González-Seguel Felipe, Pinto-Concha Juan José, Ríos-Castro Francisco, Silva-Gutiérrez Alexis, Camus-Molina Agustín, Mayer Kirby P, Parry Selina M
Servicio de Medicina Física y Rehabilitación and Departamento de Paciente Crítico, Facultad de Medicina, Clínica Alemana Universidad del Desarrollo, Santiago, Chile.
Adult Critical Care Center, INDISA Clinic, Santiago, Chile.
Arch Rehabil Res Clin Transl. 2021 Jul 13;3(3):100142. doi: 10.1016/j.arrct.2021.100142. eCollection 2021 Sep.
To evaluate learning results of critical care physiotherapists participating in a muscle ultrasound (MUS) educational program.
Cross-sectional study.
A custom-made 20-hour MUS course was performed over a 2-week time period, including knobs familiarization, patient positioning, anatomic landmarks, image acquisition, and limb muscle measurements.
Nineteen critical care physiotherapists with little to no prior experience in ultrasound (N=19).
Not applicable.
Theoretical knowledge, hands-on skills acquisition, and satisfaction were assessed. Inter- and intrarater reliability on landmarks, thickness, and pennation angle of quadriceps between participants was evaluated using intraclass correlation coefficients (ICCs). Reliability among instructors measured prior to the course was also reported as a reference.
The percentage score (mean±SD) of knowledge questionnaires was 69±11 (pre-course), 89±10 (post-course), and 92±9 (hands-on skills). Course satisfaction scores ranged from 90%-100%. Pooled interrater reliability of participants (median ICC [interquartile range]) was good (0.70 [0.59-0.79]) for thickness, moderate (0.47 [0.46-0.92]) for landmarks, and absent (0.00 [0.00-0.05]) for pennation angle and the intrarater reliability was good (0.76 [0.51-0.91]) for thickness and weak (0.35 [0.29-0.52]) for pennation angle. Interrater ICC values for instructors were excellent (0.90) for thickness, good (0.67) for landmarks, and moderate (0.41) for pennation angle and intrarater ICC values were excellent (0.94) for thickness and good (0.75) for pennation angle.
Although our sample was quite small and homogeneous, increased theoretical knowledge, high hands-on performance acquisition, and good satisfaction of physiotherapists were observed. Reliability was moderate to excellent for thickness and landmarks and absent to weak for pennation angle. Landmarking and pennation angle remain challenges for physiotherapist training in the application of MUS. Further studies are needed to identify variables that could modify reliability during MUS training.
评估参与肌肉超声（MUS）教育项目的重症监护物理治疗师的学习成果。
横断面研究。
在两周的时间内开展了一个定制的20小时MUS课程，内容包括旋钮熟悉、患者体位摆放、解剖标志、图像采集和肢体肌肉测量。
19名几乎没有或完全没有超声经验的重症监护物理治疗师（N = 19）。
不适用。
评估理论知识、实践技能掌握情况和满意度。使用组内相关系数（ICC）评估参与者之间在股四头肌标志点、厚度和羽状角方面的评分者间信度和评分者内信度。还报告了课程开始前教师之间的信度作为参考。
知识问卷的百分比得分（均值±标准差）在课程前为69±11，课程后为89±10，实践技能方面为92±9。课程满意度得分在90% - 100%之间。参与者的合并评分者间信度（中位数ICC[四分位间距]）在厚度方面良好（0.70[0.59 - 0.79]），在标志点方面中等（0.47[0.46 - 0.92]），在羽状角方面不存在（0.00[0.00 - 0.05]）；评分者内信度在厚度方面良好（0.76[0.51 - 0.91]），在羽状角方面较弱（0.35[0.29 - 0.52]）。教师的评分者间ICC值在厚度方面优秀（0.90），在标志点方面良好（0.67），在羽状角方面中等（0.41）；评分者内ICC值在厚度方面优秀（0.94），在羽状角方面良好（0.75）。
尽管我们的样本规模较小且同质化，但观察到物理治疗师的理论知识有所增加、实践操作掌握程度较高且满意度良好。厚度和标志点的信度从中等至优秀，羽状角的信度从不存在至较弱。在MUS应用中，标志点确定和羽状角测量仍是物理治疗师培训面临的挑战。需要进一步研究以确定在MUS培训期间可能改变信度的变量。
