ABOUT REAL TIME ULTRASOUND

• Overview
• Background information
• What is ultrasound imaging?
• Scope of practice issues

OVERVIEW

Ultrasound imaging is a radiological tool that has been in widespread use since the 1950's. Traditional applications in the musculoskeletal and gynecological realm are concerned with identification of tissue characteristics and structural integrity. However as the technology has been embraced as a safe, portable, objective and relatively inexpensive means of examination the ingenuity and diversity of applications has exploded.

Ultrasound imaging related to musculoskeletal rehabilitation has been ongoing since the 1980's. The technology is used both in clinical and research capacities and current physiotherapy applications include assessment of muscle morphology (size, length, girth, cross sectional area, volume), architectural changes in muscles and associated structures (fascia, organs such as the bladder) with muscle activation, integrity of fascia, and motion of neurological tissue. Clinically ultrasound imaging has been embraced in response to recent research which reveals that the primary impairment of the muscular system in individuals with low back pain is not one of strength or functional capacity but rather one of motor control of the deep muscles of the trunk. These deep muscles include the transversus abdominis, the deep segmental fibers of lumbar multifidus, the pelvic floor, and the diaphragm. The use of ultrasound imaging to observe the real-time contraction of muscles is a valuable tool, as they are deep and not readily observable.

RTUS is a powerful tool as its dynamic, real-time nature allows a physiotherapists to gather valuable information about the status of the myofascial system, provide unparalleled visual feedback to their clients and monitor the effectiveness of their treatment more objectively. Furthermore, it serves to refine the accuracy of a clinician's palpatory and observational skills in detecting subtle contractions in muscles that are deep and difficult to directly access.

Lumbar Dysfunction