Clinical utilization of musculoskeletal sonography involving non-physician rehabilitation providers: a scoping review.

BACKGROUND

Musculoskeletal sonography use in point-of-care physical medicine and rehabilitation is rapidly expanding, not only by physiatrists, but also by non-physician rehabilitation providers.

AIM

The aim of the present review was to evaluate the current range, extent and nature of the related literature and to identify emerging areas of evidence for the use of musculoskeletal sonography involving non-physician rehabilitation providers to guide research and clinical practice.

DESIGN

Scoping review.

SETTING

Inpatient, outpatient, other.

POPULATION

Musculoskeletal conditions.

METHODS

Five databases were searched and 578 unique abstracts were identified and screened for eligibility. Three raters independently read 68 full texts, and 36 articles that reported on applied uses of sonography by non-physician rehabilitation providers were included.

RESULTS

Eighteen studies described direct clinical use, primarily for outcomes measurement (N.=12) or as a biofeedback intervention (N.=10). Twelve laboratory studies were included that related morphology to patient reports or validated clinical interventions. Six additional studies, although not involving non-physician providers, were included as they presented potential valuable uses that were not noted in the other included studies, such as monitoring bone healing, tendon repair, and evaluation of idiopathic symptom reports or non-specific primary diagnoses.

CONCLUSIONS

This review indicates that non-physician rehabilitation providers use sonography for outcomes measurement and biofeedback interventions. Research is needed to evaluate effects of these uses on patient outcomes and to explore additional potential uses for clinical reasoning, treatment planning, and monitoring of tissue healing related to intervention.

CLINICAL REHABILITATION IMPACT

Implementation of musculoskeletal sonography by non-physician rehabilitation providers has the potential to be a critically advantageous addition to improve care.