Happy New Year. Your correspondent perceives most EPA research, and particularly ultrasound dose studies, has a certain polarity (ahem). The British tend to be the conservatives, focusing on athermal effects and potential to stimulate healing. The Americans seem to be more interested with thermal doses and tissue temperatures. As you'd expect, physio students are exhorted to avoid any potentially unsafe applications and so the English model of low dose applications feature in their training and lab practice. How gratifying to find A Prof David Draper's case series (6 patients) where therapeutic ultrasound (3 MHz, 1.4 W/cm^2, 6 minutes) heats adaptively shortened connective tissues of the wrist joint capsule so that manual joint glides and passive mobilizations succeed in restoring active and passive range. The reference is:
Draper, D.. (2010). Ultrasound and Joint Mobilizations for Achieving Normal Wrist Range of Motion After Injury or Surgery: A Case Series.
Journal of Athletic Training, 45(5), 486-491. Retrieved January 3, 2011, from Research Library. (Document ID: 2147735161).
This article is an interesting read and I won't critique it or reiterate his data here. What a find! Common sense and sound clinical reasoning prevails.
David is a prolific EPA researcher and co-author of a useful textbook (illustrated) "Therapeutic Modalities the Art and Science".
