Quantifying musculoskeletal motion using dynamic MRI techniques: A systematic review of validity and perspectives for musculoskeletal disorder evaluation

Abstract

This systematic review reports the evidence of validity and reliability of dynamic MRI (dMRI) techniques in quantifying in vivo skeletal joint movement (kinematics) or muscle tracking and to propose recommendations of use for the assessment of normal and impaired musculoskeletal function. A systematic search was conducted on six bibliographic databases (Web of science, PubMed, Scopus, Academic search Premier, Pascal, and Cochrane Library) for articles published between 1990 and January 2017. Prospective studies that reported the concurrent validity and/or reliability of determining in vivo skeletal joint or muscle motion using dMRI techniques were included after assessment by two independent reviewers for inclusion and exclusion criteria. Selected articles were assessed using an adapted quality assessment tool and a data extraction process. Concurrent validity and reliability measurement results were categorized as poor, moderate, or excellent for this review. Bibliographic search identified 20 articles that met the inclusion and exclusion criteria. The mean quality assessment score for all the selected articles was 66% (±10.4). Concurrent validity and/or reliability of eight dMRI techniques evaluating the musculoskeletal motion were reported. Selected studies spanned various joints and muscles with knee joint being the most evaluated joint (seven studies), followed by ankle and temporomandibular joint (two studies each). Moderate to excellent concurrent validity and reliability were reported for most of the dMRI techniques. Based on the current level of metrological evidence Cine Phase-Contrast and Real-time MRI techniques stand out for determining skeletal joint motion whereas Spin tag MRI technique stands out for determining muscle motion. dMRI techniques can be effectively applied to understand in vivo skeletal joint and muscle movement mechanics for both healthy and pathological populations. However, caution must be exercised as the evidence of validity and reliability of using these techniques in all the skeletal joints and muscles have not been systematically evaluated. Furthermore, clinical utility of the techniques in impaired population is not addressed yet in terms of concurrent validity and reliability measures setting up a good research direction for future studies. Examples of the best available techniques and outcomes for rehabilitation application will be provided during the presentation.