Bell's palsy

[sdkashif]

Dear 1234nale thanks for your query and questions. let me have a look over your query and answer it.

Low-frequency Ultrasound Penetrates the Cranium and Enhances Thrombolysis In Vitro.

The article that you have mentioned tells that low frequency ultrasound only penetrates the cranium while The frequencies used in therapy are typically between 1.0 and 3.0 MHz (1MHz = 1 million cycles per second). And these are high frequencies and therefore there will be no chance of penetration with high frequencies.

Ultrasound is a form of MECHANICAL energy, not electrical energy and therefore strictly speaking, not really electrotherapy at all. Mechanical vibration at increasing frequencies is known as sound energy. Below about 16Hz, these vibrations are not recognisable as sound, and the normal human sound range is from 16Hz to something approaching 15-20,000 Hz (in children and young adults). Beyond this upper limit, the mechanical vibration is known as ULTRASOUND. The frequencies used in therapy are typically between 1.0 and 3.0 MHz (1MHz = 1 million cycles per second). For detail about ultrasound see Therapeutic ultrasound

And again, aria of the head, easy, ears, ovaries, testicles, brain, spinal cord are highly ultrasound-sensitive organs!!!

I understand you concern regarding the contraindications of ultrasound. every good therapist is well aware of contra indication of ultrasound. Let me mention contraindication of ultrasound here. Please also see the detail for contraindications Contraindications of Ultrasound

CONTRAINDICATIONS OF ULTRASOUND

Avoid exposure to the developing foetus
Malignancy
Vascular abnormalities including DVT and severe atherosclerosis
Acute infections
Haemophiliacs not covered by replacement factor
Application over :
Specialised tissue e.g. eye and testes
The stellate ganglion
The cardiac area in advanced heart disease
The spinal cord following laminectomy
The cranium
Active epiphyseal regions in children

PRECAUTIONS OF ULTRASOUND

Anaesthetic areas should be treated with caution if a thermal dose is being applied
Subcutaneous major nerves and bony prominences
Always use the lowest intensity which produces a therapeutic response
Ensure that the applicator is moved throughout the treatment
Ensure that the patient is aware of the nature of the treatment and the expected effects
If pain, discomfort or unexpected sensations are experienced by the ptient, the treatment intensity should be
reduced. If the symptoms persist, the treatment should be terminated.

My point was don’t use methods for what you are not sure what is the greater benefit

There is recommendation in good physiotherapy text book for the use of ultrasound. During paralysis, ultrasound given over the nerve trunk just in front of the tragus of the ear may reduce the inflammation. For Reference see " Tidy's Physiotherapy 12th Edition page #162"

See For more information upon ultrasound dosage calculation

However, let me say that I was mentioning ultrasound recommendation only during the paralysis phase of Bell's palsy when the nerve is inflammed. There are also other options available for reducing inflammation like LASER, SWD. However, these are only of benefity during the stage of paralysis.

There are other modes of treatment like electrical stimulation and exercises. for detail you may see the articles below.

Evidence In Practice- Does electrical stimulation improve motor recovery in patients with idiopathic facial (Bell) palsy?

Physical therapy for Facial Palsy- A tailored treatment approach