The Role of Rehabilitative Ultrasound Imaging Technique in the Lumbopelvic Region as a Diagnosis and Treatment Tool in Physiotherapy: Systematic Review, Meta-Analysis and Meta-Regression

Abstract

Rehabilitative ultrasound imaging (RUSI) technique seems to be a valid and reliable tool for diagnosis and treatment in physiotherapy and has been widely studied in the lumbopelvic region the last three decades. The aims for this utility in clinical settings must be review through a systematic review, meta-analysis and meta-regression. A systematic review was designed following the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines with PROSPERO registration and per review in all phases of the process using COVIDENCE, analysis of risk of bias and meta-analysis using REVMAN, and meta-regression calculation using STATA. Database screening provided 6544 references, out of which 321 reported narrative synthesis, and 21 reported quantitative synthesis, while only 7 of them provided comparable data to meta-analyze the variables pain and muscle thickness. In most cases, the forest plots showed considerable I2 heterogeneity indexes for multifidus muscle thickness (I2 = 95%), low back pain (I2 = 92%) and abdominal pain (I2 = 95%), not important for transversus abdominis muscle thickness (I2 = 22%), significant heterogenity (I2 = 69%) depending on the subgroup and not important internal oblique muscle thickness (I2 = 0%) and external oblique muscle thickness (I2 = 0%). Meta-regression did not provide significant data for the correlations between the variables analyzed and the intervention, age, and BMI (Body Mass Index). This review reveals that RUSI could contribute to a high reliability of the measurements in the lumbopelvic region with validity and reliability for the assessments, as well as showing promising results for diagnosis and intervention assessment in physiotherapy compared to the traditional model, allowing for future lines of research in this area.

Effectiveness of Ultrasonography Visual Biofeedback of the Diaphragm in Conjunction with Inspiratory Muscle Training on Muscle Thickness, Respiratory Pressures, Pain, Disability, Quality of Life and Pulmonary Function in Athletes with Non-Specific Low Back Pain: A Randomized Clinical Trial

“…The RUSI technique presented several benefits for musculoskeletal soft tissue assessments, including joints, tendons, nerves and muscles [ 15 , 16 ]. Concretely, a recent systematic review with meta-analysis and meta-regression revealed that RUSI provided high reliability and validity measurements, especially in the lumbopelvic region, claiming promising findings for diagnostic and intervention evaluations in the physical therapy and rehabilitation fields [ 17 ].…”

“…In addition, the LPP condition was linked to greater diaphragm fatigability [ 28 ], reduced excursion and a higher diaphragmatic dome position [ 29 ]. Nevertheless, ultrasonography tools were cheaper and more portable compared to MRI devices, providing clear reasons for the increased use of the RUSI technique in physical therapy and rehabilitation [ 13 , 14 , 17 ].…”

Test-Retest Reliability of Ultrasonographic Measurements from the Rectus Femoris Muscle 1–5 Years after Anterior Cruciate Ligament Reconstruction in the Ipsilateral and Contralateral Legs: An Observational, Case-Control Study

“…The use of ultrasound in physiotherapy as a musculoskeletal assessment has increased [ 34 , 35 ] last decades, and in this study, we verified in an analytical and isolated way the decrease in thickness both in contraction and at rest ( Table 3 ) of the anterior rectus of the quadriceps of the subjects operated on for ACL.…”

Evaluation of open reduction and internal fixation with closed reduction and external fixation in distal radial fracture

“…In addition, processes are successful in 46 non-randomized trials including external or internal fixation in 1,519 people showed no useful results. 9,10 In addition to the lack of majority rule over the older more experienced approaches. In addition, no prospective randomised or high-quality non-randomized research has yet been performed on the most popular ideas.…”

“…In addition, no prospective randomised or high-quality non-randomized research has yet been performed on the most popular ideas. 9,10 Four systematic research studies have compared basic reduction and internal fixation to locked or direct reduction, even as it is acquainted. The data has demonstrated that a good finding has been originating from an inner obsession.…”