1
|
Strike K, Chan A, Maly MR, Newman AN, Solomon P. Scoping Review of Curricula and Pedagogical Approaches for Physiotherapist Performed Point of Care Ultrasonography. Physiother Can 2023; 75:322-336. [PMID: 38037585 PMCID: PMC10686305 DOI: 10.3138/ptc-2021-0079] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2021] [Revised: 12/07/2021] [Accepted: 02/18/2022] [Indexed: 12/02/2023]
Abstract
Purpose This study collates and maps physiotherapy pre- and post-licensure curricula and pedagogical approaches for point of care ultrasonography (POCUS). Method We used a standardized scoping review methodology and reporting framework. A total of 18,217 titles and abstracts, and 1,372 full text citations were screened, with 209 studies classified as physiotherapist performed POCUS. Results Of the 209 studies, 15 evaluated pre- and post-licensure curricula and pedagogical approaches. Seventy-two to 98% of pre-licensure programs reported including theoretical knowledge of POCUS and 44-45% reported practical teaching or competency assessment. In post-licensure studies of POCUS, 0-61% of physiotherapists reported training for POCUS. All studies of post-licensure pedagogical approaches included an assessment of theoretical knowledge of POCUS, but only one study included a practical assessment of competency. There was considerable variability in POCUS methods and duration of pedagogical approaches. Except for one study, all pedagogical approaches reported improvement in theoretical knowledge. Conclusion Progress in physiotherapy-specific, standardized, competency-based curricula and pedagogical approaches in POCUS has been limited, with minimal research available, and considerable variability both pre- and post-licensure. These findings could be used to advocate for the inclusion of POCUS in pre- and post-licensure physiotherapy curriculum, and suggest a need for clear guidelines from regulatory colleges and licensing bodies, and a common terminology for physiotherapist performed POCUS. Future directions for research include a systematic review of the psychometric properties of physiotherapist performed POCUS within and across anatomical areas, an assessment of value of different forms of training, and an evaluation of the impact of physiotherapist performed POCUS on patient outcomes.
Collapse
Affiliation(s)
- Karen Strike
- From the:
From the: School of Rehabilitation Science, Faculty of Health Science, McMaster University, Hamilton, Ontario, Canada, L8S1C7
| | - Anthony Chan
- Department of Pediatrics, McMaster University, Hamilton, Ontario, Canada
| | - Monica R. Maly
- Department of Kinesiology, Faculty of Health, University of Waterloo, Waterloo, Ontario, Canada, N2L 3G1
| | - Anastasia N.L. Newman
- From the:
From the: School of Rehabilitation Science, Faculty of Health Science, McMaster University, Hamilton, Ontario, Canada, L8S1C7
| | - Patricia Solomon
- From the:
From the: School of Rehabilitation Science, Faculty of Health Science, McMaster University, Hamilton, Ontario, Canada, L8S1C7
| |
Collapse
|
2
|
Xing Q, Hong R, Shen Y, Shen Y. Design and validation of depth camera-based static posture assessment system. iScience 2023; 26:107974. [PMID: 37810248 PMCID: PMC10551660 DOI: 10.1016/j.isci.2023.107974] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2023] [Revised: 07/20/2023] [Accepted: 09/16/2023] [Indexed: 10/10/2023] Open
Abstract
Postural abnormalities have become a prevalent issue affecting individuals of all ages, resulting in a diminished quality of life. Easy-use and reliable posture assessment tools can aid in screening for and correcting posture deviation at an early stage. In this study, we present a depth camera-based static posture assessment system to screen for common postural anomalies such as uneven shoulders, pelvic tilt, bowlegs and knock-knees, forward head, scoliosis, and shoulder blade inclination. The system consists of an Azure Kinect camera, a laptop, and evaluation software. Our system accurately measures skeleton and posture indexes and shows favorable agreement with a golden standard optical infrared motion capture system. The findings indicate that the system is a low-cost posture assessment tool with high precision and accuracy, suitable for initial screening of postural abnormalities in individuals of all ages.
Collapse
Affiliation(s)
- Qingjun Xing
- School of Sport Science, Beijing Sport University, Beijing 100084, China
| | - Ruiwei Hong
- School of Sport Engineering, Beijing Sport University, Beijing 100084, China
| | - Yuanyuan Shen
- School of Sport Engineering, Beijing Sport University, Beijing 100084, China
| | - Yanfei Shen
- School of Sport Engineering, Beijing Sport University, Beijing 100084, China
| |
Collapse
|
3
|
Ultrasound assessment of distal biceps tendon injuries. CURRENT ORTHOPAEDIC PRACTICE 2022. [DOI: 10.1097/bco.0000000000001184] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
|
4
|
Duijn EAHD, Roy van S, Karel YHJM, Provyn S, Pouliart N. An interexaminer agreement and reliability study on cadavers with musculoskeletal ultrasound of the shoulder performed by physiotherapists and radiologists compared with dissection. Musculoskelet Sci Pract 2022; 60:102569. [PMID: 35533597 DOI: 10.1016/j.msksp.2022.102569] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/22/2021] [Revised: 04/20/2022] [Accepted: 04/24/2022] [Indexed: 11/26/2022]
Abstract
STUDY DESIGN A cross-sectional inter-examiner agreement and reliability study on fresh frozen cadaver shoulders. BACKGROUND Musculoskeletal ultrasound (MSU) is frequently used by physical therapists and radiologists to improve specific diagnosis in rotator cuff related pathology. The evaluation of the rotator cable seems to be important as stabilizing structure when cuff tears occur. OBJECTIVES To evaluate the inter-examiner agreement and reliability of MSU of the shoulder to detect rotator cuff-pathology and the involvement of the rotator cable in comparison to "dissection". METHODS Physical therapists, a radiologist and an orthopedic surgeon (dissection) investigated 40 fresh frozen cadaver shoulders in order to detect shoulder pathology including rotator cable involvement. Examiners were blinded to each other's findings. RESULTS We found a strong and significant agreement between the raters: PTs, the radiologist and the dissector in this cadaver study for all rotator cuff, the long head of the biceps pathologies and in detecting abnormalities of the rotator cable. The kappa value was substantial to (almost) perfect agreement for all diagnostic outcome categories. CONCLUSIONS This study shows that among a limited group of physical therapists, one radiologist and a dissector a strong level of agreement with kappa values from substantial to (almost) perfect in finding subacromial pathology.
Collapse
Affiliation(s)
- E A H D Duijn
- Basic (bio) Medical Sciences (BMWE), Vrije Universiteit Brussel, Brussels, Belgium.
| | - S Roy van
- Vrije Universiteit van Brussel, Brussels, Belgium
| | - Y H J M Karel
- Research Group Life in Motion, Avans University of Applied Sciences, Breda, the Netherlands
| | - S Provyn
- Basic (bio) Medical Sciences (BMWE), Vrije Universiteit Brussel, Brussels, Belgium; Anatomical Research and Clinical Studies (ARCS) Vrije Universiteit Brussel, Brussels, Belgium
| | - N Pouliart
- Basic (bio) Medical Sciences (BMWE), Vrije Universiteit Brussel, Brussels, Belgium; Department of Orthopaedics and Traumatology, Universitair Ziekenhuis Brussel (UZ Brussel) Brussels, Belgium
| |
Collapse
|
5
|
Diagnostic ultrasound in patients with shoulder pain: An inter-examiner agreement and reliability study among Dutch physical therapists. Musculoskelet Sci Pract 2021; 51:102283. [PMID: 33348286 DOI: 10.1016/j.msksp.2020.102283] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/28/2020] [Revised: 09/07/2020] [Accepted: 10/27/2020] [Indexed: 01/16/2023]
Abstract
STUDY DESIGN A cross-sectional inter-examiner agreement and reliability study among physical therapists in primary care. BACKGROUND musculoskeletal ultrasound (MSU) is frequently used by physical therapists to improve specific diagnosis in patients with shoulder pain, especially for the diagnosis rotator cuff tendinopathy (RCT) including tears. OBJECTIVES To estimate the inter-examiner agreement and reliability in physical therapists using MSU for patients with shoulder pain. METHODS Physical therapists performed diagnostic MSU in 62 patients with shoulder pain. Both physical therapists were blinded to each other's results and patients were not informed about the test results. We calculated the overall inter-examiner agreement, specific positive and negative inter-examiner agreement, and inter-examiner reliability (Cohen's Kappa's). RESULTS Overall agreement for detecting RC ruptures ranged from 61.7% to 85.5% and from 43.9% to 91.4% for specific positive agreement. The specific negative agreement was lower with values ranging from 44.4% to 79.1% for RC ruptures. Overall agreement for other pathology than ruptures related to SAPS, ranged from 72.6% to 93.6% and from 77.3% to 96% for specific positive agreement. The specific negative agreement was lower with values ranging from 44.4% to 79.1% for RC ruptures and 52.5%-83.3% for other pathology than ruptures related to SAPS. Reliability values varied from substantial for any thickness ruptures to moderate for partial thickness ruptures and fair for full thickness tears. Moreover, reliability was fair for cuff tendinopathy. The reliability for AC arthritis and no pathology found was fair and moderate. There was substantial agreement for the calcifying tendinopathy. CONCLUSIONS Physical therapists using MSU agree on the diagnosis of cuff tendinopathy and on the presence of RCT in primary care, but agree less on the absence of pathology.
Collapse
|
6
|
Tat J, Tat J, Theodoropoulos J. Clinical applications of ultrasonography in the shoulder for the Orthopedic Surgeon: A systematic review. Orthop Traumatol Surg Res 2020; 106:1141-1151. [PMID: 32763009 DOI: 10.1016/j.otsr.2020.06.005] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/18/2020] [Revised: 05/04/2020] [Accepted: 06/01/2020] [Indexed: 02/03/2023]
Abstract
BACKGROUND Ultrasound imaging offers a non-invasive method to visualize the anatomy and function of the musculoskeletal system. Despite its benefits and widespread adoption in medicine, ultrasonography is still not well utilized by orthopaedic surgeons. The purpose of this systematic review was to provide a better understanding of the diagnostic accuracy and clinical utility of ultrasound of the shoulder for orthopaedic surgeons. METHODS We searched Medline, Embase, Web of Science, and Scopus databases. Our search terms included orthopedic, orthopedic surgery, ultrasonography, and shoulder. Inclusion criteria consisted of studies that used bedside ultrasound for the diagnosis and therapy of patients with common clinical entities of the shoulder presenting to orthopedic clinics, to demonstrate the utility for orthopedic surgeons. We reported sensitivity, specificity, positive predictive value, negative predictive value. Studies were excluded if they used non-diagnostic ultrasound modalities (e.g. shock wave therapy, shear wave elastography, Doppler flowmetry, speckle tracking shear strain, vibro-acoustography). RESULTS Our search strategy yielded 771 of potentially relevant publications, 41 studies were retrieved for full text screening, and 24 were included in this systematic review. We found that ultrasound used in orthopedic clinics has good sensitivity and high specificity for the assessment of partial and full rotator cuff tears of the shoulder, including post-operative cuff repairs. There was some evidence that it may also be useful for the diagnosis of subacromial-subdeltoid bursitis, AC joint arthropathy, and labral tears; however further investigations are still required. Ultrasound improves that accuracy of injections into spaces of the shoulder (subacromial bursa, acromioclavicular joint, glenohumeral joints, and the long head of biceps tendon sheath) compared to landmark guided injections, that can be helpful for diagnostic purposes, but do not improve long term clinical outcomes. DISCUSSION We reviewed the literature for orthopaedic surgeons and show that ultrasound of the shoulder can be a useful diagnostic tool for orthopedic surgeons in outpatient clinics. We found no difference in sensitivity or specificity when ultrasound was performed at bedside by orthopedic surgeons or by radiologists for patients referred to orthopedic clinic.
Collapse
Affiliation(s)
- Jimmy Tat
- Division of Orthopedic Surgery, University of Toronto, Toronto, Canada
| | - Jessica Tat
- Department of Emergency Medicine, University of Ottawa, Ottawa, Canada
| | | |
Collapse
|
7
|
Kooijman MK, Swinkels ICS, Koes BW, de Bakker D, Veenhof C. One in six physiotherapy practices in primary care offer musculoskeletal ultrasound - an explorative survey. BMC Health Serv Res 2020; 20:246. [PMID: 32209091 PMCID: PMC7092536 DOI: 10.1186/s12913-020-05119-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2019] [Accepted: 03/18/2020] [Indexed: 01/10/2023] Open
Abstract
BACKGROUND The first aim of this research was to investigate the current prevalence of musculoskeletal ultrasound in Dutch physiotherapy practices. The second aim was to explore experiences of physiotherapists with musculoskeletal ultrasound in a primary care setting with patients presenting with shoulder complaints. METHODS A random sample of 1000 owners of primary care physiotherapy practices was sent a questionnaire to investigate the prevalence of musculoskeletal ultrasound. A second questionnaire was sent to physiotherapists using musculoskeletal ultrasound to explore experiences with it in patients with shoulder complaints. RESULTS The net response rate of the first questionnaire was 57.7%. In 18% of the physiotherapy practices musculoskeletal ultrasound was offered. Sixty-nine physiotherapists returned the second questionnaire. Physiotherapists indicated they most often used musculoskeletal ultrasound in patients with shoulder complaints, mainly for suspected tissue damage (83.7%), followed by making a diagnosis (63.3%) and for determining the choice of treatment (36.7%). Physiotherapists reported the biggest advantage was that they were better able to diagnose presenting shoulder complaints. The most frequently mentioned disadvantage of the use of musculoskeletal ultrasound was that assessment is difficult and that there is a risk that findings may not be sufficiently linked to history and physical examination. CONCLUSION One in six physiotherapy practices in the Netherlands offer musculoskeletal ultrasound. It is mainly used for patients with shoulder complaints, with an emphasis on detecting tissue damage and as an aid for diagnosis. Physiotherapists trained to work with musculoskeletal ultrasound seem enthusiastic and are at the same time aware of its disadvantages.
Collapse
Affiliation(s)
- Margit K. Kooijman
- Department of Allied Health Care, NIVEL Netherlands Institute of Health Services Research, PO BOX 1568, 3500 BN Utrecht, the Netherlands
| | - Ilse C. S. Swinkels
- Department of Allied Health Care, NIVEL Netherlands Institute of Health Services Research, PO BOX 1568, 3500 BN Utrecht, the Netherlands
| | - Bart W. Koes
- Department of General Practice, Erasmus Medical Center, Rotterdam, the Netherlands
| | - Dinny de Bakker
- Department of Allied Health Care, NIVEL Netherlands Institute of Health Services Research, PO BOX 1568, 3500 BN Utrecht, the Netherlands
- Scientific Centre for Transformations in Care and Welfare (TRANZO), Tilburg University, Tilburg, the Netherlands
| | - Cindy Veenhof
- Department of Rehabilitation, Nursing Sciences and Sport, University Medical Center Utrecht, Utrecht, the Netherlands
| |
Collapse
|
8
|
Dams OC, van den Akker-Scheek I, Diercks RL, Wendt KW, Zwerver J, Reininga IHF. Surveying the management of Achilles tendon ruptures in the Netherlands: lack of consensus and need for treatment guidelines. Knee Surg Sports Traumatol Arthrosc 2019; 27:2754-2764. [PMID: 29971520 PMCID: PMC6706364 DOI: 10.1007/s00167-018-5049-5] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/02/2018] [Accepted: 06/29/2018] [Indexed: 12/11/2022]
Abstract
PURPOSE This study aimed to describe and analyse usual care of Achilles tendon ruptures (ATRs) by orthopaedic surgeons and trauma surgeons in the Netherlands. METHODS A nationwide online survey of ATR management was sent to all consultant orthopaedic and trauma surgeons in the Netherlands, requesting participation of those involved in ATR management. Data on individual characteristics and the entire ATR management (from diagnosis to rehabilitation) were gathered. Consensus was defined as ≥ 70% agreement on an answer. RESULTS A total of 91 responses (70 orthopaedic surgeons and 21 trauma surgeons) were analysed. There was consensus on the importance of the physical examination in terms of diagnosis (> 90%) and a lack of consensus on diagnostic imaging (ultrasound/MRI). There was consensus that non-surgical treatment is preferred for sedentary and systemically diseased patients and surgery for patients who are younger and athletic and present with larger tendon gap sizes. There was consensus on most of the non-surgical methods used: initial immobilisation in plaster cast with the foot in equinus position (90%) and its gradual regression (82%) every 2 weeks (85%). Only length of immobilisation lacked consensus. Surgery was generally preferred, but there was a lack of consensus on the entire followed protocol. Orthopaedic and trauma surgeons differed significantly on their surgical (p = 0.001) and suturing techniques (p = 0.002) and methods of postoperative immobilisation (p < 0.001). Orthopaedic surgeons employed open repair and Bunnell sutures more often, whereas trauma surgeons used minimally invasive approaches and bone anchors. Rehabilitation methods and advised time until weight-bearing and return to sport varied. Orthopaedic surgeons advised a significantly longer time until return to sport after both non-surgical treatment (p = 0.001) and surgery (p = 0.002) than trauma surgeons. CONCLUSION This is the first study to describe the entire ATR management. The results show a lack of consensus and wide variation in management of ATRs in the Netherlands. This study shows that especially the methods of the perioperative and rehabilitation phases were inconclusive and differed between orthopaedic and trauma surgeons. Further research into optimal ATR management regimens is recommended. In addition, to achieve uniformity in management more multidisciplinary collaboration between Dutch and international surgeons treating ATRs is needed. LEVEL OF EVIDENCE Cross-sectional survey, Level V.
Collapse
Affiliation(s)
- Olivier C. Dams
- 0000 0000 9558 4598grid.4494.dDepartment of Sport and Exercise Medicine, University of Groningen, University Medical Center Groningen, Hanzeplein 1, 9713 GZ Groningen, The Netherlands
| | - Inge van den Akker-Scheek
- 0000 0000 9558 4598grid.4494.dDepartment of Sport and Exercise Medicine, University of Groningen, University Medical Center Groningen, Hanzeplein 1, 9713 GZ Groningen, The Netherlands ,0000 0000 9558 4598grid.4494.dDepartment of Orthopaedics, University of Groningen, University Medical Center Groningen, Hanzeplein 1, 9713 GZ Groningen, The Netherlands
| | - Ron L. Diercks
- 0000 0000 9558 4598grid.4494.dDepartment of Orthopaedics, University of Groningen, University Medical Center Groningen, Hanzeplein 1, 9713 GZ Groningen, The Netherlands
| | - Klaus W. Wendt
- 0000 0000 9558 4598grid.4494.dDepartment of Trauma Surgery, University of Groningen, University Medical Center Groningen, Hanzeplein 1, 9713 GZ Groningen, The Netherlands
| | - Johannes Zwerver
- 0000 0000 9558 4598grid.4494.dDepartment of Sport and Exercise Medicine, University of Groningen, University Medical Center Groningen, Hanzeplein 1, 9713 GZ Groningen, The Netherlands
| | - Inge H. F. Reininga
- 0000 0000 9558 4598grid.4494.dDepartment of Trauma Surgery, University of Groningen, University Medical Center Groningen, Hanzeplein 1, 9713 GZ Groningen, The Netherlands
| |
Collapse
|
9
|
Chambers D, Booth A, Baxter SK, Johnson M, Dickinson KC, Goyder EC. Evidence for models of diagnostic service provision in the community: literature mapping exercise and focused rapid reviews. HEALTH SERVICES AND DELIVERY RESEARCH 2016. [DOI: 10.3310/hsdr04350] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
BackgroundCurrent NHS policy favours the expansion of diagnostic testing services in community and primary care settings.ObjectivesOur objectives were to identify current models of community diagnostic services in the UK and internationally and to assess the evidence for quality, safety and clinical effectiveness of such services. We were also interested in whether or not there is any evidence to support a broader range of diagnostic tests being provided in the community.Review methodsWe performed an initial broad literature mapping exercise to assess the quantity and nature of the published research evidence. The results were used to inform selection of three areas for investigation in more detail. We chose to perform focused reviews on logistics of diagnostic modalities in primary care (because the relevant issues differ widely between different types of test); diagnostic ultrasound (a key diagnostic technology affected by developments in equipment); and a diagnostic pathway (assessment of breathlessness) typically delivered wholly or partly in primary care/community settings. Databases and other sources searched, and search dates, were decided individually for each review. Quantitative and qualitative systematic reviews and primary studies of any design were eligible for inclusion.ResultsWe identified seven main models of service that are delivered in primary care/community settings and in most cases with the possible involvement of community/primary care staff. Not all of these models are relevant to all types of diagnostic test. Overall, the evidence base for community- and primary care-based diagnostic services was limited, with very few controlled studies comparing different models of service. We found evidence from different settings that these services can reduce referrals to secondary care and allow more patients to be managed in primary care, but the quality of the research was generally poor. Evidence on the quality (including diagnostic accuracy and appropriateness of test ordering) and safety of such services was mixed.ConclusionsIn the absence of clear evidence of superior clinical effectiveness and cost-effectiveness, the expansion of community-based services appears to be driven by other factors. These include policies to encourage moving services out of hospitals; the promise of reduced waiting times for diagnosis; the availability of a wider range of suitable tests and/or cheaper, more user-friendly equipment; and the ability of commercial providers to bid for NHS contracts. However, service development also faces a number of barriers, including issues related to staffing, training, governance and quality control.LimitationsWe have not attempted to cover all types of diagnostic technology in equal depth. Time and staff resources constrained our ability to carry out review processes in duplicate. Research in this field is limited by the difficulty of obtaining, from publicly available sources, up-to-date information about what models of service are commissioned, where and from which providers.Future workThere is a need for research to compare the outcomes of different service models using robust study designs. Comparisons of ‘true’ community-based services with secondary care-based open-access services and rapid access clinics would be particularly valuable. There are specific needs for economic evaluations and for studies that incorporate effects on the wider health system. There appears to be no easy way of identifying what services are being commissioned from whom and keeping up with local evaluations of new services, suggesting a need to improve the availability of information in this area.FundingThe National Institute for Health Research Health Services and Delivery Research programme.
Collapse
Affiliation(s)
- Duncan Chambers
- School of Health and Related Research (ScHARR), University of Sheffield, Sheffield, UK
| | - Andrew Booth
- School of Health and Related Research (ScHARR), University of Sheffield, Sheffield, UK
| | - Susan K Baxter
- School of Health and Related Research (ScHARR), University of Sheffield, Sheffield, UK
| | - Maxine Johnson
- School of Health and Related Research (ScHARR), University of Sheffield, Sheffield, UK
| | - Katherine C Dickinson
- School of Health and Related Research (ScHARR), University of Sheffield, Sheffield, UK
| | - Elizabeth C Goyder
- School of Health and Related Research (ScHARR), University of Sheffield, Sheffield, UK
| |
Collapse
|
10
|
Gulati G, Alweis R, George D. Musculoskeletal ultrasound in internal medicine residency - a feasibility study. J Community Hosp Intern Med Perspect 2015; 5:27481. [PMID: 26091660 PMCID: PMC4475265 DOI: 10.3402/jchimp.v5.27481] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2015] [Revised: 03/27/2015] [Accepted: 04/10/2015] [Indexed: 11/25/2022] Open
Abstract
Introduction Ultrasound has become indispensable in medicine for diagnosis and therapeutics. In Internal Medicine Residency Training Program (IMRTP), there is a deficiency of a structured, competency-based musculoskeletal ultrasound (MSKUS) training despite its growing popularity. Methods We conducted a feasibility study for incorporating MSKUS in IMRTP and competency assessment. We recruited internal medicine residents from all training levels. Rheumatology attending with expertise in MSKUS supervised curriculum-design and patient-based assessment. A structured curriculum was developed for knee MSKUS, including training material and a pre- and post-test. An Observed Structured Clinical Exam (OSCE) was used for competency assessment. Attending evaluations and participant feedbacks were collected. Results Fifteen residents participated and 12 completed the OSCE. The pre–post tests showed a statistically significant increase (p<0.001) for all subcomponents (anatomy, pathology, and biophysics). The residents scored high on the OSCE [8.8±1.1 (range 7–10)]. Attending evaluations for cognitive and technical skills were rated ‘Excellent’ (66%) and ‘Good’ (87%), respectively. The training program was perceived very valuable with regard to time and resources spent by residents and faculty, although some felt a need for more patient assessments. Discussion The competency assessed with our OSCE and highly positive feedback reflects this preliminary study's importance and sets the platform for future studies of formal ultrasound training in internal medicine.
Collapse
Affiliation(s)
- Gaurav Gulati
- Division of Immunology, Allergy and Rheumatology, University of Cincinnati College of Medicine, Cincinnati, OH, USA;
| | - Richard Alweis
- Department of Medicine, Reading Health System, West Reading, PA, USA
| | - David George
- Department of Medicine, Reading Health System, West Reading, PA, USA
| |
Collapse
|
11
|
Poredoš P, Čelan D, Možina J, Jezeršek M. Determination of the human spine curve based on laser triangulation. BMC Med Imaging 2015; 15:2. [PMID: 25651841 PMCID: PMC4327951 DOI: 10.1186/s12880-015-0044-5] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2014] [Accepted: 01/21/2015] [Indexed: 12/04/2022] Open
Abstract
Background The main objective of the present method was to automatically obtain a spatial curve of the thoracic and lumbar spine based on a 3D shape measurement of a human torso with developed scoliosis. Manual determination of the spine curve, which was based on palpation of the thoracic and lumbar spinous processes, was found to be an appropriate way to validate the method. Therefore a new, noninvasive, optical 3D method for human torso evaluation in medical practice is introduced. Methods Twenty-four patients with confirmed clinical diagnosis of scoliosis were scanned using a specially developed 3D laser profilometer. The measuring principle of the system is based on laser triangulation with one-laser-plane illumination. The measurement took approximately 10 seconds at 700 mm of the longitudinal translation along the back. The single point measurement accuracy was 0.1 mm. Computer analysis of the measured surface returned two 3D curves. The first curve was determined by manual marking (manual curve), and the second was determined by detecting surface curvature extremes (automatic curve). The manual and automatic curve comparison was given as the root mean square deviation (RMSD) for each patient. The intra-operator study involved assessing 20 successive measurements of the same person, and the inter-operator study involved assessing measurements from 8 operators. Results The results obtained for the 24 patients showed that the typical RMSD between the manual and automatic curve was 5.0 mm in the frontal plane and 1.0 mm in the sagittal plane, which is a good result compared with palpatory accuracy (9.8 mm). The intra-operator repeatability of the presented method in the frontal and sagittal planes was 0.45 mm and 0.06 mm, respectively. The inter-operator repeatability assessment shows that that the presented method is invariant to the operator of the computer program with the presented method. Conclusions The main novelty of the presented paper is the development of a new, non-contact method that provides a quick, precise and non-invasive way to determine the spatial spine curve for patients with developed scoliosis and the validation of the presented method using the palpation of the spinous processes, where no harmful ionizing radiation is present.
Collapse
Affiliation(s)
- Primož Poredoš
- University of Ljubljana, Faculty of Mechanical Engineering, Aškerčeva 6, 1000, Ljubljana, Slovenia.
| | - Dušan Čelan
- University Medical Centre Maribor, Ljubljanska ulica 5, 2000, Maribor, Slovenia.
| | - Janez Možina
- University of Ljubljana, Faculty of Mechanical Engineering, Aškerčeva 6, 1000, Ljubljana, Slovenia.
| | - Matija Jezeršek
- University of Ljubljana, Faculty of Mechanical Engineering, Aškerčeva 6, 1000, Ljubljana, Slovenia.
| |
Collapse
|
12
|
Thoomes-de Graaf M, Scholten-Peeters G, Duijn E, Karel Y, van den Borne M, Beumer A, Ottenheijm R, Dinant G, Tetteroo E, Lucas C, Koes B, Verhagen A. Inter-professional agreement of ultrasound-based diagnoses in patients with shoulder pain between physical therapists and radiologists in the Netherlands. ACTA ACUST UNITED AC 2014; 19:478-83. [DOI: 10.1016/j.math.2014.04.018] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2013] [Revised: 04/12/2014] [Accepted: 04/28/2014] [Indexed: 10/25/2022]
|