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Chiropractic Research Review

How Often Do You Check Your Ultrasound Units?

As of 1998, 70% of all chiropractors utilized therapeutic ultrasound in their practice; 34.3% of patients seen by these DCs received ultrasound as part of a standard office visit. The widespread use of ultrasound therapy (UST) in chiropractic practice, estimated at over one million annual applications of ultrasound, necessitates that the safety and accuracy of these units are ensured at all times.

Thirty-one DCs in San Antonio and Dallas, Texas participated in what the authors of this study consider "the first study conducted within the chiropractic profession to evaluate the performance and electrical safety" of therapeutic ultrasound.

A qualified biomedical technician with five years' experience in calibration and safety inspections tested the ultrasound units for ultrasound output, maximum electrical case leakage and maximum electrical ground resistance. Units with separate frequencies were tested on all frequencies, and units equipped with multiple soundheads were tested on all soundheads. In total, 214 separate calibration tests were performed on the units tested.

Of the 45 ultrasound units tested, 37.8% failed to meet minimum calibration standards, and 15.5% failed the electrical safety inspection. When accounting for units that failed to meet both calibration and safety standards, the total combined failure rate of all units was 44%. A significant relationship was noted between the age of the unit and its tendency to fail on one or more tests. Moreover, only two of the 45 units had been safety checked within the previous year.

Conclusions: Because one of the properties of UST is thermal effect, higher dosages can cause tissue damage, and at lower dosages, the value of the therapy may be limited to its placebo effect. There is also the potential risk of electrical hazard to patients and/or clinicians. The authors note that few of the DCs who participated in this study recognized the need for annual calibration checks and electrical safety inspections, and recommend that these requirements be emphasized in undergraduate and graduate course work at chiropractic colleges.

Take note: This paper provides an opportunity for chiropractors who utilize ultrasound to reflect on the safety of their equipment. Inquire with the manufacturer of your ultrasound unit to determine how to have it analyzed for calibration and safety.

Daniel DM, Rupert RL. Calibration and electrical safety status of therapeutic ultrasound used by chiropractic physicians. Journal of Manipulative and Physiological Therapeutics,, March/April 2003:26(3), pp171-5.

Chiropractic Research Review

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