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| ORIGINAL ARTICLE |
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| Year : 2020 | Volume
: 3
| Issue : 1 | Page : 1-4 |
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Musculoskeletal ultrasound publications in rehabilitation journals: A EURO-MUSCULUS/USPRM update
Timur Ekiz1, Ayşe Merve Ata2, Murat Kara3, Eda Gürçay4, Ke-Vin Chang5, Merve Sekizkardeş6, Simão Serrano7, Nikolaos Barotsis8, Alessandro Picelli9, Daniele Coraci10, Kamal Mezian11, Nuray Akkaya12, Tülay Tiftik13, Elem Yorulmaz14, Gülümser Aydın15, Wei-Ting Wu5, Mario Giraldo-Prieto16, Levent Özçakar3, Franco Franchignoni17
1 Department of Physical Medicine and Rehabilitation, Türkmenbasi Medical Center, Adana, Turkey
2 Department of Physical Medicine and Rehabilitation, Dr. AytenBozkaya Spastic Children Hospital and Rehabilitation Center, Bursa, Turkey
3 Department of Physical Medicine and Rehabilitation, Hacettepe University Medical School, Ankara, Turkey
4 Department of Physical Medicine and Rehabilitation, Ankara Gaziler Physical Medicine and Rehabilitation Training and Research Hospital, Ankara, Turkey
5 Department of Physical Medicine and Rehabilitation, National Taiwan University Hospital, Bei-Hu Branch, Taipei, Taiwan
6 Department of Physical Medicine and Rehabilitation, Istanbul Physical and Rehabilitation Medicine Training and Research Hospital, Istanbul, Turkey
7 Department of Physical Medicine and Rehabilitation, Leiria Hospital Center, Leiria, Portugal
8 Department of Physical and Rehabilitation Medicine, Patras University Hospital, Rio, Greece
9 Deparment of Neurosciences, Biomedicine and Movement Sciences, Neuromotor and Cognitive Rehabilitation Research Center, University of Verona, Italy
10 Department of Rehabilitation Medicine, Charles University, First Faculty of Medicine and General University Hospital in Prague, Czech Republic
11 Department of Rehabilitation Medicine, First Faculty of Medicine, Charles University, Prague, Czech Republic
12 Department of Physical Medicine and Rehabilitation, Pamukkale University Medical School, Denizli, Turkey
13 Department of Physical Medicine and Rehabilitation, Ankara Physical Medicine and Rehabilitation Training and Research Hospital, Ankara, Turkey
14 Department of Physical Medicine and Rehabilitation, Haydarpasa Numune Training and Research Hospital, Istanbul, Turkey
15 Department of Physical Medicine and Rehabilitation, Yildirim Beyazit University Medical School, Ankara, Turkey
16 Department of Physical Medicine and Rehabilitation, Health Rehabilitation Research Group, University of Antioquia, Medellin, Colombia
17 Department of Physical and Rehabilitation Medicine, Istituti Clinici Scientifici Maugeri IRCCS, Lissone (Monza and Brianza) Institute, Italy
| Date of Submission | 02-Aug-2019 |
| Date of Decision | 05-Jan-2020 |
| Date of Acceptance | 13-Jan-2020 |
| Date of Web Publication | 17-Feb-2020 |
Correspondence Address:
Dr. Timur Ekiz
Türkmenbasi Bulvari Botanik Evleri Osmanbey Apt. C Blok NO: 3/B, 01130 Seyhan, Adana
Turkey
 Source of Support: None, Conflict of Interest: None  | Check |
DOI: 10.4103/jisprm.jisprm_1_20
Background: The utility of musculoskeletal ultrasound (US), both in the clinical settings and scientific arena, has significantly increased in recent years. Aims: The aim of this study was to report and analyze the publications on musculoskeletal US in top rehabilitation journals (indexed by the 'Rehabilitation' category of Journal Citation Reports (JCR), Clarivate Analytics). Methods: The search was carried out up to July 2018 through Web of Science (Science Citation Index-Expanded). The literature search comprised all 65 journals listed in the 2017 category “Rehabilitation” according to the JCR. Results: A total of 971 papers published in 39 different journals from 1989 to 2018 were analyzed. The top three publishing countries (in decreasing order) appeared as the United States of America (USA), Turkey and Taiwan. The American Journal of Physical Medicine and Rehabilitation, PM&R and the Archives of Physical Medicine and Rehabilitation were the top three journals (in decreasing order) publishing about topics on musculoskeletal US. The most commonly studied diseases in humans were musculoskeletal conditions, followed by neurological disorders. Physiatrists and PRM departments (46.9%) prevail as far as publishing specialties were concerned. Although the use of interventional US seems to have increased after 2000, diagnostic US is still ranked the first, when the purpose of the conducted study is taken into consideration. Conclusion: Accordingly, we believe that this scientific output might help to raise awareness as regards the potential role of US in Physical and Rehabilitation Medicine.
Keywords: EURO-MUSCULUS, physical and rehabilitation medicine, publishing, ultrasonography, USPRM
How to cite this article:
Ekiz T, Ata AM, Kara M, Gürçay E, Chang KV, Sekizkardeş M, Serrano S, Barotsis N, Picelli A, Coraci D, Mezian K, Akkaya N, Tiftik T, Yorulmaz E, Aydın G, Wu WT, Giraldo-Prieto M, Özçakar L, Franchignoni F. Musculoskeletal ultrasound publications in rehabilitation journals: A EURO-MUSCULUS/USPRM update. J Int Soc Phys Rehabil Med 2020;3:1-4 |
How to cite this URL:
Ekiz T, Ata AM, Kara M, Gürçay E, Chang KV, Sekizkardeş M, Serrano S, Barotsis N, Picelli A, Coraci D, Mezian K, Akkaya N, Tiftik T, Yorulmaz E, Aydın G, Wu WT, Giraldo-Prieto M, Özçakar L, Franchignoni F. Musculoskeletal ultrasound publications in rehabilitation journals: A EURO-MUSCULUS/USPRM update. J Int Soc Phys Rehabil Med [serial online] 2020 [cited 2022 Aug 10];3:1-4. Available from: https://www.jisprm.org/text.asp?2020/3/1/1/278569 |
#Timur Ekiz and Ayşe Merve Ata Equally Contributed as First Authors.
##Levent Özçakar and Franco Franchignoni equally contributed as senior authors.
| Introduction | |  |
The utility of musculoskeletal ultrasound (US), both in the clinical settings and scientific arena, has significantly increased in recent years. This should actually not be considered unexpected as the technique is inexpensive, easily accessible, noninvasive, portable, accurate, fast, and repeatable; it has high spatial resolution and lacks ionizing radiation.[1] Looking from the scholarly publishing side of the story, with its use, physicians started to assess/quantify extra parameters and thus reached new data to report/discuss in their daily medical practice. As such, we believe that update of previous reports[2],[3] in terms of objective analysis on the scientific output might help raise awareness as regards the potential role of US in physical and rehabilitation medicine (PRM). In this aspect, we aim to report and analyze the publications on musculoskeletal US in top rehabilitation journals (indexed by the “Rehabilitation” category of Journal Citation Reports (JCR) and Clarivate Analytics). The current study is an ancillary study – dedicated to rehabilitation journals indexed in JCR only – of the larger research we are performing, to analyze the publications on musculoskeletal US publications globally, i.e., among different specialties, countries, topics, etc.[4]
| Methods | | |
The search was carried out up to July 2018 through Web of Science (Science Citation Index Expanded). The literature search comprised all 65 journals listed in the 2017 category “Rehabilitation” according to the JCR,[5] except Annals of Physical and Rehabilitation Medicine, that was included (in a high position) in the list of journals indexed by JCR just immediately later (October 2018).
All clinical studies, reviews, basic science articles (including human, animal, laboratory, and cadaveric studies), case reports, technical notes, letters, editorials, and comments were included. Irrelevant articles (e.g., those including therapeutic US or quantitative calcaneal US) were excluded. Two reviewers (MK and EG) independently selected and classified the articles by reading title and abstract; disagreement between them was solved by the third author (LÖ).
All papers were analyzed according to their titles and abstracts, and the following data were recorded: year of publication, journal, study design, sample size, type (e.g., patient vs. healthy subject vs. cadaver/phantom) and anatomical region of the study, health condition, and major purpose of US imaging (diagnostic, interventional, educational, economical, or other). Moreover, specialty, department, institution, and country of origin were defined using the affiliation provided by the first author (if not available, as specified by the corresponding author). Finally, level of evidence was assessed using the evidence levels of the Oxford Centre for Evidence-Based Medicine and the related chart adaptation.[6],[7]
| Results | | |
A total of 971 papers published in 39 different journals from 1989 to 2018 were analyzed. Publication types and related level of evidence of the studies are shown in [Table 1]. The list of the countries according to the number of published articles is given in [Table 2]. The top three countries (in decreasing order) appeared as the United States of America (USA), Turkey, and Taiwan. The distribution of the papers in terms of the journals and sample groups is given in [Table 3]. The American Journal of Physical Medicine and Rehabilitation, PM and R, and the Archives of Physical Medicine and Rehabilitation were the top three journals (in decreasing order). Overall, 644 studies assessed and/or treated patients. [Table 4] summarizes the most commonly studied diseases in humans, whereby musculoskeletal conditions ranked first, followed by neurological disorders. Physiatrists and PRM departments (46.9%) prevail as far as publishing specialties were concerned [Table 5]. Although the use of interventional US seems to have increased after 2000, diagnostic US is still ranked first, when the purpose of the conducted study is taken into consideration [Table 6]. | Table 1: Publication type and level of evidence of the analyzed papers (n=971)
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 | Table 2: Top 20 countries according to the number of musculoskeletal ultrasound papers published in the selected rehabilitation journals
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 | Table 3: Top 20 journals indexed in Journal Citation Report category “Rehabilitation” publishing musculoskeletal ultrasound papers and percentage of the study types in each journal
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 | Table 5: Distribution of the papers according to the department of the first/corresponding author
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 | Table 6: Numbers (percentages) of paper categories according to time periods
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| Discussion | | |
This update on articles published in PRM journals draws attention to various changes. The total number of US publications has highly increased after 2000. Although level IV–V studies constituted the greatest percentage of publications (72%), level I studies (meta-analysis and controlled studies) started to have a considerably increasing ratio (8%) when compared with the previous report.[2] The USA, Turkey, and Taiwan remained the first three countries with the greatest number of publications in this field,[2] while each of the remaining countries represented <10% of publications on rehabilitation journals; herewith, new countries (e.g., United Kingdom and Italy) have entered the list. This situation can probably be attributed to the increased awareness as well as availability of US in PRM departments, in a growing amount of countries (whose number needs to be increased still further). Indeed, the overall finding is relevant when considering the need to allocate educational resources for musculoskeletal US in countries/regions with relatively low or without any significant presence in [Table 2].
The American Journal of Physical Medicine and Rehabilitation, PM and R, and the Archives of Physical Medicine and Rehabilitation were the top three journals publishing about topics on musculoskeletal US. Of note, one can easily notice that many of the cover images of the first journal contain US figures during the recent years. Another important fact that needs to be highlighted is related to the study samples. Overall, the relevant percentages of studies on patients were relatively higher in some journals linked with PRM societies (e.g., the American Journal of Physical Medicine and Rehabilitation and Journal of Rehabilitation Medicine) as compared with the average in the remaining journals.
About half of the musculoskeletal US studies found in rehabilitation journals seem to be published by PRM departments, followed by those of physical therapy and sports medicine. Moreover, several other departments such as orthopedics, health sciences, radiology, bioengineering, neurology, kinesiology, and rheumatology have also published on the same topic in PMR journals. Musculoskeletal conditions had been more commonly studied than neurological disorders. While most of the researches were on diagnostic US at all time periods, the number of studies on interventional US appeared to gain momentum after 2000.
| Conclusion | | |
To summarize, awareness as regards the utility of US is ever-increasing in musculoskeletal medicine. Each day, many other physicians/clinics cross the barriers (i.e., lack of device and lack of education)[8] and join the team where US is already accepted as an “examination” not a simple imaging modality. Yet, it is the 6th finger, stethoscope, or the extended hand of physiatrists.[9],[10] In this process, the support of the national and international scientific societies, such as ISPRM, is crucial. For sure, the “win-win” process is mounted by the increased number of scientific events and materials, such as congresses, symposia, seminars, meetings, workshops, and books, organized or edited not only by physiatrists[9],[10] but also by other physicians and health-care professionals worldwide. Last but not least, after having released several recommendation papers and guides on various US topics,[1],[11],[12] the working groups (i.e., EURO-MUSCULUS: European Musculoskeletal Ultrasonography Society Group; and USPRM: The US Task Force of ISPRM, the International Society of Physical and Rehabilitation Medicine) are launching the standardized curriculum and accreditation/certification in our specialty shortly.
Financial support and sponsorship
Nil.
Conflicts of interest
There are no conflicts of interest.
| References | | |
| 1. | Özçakar L, Kara M, Chang KV, Çarl AB, Akkaya N, Tok F, et al. Nineteen reasons why physiatrists should do musculoskeletal ultrasound: EURO-MUSCULUS/USPRM recommendations. Am J Phys Med Rehabil 2015;94:e45-9.  |
| 2. | Ulaşli AM, Kara M, Özçakar L. Publications of physical and rehabilitation medicine physicians concerning musculoskeletal ultrasonography: An overview. J Rehabil Med 2011;43:681-3. |
| 3. | Akkaya N, Ulaşlı AM, Özçakar L. Use of musculoskeletal ultrasound in clinical studies in physiatry: The “stethoscope” is also becoming the “pen”. J Rehabil Med 2013;45:701-2. |
| 4. | Kara M, Gürçay E, Ekiz T, Sekizkardeş M, Yorulmaz E, Ata AM, et al. EURO-MUSCULUS/USPRM global report on musculoskeletal ultrasound publications. Am J Phys Med Rehabil 2019;[In Press] |
| 5. | |
| 6. | OCEBM Levels of Evidence Working Group. The Oxford Levels of Evidence 2. Oxford, UK: Oxford Centre for Evidence-based Medicine; 2019. Available from: https://www.cebm.net/index.aspx?o=5653. [Last accessed on 2019 Jul 11]. |
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| 8. | Ozçakar L, Tok F, Kesikburun S, Palamar D, Erden G, Ulaşli A, et al. Musculoskeletal sonography in physical and rehabilitation medicine: Results of the first worldwide survey study. Arch Phys Med Rehabil 2010;91:326-31. |
| 9. | Özçakar L, De Muynck M, editors. Musculoskeletal Ultrasound in Physical and Rehabilitation Medicine. Milano: Edi-Ermes; 2014. |
| 10. | Özçakar L, editor. Sonographic Atlas for Common Musculoskeletal Pathologies. Milano: Edi-Ermes; 2017. |
| 11. | Özçakar L, Kara M, Wang TG, De Muynck M. EURO-MUSCULUS/USPRM basic scanning protocols: A practical guide for physiatrists. Eur J Phys Rehabil Med 2015;51:477-8. |
| 12. | Kara M, Kaymak B, Ulaşli AM, Tok F, Öztürk GT, Chang KV, et al. Sonographic guide for botulinum toxin injections of the upper limb: EUROMUSCULUS/USPRM spasticity approach. Eur J Phys Rehabil Med 2018;54:469-85. |
[Table 1], [Table 2], [Table 3], [Table 4], [Table 5], [Table 6]
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