Chan Division of Occupational Science and Occupational Therapy, University of Southern California, Los Angeles, CA, USA -
Eur J Phys Rehabil Med. 2016 Apr;52(2):253-62. Epub 2015 Jul 16.
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.
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.
Scoping review.
Inpatient, outpatient, other.
Musculoskeletal conditions.
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.
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.
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.
Implementation of musculoskeletal sonography by non-physician rehabilitation providers has the potential to be a critically advantageous addition to improve care.
肌骨超声在即时医疗物理医学和康复中的应用正在迅速扩展，不仅由物理治疗师使用，也由非医师康复提供者使用。
本综述的目的是评估相关文献的范围、程度和性质，并确定非医师康复提供者使用肌骨超声的新兴证据领域，以指导研究和临床实践。
范围综述。
住院、门诊、其他。
肌骨疾病。
检索了 5 个数据库，确定了 578 个独特的摘要，并对其进行了筛选以确定是否符合入选标准。3 名评审员独立阅读了 68 篇全文，其中 36 篇文章报告了非医师康复提供者应用超声的情况，包括在内。
18 项研究描述了直接临床应用，主要用于结局测量（N=12）或作为生物反馈干预（N=10）。包括 12 项实验室研究，这些研究将形态与患者报告或验证的临床干预相关联。另外还有 6 项研究虽然不涉及非医师提供者，但也包括在内，因为它们提出了一些潜在的有价值的用途，这些用途在其他纳入的研究中没有被注意到，例如监测骨愈合、肌腱修复以及评估特发性症状报告或非特异性主要诊断。
本综述表明，非医师康复提供者将超声用于结局测量和生物反馈干预。需要研究这些用途对患者结局的影响，并探索临床推理、治疗计划以及与干预相关的组织愈合监测方面的其他潜在用途。
非医师康复提供者实施肌骨超声有可能成为改善护理的重要优势。
