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Advances in Rehabilitative Ultrasound Imaging and Sensing

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A special issue of Sensors (ISSN 1424-8220). This special issue belongs to the section "Physical Sensors".

Deadline for manuscript submissions: closed (20 July 2023) | Viewed by 21681

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Dr. Tomasz Wolny

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Musculoskeletal Elastography and Ultrasonography Laboratory, Institute of Physiotherapy and Health Sciences, The Jerzy Kukuczka Academy of Physical Education, 40-065 Katowice, Mikolowska 72B, Poland
Interests: physiotherapy; manual therapy; neurodynamics; RUSI (Rehabilitative Ultrasound Imaging)
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Special Issue Information

Dear Colleagues,

Currently, there is a growing interest among physiotherapists regarding the use of ultrasound imaging in clinical work. The use of ultrasound imaging in physiotherapy is known as rehabilitative ultrasound imaging (RUSI). RUSI is used in physiotherapy in some ways: Diagnostic US (as an aid in the functional diagnosis of neuromuscuoskeletal disorders - point-of-care applications), Rehabilitative US (as sonofeedback to support therapeutic management), Interventional US (as percutaneous procedures like dry needling, acupuncture e.t.c.) and Reaserch US (explore muscle and soft-tissue structure and function, develop and evaluated screening tool and intervention). RUSI is widely used for the assessment and treatment of lower back pain, neck pain, rotator cuff issues, pelvic floor dysfunction, and many other conditions. The scientific evidence in the literature supporting the diagnostic and therapeutic benefits of RUSI is growing; however, much remains to be explored. Future research should aim to increase the areas of application for RUSI and show the possibility of its use in other diseases for which its usefulness has not been assessed thus far. Studies should also aim to extend the diagnostic and measurement capabilities of RUSI in terms of functional diagnostics in order to facilitate accurate diagnoses, allow for objective assessments of the severity of disorders, and to monitor the progress of therapy and assess the final effects of therapy. In addition, future research should present optimal training strategies using sonofeedback with physiotherapy for neuromusculoskeletal disorders.

This Special Issue, ‘Advances in Rehabilitative Ultrasound Imaging and Sensing’, aims to collect original scientific articles and reviews on the latest developments regarding the use of RUSI in physiotherapy.

Dr. Tomasz Wolny
Guest Editor

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Keywords

rehabilitative ultrasound imaging
RUSI
ultrasound imaging
USI
shear wave elastography
physiotherapy
rehabilitation
biofeedback
sonofeedback

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Published Papers (6 papers)

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Research

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15 pages, 2147 KiB

Open AccessArticle

The Effects of Isometric Fatigue on Trunk Muscle Stiffness: Implications for Shear-Wave Elastography Measurements

by Rok Vatovec, Žiga Kozinc and Matej Voglar

Sensors 2022, 22(23), 9476; https://doi.org/10.3390/s22239476 - 4 Dec 2022

Cited by 7 | Viewed by 2603

Abstract

Muscle stiffness has been implicated as a possible factor in low back pain risk. There are few studies on the effects of isometric fatigue on the shear modulus of trunk muscles. This study aimed to investigate the effects of trunk isometric fatigue on the passive and active (during low and high-level contractions) shear moduli of the erector spinae (ES) and superficial and deep multifidus (MF) muscles. We assessed passive and active shear modulus using shear-wave elastography in healthy young participants (n = 22; 11 males, 11 females), before and after an isometric trunk extension fatigue protocol. Maximal voluntary force decreased from 771.2 ± 249.8 N before fatigue to 707.3 ± 204.1 N after fatigue (−8.64%; p = 0.003). Passive shear modulus was significantly decreased after fatigue in the MF muscle (p = 0.006–0.022; Cohen’s d = 0.40–46), but not the ES muscle (p = 0.867). Active shear modulus during low-level contraction was not affected by fatigue (p = 0.697–0.701), while it was decreased during high-level contraction for both muscles (p = 0.011; d = 0.29–0.34). Sex-specific analysis indicated the decrease in ES shear modulus was significant in males (p = 0.015; d = 0.31), but not in females (p = 0.140). Conversely, the shear modulus in superficial MF had a statistically significant decrease in females (p = 0.002; d = 0.74) but not in males (p = 0.368). These results have important implications for further investigations of the mechanistic interaction between physical workloads, sex, muscle stiffness (and other variables affecting trunk stability and neuromuscular control), and the development/persistence of low back pain. Full article

(This article belongs to the Special Issue Advances in Rehabilitative Ultrasound Imaging and Sensing)

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10 pages, 2121 KiB

Open AccessArticle

Changes in Ultrasound Measurements of the Ulnar Nerve at Different Elbow Joint Positions in Patients with Cubital Tunnel Syndrome

by Tomasz Wolny, César Fernández-de-las-Peñas, Arkadiusz Granek and Paweł Linek

Sensors 2022, 22(21), 8354; https://doi.org/10.3390/s22218354 - 31 Oct 2022

Cited by 9 | Viewed by 3732

Abstract

Ultrasound imaging (US) is increasingly being used in the diagnosis of entrapment neuropathies. The aim of the current study was to evaluate changes in stiffness (shear modulus), cross-sectional area (CSA), and trace length (TRACE) of the ulnar nerve in patients with cubital tunnel syndrome (CuTS), with shear wave elastography (SWE). A total of 31 patients with CuTS were included. CSA, shear modulus, and TRACE examinations were performed in the SWE mode in four positions of the elbow: full extension, 45° flexion, 90° flexion, and maximum flexion. There were significant side-to-side differences in the ulnar nerve elasticity value at 45°, 90°, and maximal elbow flexion (all, p < 0.001) but not at elbow extension (p = 0.36). There were significant side-to-side differences in the ulnar nerve CSA value at each elbow position (all, p < 0.001). There were significant side-to-side differences in the ulnar nerve trace value at each elbow position (all, p < 0.001). The symptomatic ulnar nerve in patients with CuTS exhibited greater stiffness (shear modulus), CSA, and TRACE values, compared with the asymptomatic side. US examinations (shear modulus, CSA, and TRACE evaluation) of the ulnar nerve can be helpful in supporting and supplementing the diagnosis in patients with CuTS. Full article

(This article belongs to the Special Issue Advances in Rehabilitative Ultrasound Imaging and Sensing)

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11 pages, 1142 KiB

Open AccessArticle

Identifying Demographic, Clinical, Muscular and Histological Factors Associated with Ultrasound Cervical Multifidus Measurement Errors in a Chronic Neck Pain Population

by Juan Antonio Valera-Calero, Marcos José Navarro-Santana, Gustavo Plaza-Manzano, César Fernández-de-las-Peñas and Ricardo Ortega-Santiago

Sensors 2022, 22(21), 8344; https://doi.org/10.3390/s22218344 - 31 Oct 2022

Cited by 9 | Viewed by 2150

Abstract

Ultrasound imaging (US) is a widely used imaging tool in physiotherapy for assessing muscle morphology and quality, among other purposes, such as ensuring the patients’ safety during invasive procedures or providing visual feedback during motor control exercises. Identifying factors associated with measurement errors is essential to target avoid bias in high-risk of bias populations. Therefore, this study aimed to assess whether demographic, clinical, muscular and histological factors are associated with ultrasound measurement errors in patients with idiopathic chronic neck pain. B-mode images were acquired and analyzed in 126 patients with chronic neck pain by two experienced examiners. Cross-sectional area, muscle perimeter, mean echo intensity and percentage of fatty infiltration were analyzed. The interexaminer agreement was assessed by calculating the absolute error, intraclass correlation coefficient (ICC), standard error of measurement (SEM) and minimal detectable changes (MDC). A Pearson’s correlation matrix including all variables was calculated to conduct a multivariate linear stepwise regression model for estimating the explained variance for each measurement error. Results demonstrated excellent reliability (ICC = 0.965) for assessing the cross-sectional area, and good reliability for assessing the muscle perimeter, mean echo intensity and intramuscular infiltrates estimation (ICC = 0.898, 0.882 and 0.758, respectively). Although clinical variables were not associated with measurement errors (p > 0.05), multiple correlations were found between demographic and cervical multifidus characteristics with measurement errors. Full article

(This article belongs to the Special Issue Advances in Rehabilitative Ultrasound Imaging and Sensing)

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Review

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13 pages, 661 KiB

Open AccessReview

Using Shear-Wave Elastography to Assess Exercise-Induced Muscle Damage: A Review

by Urška Ličen and Žiga Kozinc

Sensors 2022, 22(19), 7574; https://doi.org/10.3390/s22197574 - 6 Oct 2022

Cited by 18 | Viewed by 4614

Abstract

Shear-wave elastography is a method that is increasingly used to assess muscle stiffness in clinical practice and human health research. Recently, shear-wave elastography has been suggested and used to assess exercise-induced muscle damage. This review aimed to summarize the current knowledge of the utility of shear-wave elastography for assessment of muscle damage. In general, the literature supports the shear-wave elastography as a promising method for assessment of muscle damage. Increases in shear modulus are reported immediately and up to several days after eccentric exercise, while studies using shear-wave elastography during and after endurance events are showing mixed results. Moreover, it seems that shear modulus increases are related to the decline in voluntary strength loss. We recommend that shear modulus is measured at multiple muscles within a muscle group and preferably at longer muscle lengths. While further studies are needed to confirm this, the disruption of calcium homeostasis seems to be the primary candidate for the underlying mechanism explaining the increases in shear modulus observed after eccentric exercise. It remains to be investigated how well the changes in shear modulus correlate with directly assessed amount of muscle damage (biopsy). Full article

(This article belongs to the Special Issue Advances in Rehabilitative Ultrasound Imaging and Sensing)

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13 pages, 2073 KiB

Open AccessCase Report

Ultrasound Diagnostic and Physiotherapy Approach for a Patient with Parsonage–Turner Syndrome—A Case Report

by Tomasz Wolny, Katarzyna Glibov, Arkadiusz Granek and Paweł Linek

Sensors 2023, 23(1), 501; https://doi.org/10.3390/s23010501 - 2 Jan 2023

Cited by 4 | Viewed by 4434

Abstract

Parsonage–Turner syndrome (PTS) is a rare neurological disorder that causes major diagnostic problems. This paper presents a case report of a patient with PTS and proposes a new physiotherapy program. Case description: a 23-year-old man presents a sudden severe pain of his right arm. The man is consulted by several doctors and physiotherapists. Three magnetic resonance imagings (MRI), a nerve conduction study (NCS), and needle electromyography (EMG) are performed. After 6 months, based on medical history, physical examination and ultrasound imaging (UI), the physiotherapist suggests PTS, which is confirmed by a neurologist. Intervention: due to the lack of physiotherapy treatment standards in PTS, we apply neurodynamic techniques. Outcomes: neurodynamic techniques are effective in reducing pain and paraesthesia, improving sensation, and reducing nerve swelling (assessed by UI), as well as improving manual dexterity and overall health status. Conclusions: the patient with PTS is challenging for making an accurate diagnosis. This study shows an important role for UI, which shows changes in the musculocutaneous nerve, despite the lack of abnormalities in the MRI, NCS, and EMG, and helps in making an accurate diagnosis. This report also confirms that physiotherapy based on neurodynamic techniques may have beneficial effects in PTS. Full article

(This article belongs to the Special Issue Advances in Rehabilitative Ultrasound Imaging and Sensing)

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12 pages, 4580 KiB

Open AccessSystematic Review

Core Synergies Measured with Ultrasound in Subjects with Chronic Non-Specific Low Back Pain and Healthy Subjects: A Systematic Review

by Maria Cervera-Cano, Luis López-González, David Valcárcel-Linares, Samuel Fernández-Carnero, Alexander Achalandabaso-Ochoa, Verónica Andrés-Sanz and Daniel Pecos-Martín

Sensors 2022, 22(22), 8684; https://doi.org/10.3390/s22228684 - 10 Nov 2022

Cited by 9 | Viewed by 3268

Abstract

Low back pain represents the leading cause of disability since 1990. In 90% of cases, it is classified as non-specific low back pain, being chronic in 10% of subjects. Ultrasound has proven to be an effective measurement tool to observe changes in the activity and morphology of the abdominal muscles. This article reviews which core synergies are studied with ultrasound in healthy subjects and with chronic non-specific low back pain. A systematic review was conducted on studies analyzing synergies between two or more core muscles. Publications from 2005 until July 2021 were identified by performing structured searched in Pubmed/MEDLINE, PEDro and WOS. Fifteen studies were eligible for the final systematic review. A total of 56% of the studies established synergies between the core muscles and 44% between the homo and contralateral sides of the core muscles. The most studied core synergies were transversus abdominis, internal oblique and external oblique followed by the rectus abdominis and the lumbar multifidus. No studies establishing synergies with diaphragm and pelvic floor were found. Eight studies were conducted in healthy subjects, five studies in subjects with chronic non-specific low back pain compared to healthy subjects and two studies in subjects with chronic non-specific low back pain. Full article

(This article belongs to the Special Issue Advances in Rehabilitative Ultrasound Imaging and Sensing)

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