Saturday, June 13, 2009

Rehabilitative Ultrasound imaging (RUSI): what is coming ahead in physiotherapy!!!


Following is a part of a review that is for a journal.

Background:
The use of ultrasound imaging by physical therapists is growing in popularity (21). A special issue of the JOSPT (journal of sports physical therapy) in 2007 has been released on collection of commentaries, case reports, and research reports that document current applications and evidence for rehabilitative ultrasound imaging (RUSI) in patients with neuromusculoskeletal disorders. Professor Maria Stokes of Southampton university of UK is a renowned researcher in the field of neuro-rehabilitation has put much of her efforts in researching on RUSI. According to Professor Maria Stokes there is a need of development of investigative & rehabilitation techniques for the following purposes:

1. Provide accurate, objective tools to aid clinical assessment and motor recovery.
2. Provide valid and reliable investigative tools for research to examine mechanisms of neuromuscular function & to examine the effectiveness of treatments.
3. Provide biofeedback to aid rehabilitation.

According to Prof. Stokes 3 currently emerging prominent rehabilitative tools to accomplish above said purposes are:

1. Rehabilitative Ultrasound imaging (RUSI)
2. Brain Computer Interfacing (BCI)
3. Mechanomyography (MMG)


Our current focus of this discussion is RUSI or the Rehabilitative Ultrasound imaging. According to Jackie & colleagues RUSI is an emerging tool in physical therapy profession which relates to the larger field of medical ultrasound imaging. Further they recommended to physiotherapists in this specialized area to possess knowledge on basic ultrasound imaging and instrumentation principles, including an understanding of the various modes and applications of the technology with respect to neuromusculoskeletal rehabilitation.

Introduction to RUSI: Ultrasound imaging offers a safe, non-invasive, objective and relatively inexpensive means of examining muscle. This use of ultrasound, now termed RUSI, is distinct from the diagnostic use of ultrasound for musculoskeletal conditions.

Its use by physiotherapists was formally established as a specialist field within medical imaging in 2006 at an International Symposium held in Texas (Whittaker et al., 2007). This Symposium aimed to set international guidelines for clinical practice, research and training of physiotherapists in ultrasound imaging in rehabilitative musculoskeletal conditions. Professor Maria Stokes runs an introductory course in RUSI for physiotherapists in collaboration with a Specialist Sonographer.

Several muscles such as Lumbar Multifidus, Abdominal muscles, Posterior neck muscles, Quadriceps, Anterior tibial muscles, Masseter, Trapezius have been studied by various researchers (See Images of these muscles at www.southampton.ac.uk/.../mariastokes.html) and the technique is used in various studies of disorders involving muscle dysfunction. An example of RUSI as a biofeedback tool is for observing the changes in the abdominal muscles as they contract.

References:
1. www.southampton.ac.uk/.../mariastokes.html
2. www.maherpt.com/rtus.aspx

3. Teyhen DS; J Orthop Sports Phys Ther. 2007:37(8):431-433.
4. Jackie L et al; J Orthop Sports Phys Ther. 2007:37(8):434-449; published online 30 May 2007.




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