Therapeutic ultrasound and fracture healing: A survey of beliefs and practices
Therapeutic ultrasound and fracture healing: A survey of beliefs and practices
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DOI：
10.1016/j.apmr.2003.12.040
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发表时间：
2004-10-01
影响因子：
4.3
通讯作者：
Bhandari, M
中科院分区：
文献类型：
--
作者：
Busse, JW;Bhandari, M
设计：横断面调查。背景：大学。参与者：骨科医生、骨科高级住院医师和最后6个月的物理治疗师。干预措施：不适用。主要观察指标：受访者对(1)治疗性超声波在骨折愈合中的作用，(2)治疗性超声波在骨折愈合中的临床应用，(3)不使用治疗性超声波的理由，以及(4)骨折愈合时间的临床显著差异的具体看法的百分比。结果：22名骨科医生应答率为20人(90.9%)，5名资深骨科住院医师应答率为5人(100%)，50名PT高年级学生应答率为34人(68.0%)。大多数接受调查的PT高年级学生(58.8%)和骨科住院医生和外科医生(60.0%)报告说，在某些情况下，治疗性超声波可能有助于骨折愈合。然而，大多数受访者没有使用这种模式(60.0%的外科医生，88.2%的高级PT学生)，大多数外科医生(32.0%)表示缺乏证据，大多数高级PT学生(58.8%)表示缺乏可用性是主要障碍。32%的外科医生认为超声波是禁忌，不利于骨折愈合，或认为超声毫无用处，20.5%的PT学生认为超声波是禁忌，对骨折愈合有害或可能有害。大多数骨科住院医生和外科医生(52.0%)报告说，与高年级PT学生相比，缩短4周的骨折愈合时间具有临床意义，大多数人(64.7%)表示缩短2周将具有临床意义。结论：一些外科医生和PT学生认为治疗性超声波是禁忌，不利于骨愈合；但大多数人认为治疗性超声波至少在某些情况下有助于骨折愈合。目前这种方式的使用很少，主要是因为人们认为缺乏证据和缺乏可获得性。需要大型随机试验来进一步确定超声波在骨折愈合中的作用。(C)2004年，由美国康复医学大会和美国物理医学和康复学会提供。
Objective: To explore current beliefs among senior physiotherapy (PT) students and orthopedic surgeons on the clinical utility of therapeutic ultrasound for assisting fracture healing.Design: Cross-sectional survey.Setting: University.Participants: Orthopedic surgeons, senior orthopedic surgery residents, and PT students in their final 6 months of study.Interventions: Not applicable.Main Outcome Measures: Percentage of respondents reporting specific perceptions on (1) the role of therapeutic ultrasound in fracture healing, (2) clinical use of therapeutic ultrasound for fracture healing, (3) rationale for not using therapeutic ultrasound for healing fractures, and (4) what constitutes a clinically significant difference in fracture healing time. Between-group comparisons were conducted for survey responses.Results: The response rate was 20 of 22 (90.9%) orthopedic surgeons, 5 of 5 (100%) senior orthopedic residents, and 34 of 50 (68.0%) senior PT students. The majority of senior PT students (58.8%) and orthopedic residents and surgeons (60.0%) surveyed reported the belief that therapeutic ultrasound may help in assisting fracture healing in some cases. However, the majority of respondents do not use this modality (60.0% of surgeons, 88.2% of Senior PT students), with most surgeons (32.0%) citing lack of evidence and most senior PT students (58.8%) indicating lack of availability as the predominant barrier. Thirty-two percent of surgeons felt that ultrasound was contraindicated and harmful to healing fractures, or that it was of no use, and 20.5% of PT students reported the belief that ultrasound was contraindicated and was, or may be, harmful to healing bone. Most orthopedic residents and surgeons (52.0%) reported that a reduction in fracture healing time of 4 weeks would be clinically significant versus senior PT students, the majority of whom (64.7%) indicated that a reduction of 2 weeks would be clinically significant.Conclusions: Some surgeons and PT students believed that therapeutic ultrasound is contraindicated and harmful to healing bone; however, most believed that therapeutic ultrasound may help in assisting fracture healing, in at least some cases. Current usage of this modality is rare, primarily due to the perceived lack of evidence and lack of availability. Large randomized trials are needed to define further the role of ultrasound in fracture healing. (C) 2004 by the American Congress of Rehabilitation Medicine and the American Academy of Physical Medicine and Rehabilitation.