The use of ultrasounds in medicine requires, like all physical agents potentially harmful to human health, an accurate assessment of the risks to the health of patients. The nature and extent of these risks depend on exposure levels which in turn are differentiated according to the specific diagnostic or therapeutic applications. Intermediate exposure levels are associated to physiotherapic applications. To analyze specific issues relating to the effectiveness and safety of physiotherapic treatments, a review of the scientific literature and technical standards was carried out. At present, the actual effectiveness of ultrasound physiotherapy is still far from being clearly assessed: further clinical and experimental studies are needed in order to optimize therapies, determining the benefits and risks of treatments and deepening the understanding of the action mechanisms of the physical agent, even on the basis of a better characterization of those physical quantities mostly significant for biological effects. The examination of technical standards defining the security requirements of the equipment allowed the identification of some critical issues; on these bases some proposals are suggested for the improvement of quality and safety of treatments. Key words: ultrasounds, physiotherapy, efficacy, safety.
L'utilizzo degli ultrasuoni in medicina richiede, come per tutti gli agenti fisici potenzialmente dannosi per la salute umana, un'attenta analisi dei rischi per la salute dei soggetti trattati. La natura e l'entità di tali rischi dipendono dai livelli di esposizione che a loro volta sono differenziati in base alla specifica applicazione diagnostica o terapeutica. Livelli intermedi di esposizione sono connessi con le applicazioni in fisioterapia. Quest'ultime presentano problematiche specifiche relative all'efficacia e alla sicurezza dei trattamenti, in relazione alle quali è stato effettuato un esame della letteratura scientifica e della normativa tecnica. A tutt'oggi la reale efficacia dei trattamenti fisioterapici ad ultrasuoni non è stata chiaramente accertata: al fine di ottimizzare le terapie sono necessari ulteriori studi, sia clinici che di laboratorio, volti a determinare i benefici e i rischi dei trattamenti, approfondendo la conoscenza dei meccanismi di azione dell'agente fisico, anche sulla base di una migliore caratterizzazione delle grandezze fisiche più significative per gli effetti biologici. L'esame delle norme tecniche che definiscono i requisiti di sicurezza delle apparecchiature ha permesso di identificare alcune criticità, sulla base delle quali vengono formulate alcune proposte per il miglioramento della qualità e della sicurezza dei trattamenti. Parole chiave: ultrasuoni, fisioterapia, efficacia, sicurezza
Health issues and regulatory aspects of the use of ultrasound in physiotherapy/Problematiche sanitarie e aspetti normativi dell'utilizzo degli ultrasuoni in fisioterapia
Calicchia Paola;
2015
Abstract
The use of ultrasounds in medicine requires, like all physical agents potentially harmful to human health, an accurate assessment of the risks to the health of patients. The nature and extent of these risks depend on exposure levels which in turn are differentiated according to the specific diagnostic or therapeutic applications. Intermediate exposure levels are associated to physiotherapic applications. To analyze specific issues relating to the effectiveness and safety of physiotherapic treatments, a review of the scientific literature and technical standards was carried out. At present, the actual effectiveness of ultrasound physiotherapy is still far from being clearly assessed: further clinical and experimental studies are needed in order to optimize therapies, determining the benefits and risks of treatments and deepening the understanding of the action mechanisms of the physical agent, even on the basis of a better characterization of those physical quantities mostly significant for biological effects. The examination of technical standards defining the security requirements of the equipment allowed the identification of some critical issues; on these bases some proposals are suggested for the improvement of quality and safety of treatments. Key words: ultrasounds, physiotherapy, efficacy, safety.I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.
