Effects of low-intensity pulsed ultrasound on soft tissue micro-circulation in the foot



Low-intensity pulsed ultrasound (LIPUS) has been shown to accelerate bone healing and is considered to increase blood flow. The aim of this study was to assess changes in micro-circulation of the foots’ soft tissue in response to LIPUS intervention. We hypothesised improved micro-circulation in response to LIPUS.


Micro-circulation was assessed in 2 mm and 8 mm-deep skin of 50 healthy volunteers using non-invasive laser-doppler spectrophotometry (O2C-device). Measurements were performed before LIPUS-intervention (pre), directly after intervention (post) and 20, 40 and 60 minutes after LIPUS.


All parameter of micro-circulation increased directly after LIPUS intervention at 8 mm depth. Participants with a low pre-intervention flow showed the largest changes (p < 0.001) with an increased post-flow of 38%. SO2 levels increased significantly after intervention (p = 0.045) and decreased after 60 minutes in comparison to pre-intervention status. rHb levels after 60 min were significantly higher in comparison to pre-intervention levels.


In healthy volunteers, low-intensity pulsed ultrasound led to significant short-term changes in microcirculation of the foot. Younger subjects with a low pre-flow level and smokers showed a higher potential to increase blood flow after LIPUS.

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We would like to thank Daniel Timo Behrens for his consultation.

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Correspondence to Matthias Knobe.

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The authors declare that they have no conflict of interest.



Ethical approval

Ethics committee of the RWTH Aachen University Hospital, ethics approval EK 346/14.

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Each author certifies that his or her institution approved the human protocol for this investigation, that all investigations were conducted in conformity with the ethical principles of research, and that informed consent for participation in the study was obtained.

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Kösters, A.K., Ganse, B., Gueorguiev, B. et al. Effects of low-intensity pulsed ultrasound on soft tissue micro-circulation in the foot. International Orthopaedics (SICOT) 41, 2067–2074 (2017). https://doi.org/10.1007/s00264-017-3574-3

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  • Low-intensity pulsed ultrasound
  • O2C
  • Micro-circulation
  • Blood flow
  • Soft tissue
  • Hindfoot