Use of thoracic ultrasound by physiotherapists: a scoping review of the literature

Abstract

Background
Use of diagnostic thoracic ultrasound (TUS) in medical professions to examine the pleura, lung parenchyma and diaphragm is gaining in popularity, however the ways in which physiotherapists are using TUS is unclear.
Objective
The aim of this scoping review is to gain an understanding of the emerging evidence base surrounding physiotherapy use of TUS to inform research and clinical practice.
Data Sources
A systematic search was conducted of the following databases: Cochrane, EPPI centre, PROSPERO, Medline, CINAHL, AMED, EMBASE, HMIC, and BNI.
Study Selection
Inclusion criteria: primary research reporting the use of diagnostic TUS; a physiotherapist as part of the study design or as the chief investigator; published in English.
Synthesis Methods
Data regarding demographics, design, type of conditions and anatomical structures investigated and profession leading the TUS of included papers were compiled in a tabular format.
Results

Of the 26 included papers, 9 studied healthy participants, 4 studied COPD and 4 studied critical care patients. Most papers (n=23) involved scanning the diaphragm. In 8 studies the physiotherapist operated the TUS.
Limitations
The paper selection process was performed by one author; with no cross-checking by another individual.

Conclusion
Use of TUS by physiotherapists is an emerging area in both diaphragm and lung diagnostics. A wide range of patient populations may benefit from physiotherapists using TUS. Papers in this review are heterogeneous making any generalisability difficult but does show its potential for varied uses. TUS is an innovative skill in the hands of physiotherapists, but more research is needed.

Funding: National Institute of Health Research (NIHR): Internship programme – no involvement

Contribution of the paper:
 Thoracic ultrasound is gaining popularity amongst physiotherapists.
 The diaphragm is the most investigated structure by physiotherapists.
 Physiotherapists use thoracic ultrasound on a broad range of pathologies and patient populations.