Wednesday, August 8, 2007

A new tool in physical therapy research (and for some, PT practice) is Real Time Ultrasound Imaging (RTUSI). It has the potential to provide precise and specific feedback regarding neuromuscular control of abdominal and pelvic muscles.

As a nice article by Jackie Whittaker BSc PT, FCAMT, CGIMS, CAFCI describes the potential benefits and pitfalls that come with this new tool. Obviously, US imaging in not currently included in PT education. This can be a hurdle in scope of practice fights. Whittaker states that:

In the current environment of evidence-based practice and fiscal accountability, it is imperative that physical therapists be allowed access to the tools that will optimize the effectiveness of their interventions.
A major practical hurdle I see is reimbursement. In the US, insurance companies such as UHC are already trying to "control costs" (not to normalize costs to enrollees but to optimize profits to share holders, but that's a whole other story) by basically not paying for PT. This is done by high copays, deductibles, and arbitrary visit limits. In this world, it would be hard to convince many PT's to invest in an US imaging system, attain the education to use it, take the extra time in clinic to use it, and still get paid about $60 for a visit.

I do think Real Time US Imaging has a high potential for clinic use. We'll see how the research and willingness of payors dictates RTUSI's evolution.

Lastly, this months Journal of Orthopedic and Sports Physical Therapy is mostly devouted to RTUSI. I haven't read all the article yet, but for many of us, it will be a step in the direction of clarifying how and why RTUSI should be used in our clinic.


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