Cell membrane destabilization results in an increase in cellular permeability, therefore many molecules travel into the cell, precipitating secondary effects:

• increase in cell membrane permeability
• increase of intracellular calcium (known as second messenger for cell function, including protein synthesis)
• increase mast cell degranulation
• increase histamine and chemotactic factor release by granules from mast cells and circulating platelets (influencing circulation and protein synthesis)

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In summary cell membrane destabilization is thought to enhance the inflammatory response from the inflammatory phase, consequently aiding and speeding up tissue regeneration and repair.

The most important parameters for the generation of mechanical non-thermal effects are:

• ultrasound frequency
• intensity of ultrasound emission
• exposure time

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At high ultrasound frequencies, on the order of the MHz (like in traditional high frequency ultrasound devices), the production of cavitation bubbles becomes more difficult than at low ultrasound frequencies, of the order of the kHz (like with EQultrasound Pro Therapy).

To achieve cavitation with high frequency 1-3 MHz devices, ultrasound intensity must be significantly increased, to ensure that the cohesive forces of interstitial fluids are overcome and voids are created; too high ultrasound intensities can lead to burns and tissues damages. Furthermore histamine is released by the degranulation of mast cells. The rate at which this occurs is proportional to the ultrasound intensity (the higher the ultrasound intensity, the more histamine is released). It is possible to form too much histamine with a high intensity output, which could prolong the inflammation instead of stimulating healing.

This is one of the major advantages offered by EQ Pro Therapy low frequency / longwave therapy (38 kHz +/-2) versus traditional high frequency ultrasound therapy (1-3 MHz): since EQPro Therapy operates at a much lower frequency than traditional high frequency devices, it can safely produce stable cavitation, acoustical streaming and micro-streaming without the need to increase significantly ultrasound intensity.

The acoustic and mechanical effects produced by EQ Pro Therapy increase cellular metabolic activity, cellular permeability, blood micro-circulation, enzymatic activity, tissue oxygenation and remove metabolic debris produced by the injury. All these physiological effects contribute to accelerate healing, reducing edema and pain, and speeding up the inflammatory phase of tissue repair for a faster recovery of the treated areas.

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EQultrasound Non-Thermal Mechanical Effects

This treatment modality is indicated for pathologies still in the acute phase or in general when heat is an undesirable element. In fact pauses in the ultrasound wave emission allow the dissipation of heat by blood circulation.

For example pulsed ultrasound therapy is very effective in reducing edema and swellings / hematomas at early stage associated with recent soft tissue injuries.

The acoustic and mechanical non-thermal effects produced by EQultrasound Pro Therapy are:

• stable cavitation
• acoustic streaming
• micro-streaming
• mechanical vibration (micro-massage)

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Cavitation is the term used to describe the influence of an ultrasonic wave on the formation, growth and oscillation of micro-bubbles inside interstitial fluids (which are the fluids that bathe and surround cells). The oscillation of micro-bubbles in response to the ultrasound wave, without an increase in the bubbles’ overall size, is called stable cavitation.

Periodic radial oscillations of these micro-bubbles inside interstitial fluids (stable cavitation), create complex streaming patterns within the liquid in the vicinity of the oscillating bubble surface.

Acoustic streaming is the movement of interstitial fluids along cell membranes.

Microstreaming consists of circular currents inside interstitial fluids surrounding the cavitational bubbles, which make cells and intracellular organelles twist and rotate generating a form of micro-massage.

Furthermore the pulsed emission modality creates a very strong mechanical vibration on treated tissues, resulting also in a form of micro-massage, which actively supports the drainage of edemas, hematomas and excess fluids build-up in general.

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Stable Cavitation and Acoustical Streaming Physiological Effects