Reliability of Ultrasound Muscle Assessment in People With Critical Illness Performed by Occupational Therapy...

The use of ultrasound as an assessment tool by occupational therapists in the context of intensive care can support the clinical reasoning in identifying the impacts of musculoskeletal alterations on the ability to perform activities of daily living and other meaningful occupations. However, ultrasonography is not part of the core curriculum in occupational therapy education, and the knowledge and technical requirements necessary for its use by these professionals remain unclear. Therefore, the aim of this study was to analyze the intraexaminer and interexaminer reliability of ultrasound muscle assessment among occupational therapy students and occupational therapists after the completion of a standardized training program. Data collection included 8 h of examiner training and image acquisition. Three examiners were trained by an occupational therapist experienced in muscle assessment using ultrasound, including two occupational therapy undergraduate students and one occupational therapist. Each examiner performed two assessments of each muscle group, without knowing the results of their own evaluations or those of the other examiners. Participants were recruited by convenience, including adults and older people who were admitted to the intensive care unit. The sample size of this study was seven participants. For descriptive analyses, categorical variables were expressed in absolute and relative frequency. Continuous variables were presented as median and interquartile range or as mean and standard deviation. For the interobserver and intraobserver reliability analyses, the values of the intraclass correlation coefficient were performed. A total of 280 US images were analyzed. In regards to inter-examiner reliability, excellent results were found for all muscle groups (ICC: 0.785-0.986). For the intraexaminer reliability, excellent results were found in the majority of analyzes performed (ICC: 0.779-0.997), with two exceptions. Occupational therapy students and occupational therapists demonstrated excellent reliability in the ultrasound assessment of muscle thickness. These findings may support the clinical reasoning of occupational therapists to improve outcomes in occupational performance and participation of critically ill survivors.