Sonicator® 706 - Artisan Technology Group
Contents
1. strains arthritis stone bruise tenosynovitis scar tissue dislocations sacro lumbar strain separations LIST OF GENERAL CONDITIONS TREATED BY ULTRASOUND AS AN ADJUNCTIVE THERAPY Arthrosis large articulations small articulations coccygodynia lumbago neuralgia intercostal periostotis sciatica Sudeck s Atrophy coxitis myalgia neuritis plantar warts sinusitis frontal syndrome scalenus bursitis Dupuytren s Contracture myelitis osteitis postoperative pain radiculitis sinusitis maxillary tenovaginitis claudication intermittent herpes zoster neuralgia periarthritis humeroscapular Ravnaud s diseases Spondylitis Deforman s periarthritis chronic stump phantom pains CONTRAINDICATIONS TO ULTRASOUND THERAPY Over malignant tumors over epiphysis of growing bone over acute infections acute thrombophlebitis or phlebothrombosis over pregnant uterus over the eyeball over areas of impaired sensation over brain or bulbar area of spinal cord over areas of inadequate circulation over the heart over reproductive organs in patients with hemorrhagic diatheses In addition authors have recommended special precautions to dosage when an area of the spinal cord is to be treated following a laminectomy It has also been reported that ultrasound should not be given over pacemakers or over pacemaker leads 13 REFERENCES We recognize the reader s interest in clinical ultrasound may extend beyond the level o2. chronic strain or may be developed as a result of stress from functional daily activities or postural habits Though local in nature reports in the literature indicate the discomfort may be referred through the autonomic nerve fibers to other areas of the body so called referred pain These areas may be palpated with finger tip pressure located by using the eraser end of a pencil or by means of DELTOID SUPINATORS MIDDLE FINGER EXTENSOR VASTUS MEDIALIS LONG EXTENSORS electrical currents It has been suggested the combina tion of electrical stimulation and ultrasound is beneficial in both locating and treating those involved areas A tetanizing current within comfortable intensity range of the patient is normally used for both location and treatment offering massage like contraction to the muscles where it is applied Articles of reference are listed The application is widespread and successful treatments have been reported in both acute and chronic conditions i SSETER MASSETER gme ma W E REFERRED PAIN ma J 6 SERENA TRAPEZIUS 4 TRIGGER POINT ead e O JO BUPRASPINATUS te TERES MINOR 2 eNe PA eraseinatus oc T RHOMBOD MAJQA sel Th ONG MULTIFDUS RONG gi GLUTEUS MINIMUS 4 a h 4 B BICEPS FEMORIS afe GASTROCNEMIUS SOLEUS f TEMPORALIS SPLENIUS CAPITIS POSTERIOR CERVICAL STERNOMASTOID LEVATOR SCAPU
3. Anaheim CA 92805 Toll Free 800 854 9305 Or 714 533 2221 LIMITED WARRANTY This Product is warranted against defects in materials and workmanship for a period of one year from the date of purchase During the warranty period Mettler Electronics Corp will at its discretion either repair or replace the Product without charge for these types of defects For service under this warranty the Product must be returned within the warranty period to Mettler Electronics Corp Shipping charges to and from Mettler Electronics Corp under this warranty must be paid by the buyer The buyer must also include a copy of the sales receipt or other proof of the date of purchase If the Product is returned without proof of the date of purchase it will be serviced as an out of warranty product at Mettler Electronics Corp s prevailing service rates This warranty shall not be effective unless the Warranty Registration card included with the Product is returned to Mettler Electronics Corp within thirty 30 days of the date of purchase Alteration or misuse or neglect of the Product voids the warranty Except as specifically set forth above Mettler Electronics Corp makes no warranties expressed or implied including without limitation any implied warranty of merchantability or fitness for a particular purpose with respect to the Product If any implied warranties apply as a matter of law they are limited in duration to One year Mettler
4. Electronics Corp shall not be liable for any indirect special consequential or incidental damages resulting from any defect in or use of the Product Any suit brought by the buyer relating to this warranty must be commenced within one year from the date any claim arises and must be brought only in the State or Federal courts located in Orange County California Some states do not allow limitations on how long an implied warranty lasts or the exclusion or limitation of incidental or consequential damages so the above limitations or exclusions may not apply to the buyer This warranty gives the buyer specific legal rights and the buyer may also have other rights which vary from state to state Copyright 1986 by Mettler Electronics Anaheim CA TABLE OF CONTENTS Fable of Contents sid ces ie 0 wtedavd Pons E aA bad Gave A bites ii Introduction sese l A ate cele C O is 1 Safety Precautions Cleaning Instrucitons Guarantee Shipping Unpacking and Installation Wall Mounting Caution Specifications i255 ithe dit taka aed he tent Ale ead doen i bded iM adit eth 2 amp 3 Control Panel Description 0 ccc ce cece cece cece eee rea 4 Operating 1iistrictions 0405 4 ba ke i ien ar TA aaa Gas o ae en deo wh OS 5 Operator Troubleshooting Guide 0 cc cece cece ee cere eet ene e ne a 6 General Application Information 0 cece e cece e eee tere teen eee eeeneees 7 About Ultrasound Neurotrophic A
5. LAE REFERENCES Travel J and Rinzier S H The Mvofascial Genesis of Pain POSTGRADUATE MEDICINE Vol II No 5 May 1952 STERNALIS 12 SERRATUS ANTERIOR PECTORALS STU ADDUCTOR POLLICUS FIRSTINTEROSSEOUS ADDUCTOR LONGUS ABDUCTOR HALLUICHS Sola A E Myofascial Trigger Point Pain in the Neck and Shoulder Girdle NORTHWEST MEDICINE Vol 54 pp 980 984 September 1955 PHONOPHORESIS Phonophoresis or sonophoresis has been described as the use of ultrasonic waves for the percutaneous transport of drugs Since the technique was first introduced it has grown in popularitv and to manv authors seems to be a method of choice for driving topicallv applied medication into deep layers of soft tissues The effect of ultrasound energy in increasing membrane permeability appears to be part of the reason for improvement in pain relief The coupling material contains medication in variable strengths from 0 5 to 10 and both the moving and stationary head techniques have been used According to the literature settings of 1 2 W cm for moving head and 0 1 0 2 W cm for stationary techniques have been applied COMMON CONDITIONS ENCOUNTERED IN ATHLETICS TREATED BY ULTRASOUND AS AN ADJUNCTIVE THERAPY Charley horse contusions edema trauma synovitis adhesions myositis ossificans pulled muscles sprains neuritis sacro iliac strain wry neck bursitis sciatica shin splints pulled tendons
6. SONICATOR 706 FCC Frequency Interference Statement Warning This equipment generates and uses radio frequency energy and if not installed and operated in strict accordance with the manufacturer s instructions may cause radio frequency interference Notice 1 This equipment has been verified to comply with the specifications in Part 18 of FCC Rules which are designed to provide reasonable protection against radio frequency interference However there is no guarantee that interference will not occur in a particular installation Notice 2 If this equipment is found to be the source of radio frequency interference which can be determined by turning the equipment off and on the user should try to correct the interference by one or more of the following measures e Reorient the receiving antenna as applicable e Relocate the Sonicator with respect to the receiver e Move the Sonicator away from the receiver e Plug the Sonicator into a different outlet than the receiver e If necessary the user should consult with the dealer or manufacturer for additional suggestions The user may find FCC s Interference Handbook helpful It is available from the U S Government Printing Office Washington D C 20402 Stock No 004 000 00450 7 Notice 3 The manufacturer is not responsible for any interference caused by unauthorized modification to this equipment Mettler Electronics Corp 1333 S Claudina St
7. ctivate frequently it may be an indication that coupling is either insufficient in quantity or inefficient in performance The lack of good coupling may be caused by not using a good coupling agent such as Sonigel not using sufficient amounts of the coupling agent you cannot use too much or contact with a very small area such as at the extremities hands and feet without the use of copious amounts of a coupling agent When treating an area suchas a hand or foot you may treat under water as indicated in the illustration on page 8 You may also use a cushion filled with the couplant to treat an irreqular surface Selecting the proper couplant insures proper energy transmission thereby enhancing the efficiency of treatment while discouraging energy reflection back to the disc causing eventual damage and possible depolarization NOTE If unable to resolve a problem with the unit contact your dealer or communicate directly with the manufacturer GENERAL APPLICATION INFORMATION ABOUT ULTRASOUND Ultrasound is a form of acoustical vibration occuring at frequencies too high to be perceived by the human ear The limit for the audible range is at about 20 KHz Frequencies above this level are considered ultrasound The range from 700 KHz to 1 1 MHz appeared during early investigative work to be best suited to clinical applications Most domestic units operate at frequencies within this range The physics of ultrasound and audible sound bear c
8. d amp Biological Tissues Workshop Proceedings Batalle Memorial Inst U S Dept of Health Sept 72 In addition we have a packet of information available which includes selected reprints ultrasound technique and trigger point charts etc For your free copy write Educational Dept Mettler Electronics Corp 1333 S Claudina St Anaheim California 92805 14 Printed in U S A 1000 6 85 IR6 17 SONICATOR 706 USER MANUAL ANETTLER SELECTRONICS corp Additional copies of this chart are available upon request bv writing Mettler Electronics Corp 1333 So Claudina St Anaheim Calif 92805 U S A Telephone 714 533 2221 s 800 854 9305 U S A FAX 714 635 7539
9. d cylindrical beam with an area of 10 cm as measured 5 mm from the ceramic disc surface when the radiation is emitted into the equivalent of an infinite medium of distilled degassed water 30 C and with line voltage variations in the range of 10 of the rated value The beam of the applicator is circular in all planes parallel to the applicator face If a cross section is taken through the axis of the beam the pattern varies with distance from the face A few inches from the face it is a single smooth bell shaped curve Nearer the face the pattern varies more due to phase cancellations A sample curve as measured 5 mm from the surface is shown below OUTPUT INTENSITY j DISTANCE FOR A 10 cm APPLICATOR lt l 0 l 20 15 10 5 CENTER 5 10 15 20 DISTANCE FROM CENTER OF APPLICATOR IN mm TREATMENT TIMER Indicator The timer digital indicator indicates set time in minutes and seconds prior to the start of treatment and treatment time remaining during the treatment The timer also indicates the remaining treatment time during the hold period Accuracy 1 second at all settings Maximum treatment time 29 minutes CERTIFICATION The Sonicator ME 706 complies with the ultrasound performance standards set forth in the Code of Federal Regulations Title 21 Food and Drugs Part 1050 10 LABEL ABBREVIATIONS USED S N Serial Number Coll Collimating Gen Generator cm Square centimeter Freq Fr
10. equency MHz Megahertz BNR Beam Non uniformity Ratio OTHER ABBREVIATIONS W Watts CW Continuous waveform W cm Watts per square centimeter LED Light Emitting Diode SONICATOR CONTROL PANEL CONTROL PANEL DESCRIPTION Refer to the control panel drawing The number associated with each control and indicator described below corresponds with the number shown on the Sonicator ME 706 control panel drawing 1 2 Main Power Control A rocker type ON OFF selector depress left ON right OFF Power Level Control Determines the output level as indicated on the power output indicator Mode Selector Selects either continuous wave CW or pulse modulated PULSE operation Initial turn on is in CW mode Indicator Function Selector Determines one of two types of indication provided by the power output indicator W or W cm Initial turn on is in W mode Treatment Time Selector Allows selection of treatment times from zero to 29 minutes as indicated on the treatment time indicator GO Switch Selecting this function activates the timer which counts down in one second intervals and the ultrasonic power HOLD Switch Selecting this function stops the timer which remains in a hold state at the indicated time remaining and turns off the ultrasonic power Minutes TIMER Seconds 10 Indicator Lights Green LED light emitting diode indicators fo
11. ergy absorption yet fast enough to eliminate excessive amounts of absorption which could produce periosteal pain On occasion irregular surfaces of the body are treated hands and may offer a poor surface for proper soundhead contact The underwater technique may be used for these applications The part to be treated and the soundhead are submerged in water and the soundhead is moved over the area keeping the head to 1 inch away from the area of treatment As air bubbles appear on the surface of the soundhead they should be wiped away to insure proper transmission of energy d fj R NEUROTROPHIC APPROACH It is most important that the neurotrophic nerve root approach be used because it generally produces an analgesic effect on the sensory nerves to the involved tissues Most physicians recommend that the area of involvement be treated first A strip slightly wider than the diameter of the applicator should be treated in the cervical section In the dorsal region the area should be about two inches wide The strip should be increased from two to four inches as you render treatment through the lumbar and sacral areas These strips should reach to but not include the spinal process The first area is from the cervical through the first dorsal This area controls nerve roots leading to the lower neck upper section of the back shoulders arms hands and fingers The second is the thoracic area which extend
12. ertain similarities with frequency being the exception Both travel as longitudinal compressed waves through a conducting medium Ultrasound waves can be propagated in a gaseous liquid or solid medium but not in air High frequency sound waves are formed by areas of compression and rarefaction of the molecules It is not within the scope of this manual to discuss this subject in depth The reader can choose his own level of familiarity through reading the articles offered as references However it is important to know ultra sound exhibits certain beaming proper ties It can be reflected refracted scattered and absorbed In passing through media it is attenuated and the absorbed energy is transformed into heat The attenuation coefficient for longitudinal waves in liquid and soft tissues is high producing the phenomenon at bone surfaces known as selective heating Clinical ultrasound is produced through the reverse piezoelectric effect Electricity is carried from a radio frequency source to an electrode in contact with the surface of an especially cut crystal The electrical charges applied to the crystal surface produce mechanical vibrations or the so called reverse piezoelectric effect Ultrasound waves need a medium for their transmission and that is accomplished by using a proper coupling agent This coupling layer between the transducer and body surface should assist in the propagation of the mechanical vibrations and prevent loss of
13. f information we are able to provide in this manual To assist you in your search we are including the titles of text books and selected articles Each of them in turn will offer additional sources for reference 1 Griffin J E amp Karselis T C Physical Agents for Physical Therapists C C Thomas Springfield Ill 1978 pp 225 227 2 Griffin J E amp Touchstone J Effects of Ultrasonic Frequency of Phono phoresis of Cortisol into Swine Tissues Am J Phys Med 51 62 1972 3 Kleinkort J A amp Wood F Phonophoresis With One Per Cent Versus Ten Percent Hydrocortisone Phys Ther 55 1320 1975 4 Travel J and Rinzier S H The Myofascial Genesis of Pain POST GRADUATE MEDICINE Vol II No 5 May 1952 5 Sola A E Myofascial Trigger Point Pain in the Neck and Shoulder Girdle NORTHWEST MEDICINE Vol 54 pp 980 984 Sept 1955 TEXT BOOKS 1 Handbook of Physical Medicine and Rehabilitation second edition F H Krusen M D F J Kottke M D P M Ellwood Jr M D W B Saunders Co Phila 2 Physical Agents for Physical Therapists Griffin J E and Karselis T C C C Thomas Springfield Il pp 225 227 ARTICLES 1 Advantages and Limitations of Ultrasonics in Medicine H P Schwan Ph D amp E L Carstensen M S JAMA 5 52 Vol 149 PP 121 125 2 Non surgical Management of the Pain Dysfunction Syndrome W H Bell D D S JADA Vol 79 July 69 3 Interaction of Ultrasoun
14. her than those specified herein may result in hazardous exposure to ultrasonic energy Electric treatment tables or whirlpools which may come in contact with the patient during a treatment with the Sonicator ME 706 should be adequately grounded and safety tested to insure safe operation with the Sonicator ME 706 SPECIFICATIONS ULTRASONIC GENERATOR Input 120VAC 60Hz 0 5 amperes maximum Other voltages are available Frequency 1 0 MHz 5 Pulse repetition rate 100 Hz 20 PULSE MODE Pulse duration 2 msec 20 PULSE MODE Temporal Peak Average intensity ratio 5 20 Indication accuracy 20 for any level above 10 of maximum Output The output waveform in continuous or pulsed as programmed by the front panel control In the pulse mode the 1 0 MHz is square wave pulse modulated The power level is adjusted by varying the pulse amplitude The pulse waveform is shown below In the continuous mode the power is on all the time the timer is running The continuous mode waveform is shown below ULTRASONIC APPLICATOR Piezoelectric disc The output transducer utilizes a barium titanate piezoelectric disc with an especially coated face Frequency 1 0 MHz 5 Effective Radiating Area 10 cm 20 Beam type Collimating Maximum beam non uniformity ratio 6 1 Spatial Pattern The applicator produces a collimate
15. nces between transducers of varying radiating areas are shown below The chart is a calculation of power output for three transducer crystals with different radiating areas Intensity Setting Crystal Effective Effective Watts W cm Radiating Area Produced 1 5 5 cm2 7 5 W 1 5 6 cm 90W 1 5 10 cm 15 0 W Vou will note though the intensitv setting remained constant the amount of energy delivered varied appreciably We caution you to consider this since units of different manufacture are available in many departments If watts per square centimeter is used as the prescribed intensity setting the effective watts delivered will not remain constant For this reason we suggest that using average power or WATTS as the intensity setting insures the amount delivered by any unit and any sized crystal remains constant as desired 10 CONTINUOUS AND PULSED WAVES Ultrasound may be applied in either continuous or pulsed waveform Advocates of pulsed beam applications suggest the approach reduces the thermal effects while accenting the mechanical Wulff in his paper titled Reduction of Thermic Effect of Ultrasound Dosages by the Use of Pulsed Ultrasound Energy reported the use of pulsed ultrasound energy permits accurately controlled reduction of total ultrasound intensities employed in therapy He recommended the use of rectangular pulses and stated The biologic response reactions of the sonated tissue seems to c
16. ntrol panel drawing Numbers in the following operating procedures for example 1 indicate the control or indicator number shown in the drawing 1 Connect the unit to an appropriatelv grounded 120VAC 60Hz receptacle 2 Energize the unit by pressing the MAIN POWER SWITCH 1 to the left 3 Enter the treatment time using the TREATMENT TIME SELECTOR 5 The treatment time must be entered using two digits a For times up to 9 minutes enter 0 followed by the second digit Example For 9 minutes enter a 0 then a 9 b For 10 to 29 minutes enter a 1 or 2 followed by the second digit Example For 15 minutes enter a T then a 5 c If an incorrect time is entered accidentally cycle the MAIN POWER CONTROL 1 and reselect the desired treatment time 4 Select continuous wave CW or pulse modulated PULSE mode by pressing the appropriate MODE SELECTOR 3 function 5 Select the desired power output indication by pressing the appropriate INDICATOR FUNCTION SELECTOR 4 switch W or W cm 6 Coat the area to be treated with Sonigel and couple the applicator to the patient 7 Press the GO SWITCH 6 to initiate treatment time and power output 8 Adjust the POWER LEVEL CONTROL 2 to the desired output level as indicated on the POWER OUTPUT INDICATOR 9 a Treatment can be stopped at any time by pressing the HOLD SWITCH 7 The power will stop and the timer will hold its
17. ontinue during the sound free intervals provided that a ratio between pulse duration and free interval of 1 4 is maintained The ME 706 provides both continuous and pulse wave capabilities Continuous is a 100 duty cycle and an unmodulatd wave which orginates from a filtered DC power source The pulse setting has a pulse frequency of 100 Hz with a pulse width of 2 milliseconds and 8 milliseconds between pulses On time to total time is 1 5 The duty cycle is 20 and on time to off time is a ratio of 1 4 In the pulse mode the meter reads peak power COMBINATION THERAPY Combination therapy may be performed by plugging the Sys Stim muscle stimulator active lead wire black and negative into the black col lared phone jack located on the bottom of the Sonicator 705 706 The phone jack is identified by the symbol N When output is generated by the stimulator it will be passed to the metal ring on the transducer head by means of this connection The timer on the Sonicator will control the length of time ultrasound is delivered The Sys Stim timer is placed into timer bypass during combination therapy When the selected time has elapsed on the Sonicator indicating the end of treatment press hold on the Sys Stim to stop stimulation output through the transducer 11 TRIGGER POINTS are small areas of localized sensiti vity and pain found in muscles and connective tissue They may be produced by trauma can be a result of
18. pproach Output Levels Continuous and Pulsed Waves Combination Therapy Phonophoresis Common Conditions Encountered in Athletics Treated by Ultrasound as an Adjunctive Therapy List of General Conditions Treated by Ultrasound as an Adjunctive Therapy Contraindications to Ultrasonic Therapy References INTRODUCTION SAFETY PRECAUTIONS This unit operates with high voltages Servicing of the Sonicator ME 706 should be referred to qualified service technicians or returned directly to the factory To assure continued compliance with FDA 21 CFR 1050 10 standards the ME 706 should be factory calibrated and safety tested at least once each year Mettler Electronics recommends that all service work be performed at the factory However a service manual can be obtained by writing the factory for those who are qualified to service the device and are fully aware of their responsibilities CLEANING INSTRUCTIONS To clean the molded plastic enclosure of the Sonicator ME 706 generator housing or applicator handle use a mild detergent with a damp soft cloth Use of any other cleaning agent or solvent is not warranted or recommended SHIPPING The instrument is shipped complete in one carton containing the unit itself a wallmounting plate with three screws guarantee card operating instructions and one tube of Sonigel coupling agent We recommend that you retain the shipping carton in the event you need to return the unit for factory se
19. r each power output indicator function W and W cm and for each mode CW and PULSE Two of these indicators are lit during Sonicator operation one each for indicator function and mode selected Power Output Indicator Provides indication of ultrasonic power output W In CW mode the indicator displavs average ultrasonic power in watts In PULSE mode it displavs peak pulse ultrasonic power in watts W cm In CW mode the indicator displays average effective intensity in watts per square centimeter In PULSE mode it displays peak pulse effective intensity in watts per square centimeter Treatment Time Indicator Indicates treatment time selected and displays remaining time when the timer is activated Power output automatically drops to zero watts at the end of the selected treatment time Sonicator ME 706 Indicator Lights DW O Average ultrasonic power in watts continuous wave B cw Pusl O mode D w ye O l Peak pulse ultrasonic power in watts pulse modulated OJ cw Puse Q mode Ol w IO aa Witenes L Average effective intensity in watts per square Qi cw Pus O centimeter continuous wave mode Ow pa e gto i aati Peak pulse effective intensity in watts per square O cw PuLse centimeter pulse modulated mode e This symbol as used above indicates lighted LED s at each of the four output settings OPERATING INSTRUCTIONS Refer to the co
20. running time b Restart the treatment by pressing the GO SWITCH 6 c A single long buzz sounds at the end of treatment time d Several short buzzes sound if treatment time is interrupted 5 OPERATOR TROUBLESHOOTING GUIDE Sympton Action Check 1 No lights when MAIN POWER Line cord properly connected to SWITCH is depressed AC outlet 2 TIMER indicates a number between Cycle the MAIN POWER SWITCH 01 and 29 or 88 88 98 88 or 64 88 OFF amp ON and program the but the unit will not start when GO TIMER with TWO digits as per is pressed the operating instructions page 5 3 After starting the unit stops with Check for adequate transducer the TREATMENT TIME INDICA coupling and use of recom TOR showing time left and the mended couplant such as Sonigel buzzer sounds five short buzzes then press the GO SWITCH Read the paragraph below The Sonicator ME 706 has a special feature a no load sensor that limits and cuts off power automatically if contact between the transducer and the patient s skin is interrupted for a period of time The buzzer will buzz for several about five short buzzes when the automatic no load sensor shuts off the unit This feature adds another dimension of protection against excessive heat build up on the ceramic disc Initial dis contact produces a drop in the amount of current flowing to the disc and within about 3 to 5 seconds energy is totally cut off Should this feature a
21. rvicing UNPACKING AND INSTALLATION Upon receipt of the unit check for visible and hidden damage If any damage is apparent upon opening the case hold all shipping materials including the case and call the shipping agency which delivered the unit They are responsible for all damage in transit therefore all claims should be filed directly with them The factory will not be responsible for any damage in shipment nor allow any adjustment unless proper formal claim has been filed by the receiver against the carrier The unit operates on 120 volts 60 hertz alternating current Other voltages are available Unless your voltage and frequency are as above DO NOT CONNECT THE UNIT TO YOUR SUPPLY If only direct current DC is available use a converter that provides 120 volts AC 60 hertz with a capacity of 100 watts WALL MOUNTING To fasten the mounting plate on a wooden surface use the three screws included with the unit On a dry wall or plaster surface use two well nuts Position the plate with the slot facing upward and angled out from the wall Lower the mounting screw located on the upper back of the unit firmly into the mounting plate slot CAUTION Federal law restricts this device to sale or on the order of a physician dentist veterinarian or any other practitioner licensed by the law of the state in which he practices to use or order the use of this device Use of controls or adjustments or performance of procedures ot
22. s from the first dorsal through the first lumbar This section controls the upper trunk of the body The third and last is the lower lumbar and sacral starting from the first lumbar through the coccyx This section controls the nerve roots to the hips and legs The above is not an exact outline but it should suffice for ultrasonic treatment Since such a large group of nerve roots are always treated at one time care need not be taken to locate the specific nerve roots that are indicated ANTERIOR POSTERIOR Cervical Sw 5M Dorsal 6W amp 5M Lumbar sacral 6W amp SM POSTERIOR TREATMENT Note W total watts output and M minutes Where not marked use An average of treatment time and output output level shown on levels used by present day therapists the anterior chart Dosage in total watts or watts per square centimeter and treatment time may vary from patient to patient and with areas to be treated Generally the transducer applicator is moved in a slow steady rotary or stroking motion at the approximate rate of 24 square inches 155cm per minute Most treatments require repetition over this area for a period of five minutes For a few hours duration after ultrasonic treatment the pain may increase If this occurs treatments should be continued but witha slight reduction in time and power Frequency of treatment varies from once daily to three times per week OUTPUT LEVELS The differe
23. transmission The crystal may be natural or synthetic and may be salt quartz poly crystalline or ceramic When this crystal is in resonance with the driving oscillator optimum conversion from electrical to mechanical energy is achieved A disadvantage of quartz is that it requires extremely high voltages of the applicator 3000 4000V to energize it for an intensity of 3 W cm Ceramic crystals require less 30 40V thus allowing use of longer thinner and more flexible coaxial cables The Sonicator ME 706 uses a barium titanate cobalt ceramic Ultrasonic energy is expressed in watts W or watts per square centimeter W cm Average intensity is obtained by measuring the total output of the applicator in watts and then dividing it by the size of the effective radiating area of the applicator The effective radiating area is different from the overall dimension of the applicator face Once the coupling agent is applied to the body surface the applicator placed in contact and the desired output selected in total watts or watts per square centimeter the technique of applicaton is by means of circular or stroking movement In the circular method the soundhead of the applicator is moved in slow and circular overlapping movements In the stroking or paint brush method slow to and fro strokes are used again with slight overlapping Motion with either technique should be slow enough to insure proper en
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