼痛。关于超声对人体感觉和血管功能的生理影响的证据并不完整。因此,本研究的目的是确定两种剂量的超声(3兆赫,1:4,0.25瓦/平方厘米,5分钟;1兆赫,连续,0.8瓦/平方厘米,3分钟)对健康前臂的感觉和血管反应的短期影响。

方法

招募了20名健康受试者(平均年龄29.6±8.8岁)参与研究。使用组织活力成像系统测定前臂远端的浅表血流(SBF)。使用神经测量仪CPT/C设备从无名指(C7、C8)测定感觉阈值(SPT),以评估A-β(2000赫兹时)和C纤维功能(5赫兹时)。受试者的双手随机分配到分组顺序(AB/BA)。在应用超声和对照之前及之后立即获得分数。使用重复测量分析这些分数的差异。

结果

3兆赫脉冲超声和1兆赫连续超声均显示浅表血流(3兆赫,平均变化=2.8 AU;1兆赫,平均变化=3.9 AU,p均<0.05)、皮肤温度(2.5°C和1.1°C,p<0.05)以及5赫兹时的感觉阈值(1.3和1毫安,p<0.05)随时间有小到中度(效应大小=0.12至0.68)的统计学显著降低。2000赫兹时的感觉阈值在所有三种情况下均未改变(p>0.05)。年龄和性别对所有结果指标也均无影响(p>0.05)。

结论

本研究表明,在3兆赫和1兆赫超声作用后,皮肤血流、皮肤温度和C纤维感觉阈值立即有轻微降低。观察到的反应可能是由于凝胶的热冷却效应或超声对正中神经和尺神经C纤维的直接作用。超声对A-β纤维的影响可忽略不计。这表明未来研究超声的生理效应应朝着研究更大剂量并在患者群体中研究其效应的方向发展。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1847/4040486/7a767ed68604/2050-5736-2-10-1.jpg

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