Muscular Atrophy in the Hemiplegic Thigh in Patients After Stroke

Metoki, Norifumi; Satō, Yoshihiro; Satoh, Kei; Okumura, Ken; Iwamoto, Jun

doi:10.1097/01.phm.0000091988.20916.ef

Cited by 60 publications

(53 citation statements)

References 15 publications

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“…At 1 month post stroke, no change in lean muscle mass was found in the paretic leg or arm with DEXA imaging, 28 but by 2-4 months a decrease in lean muscle mass was evident in the paretic leg and arm muscles with both DEXA and CT imaging. 28,29,34 In the chronic phase (>6 months after stroke), a decrease in lean muscle mass on the paretic side relative to the non-paretic side was found with both DEXA and CT imaging, 27,31,33,35 meaning that many people with stroke are living with long-term effects of decreased muscle mass in the paretic muscles. A decrease in lean muscle mass with an increase in non-contractile tissue, including fat mass, is common with ageing.…”

Section: Muscle Sizementioning

confidence: 99%

“…27,29,31,[33][34][35] The studies reviewed found that the change in pennation angle differed for the muscles of the upper and lower extremities, increasing in the former and decreasing in the latter. [39][40][41] Only three studies were identified that examined changes in pennation angle, which makes it difficult to draw conclusions as to whether the differences in pennation angle are related to the function of the muscles (differences in patterns of use between gastrocnemius in the leg and brachialis in the arm) or to their structural composition.…”

Section: Architectural Changes In Muscle After Strokementioning

confidence: 99%

“…26 Two types of imaging are used to estimate muscle mass; five of the studies we reviewed used dual-energy X-ray absorptiometry (DEXA), 27-31 three used computed tomography (CT), [32][33][34] and one study used both methods 35 (see Table 1). DEXA provides a measure of appendicular lean soft tissue based on an algorithm that uses bone mineral density and soft tissue mass to calculate lean mass.…”

Section: Muscle Sizementioning

confidence: 99%

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Factors That Influence Muscle Weakness Following Stroke and Their Clinical Implications: A Critical Review

Gray¹,

Rice

Garland

2012

Physiotherapy Canada

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Purpose : To provide a comprehensive review of changes that occur in the muscle after stroke and how these changes influence the force-generating capacity of the muscle. Methods: A literature search of PubMed, CINAHL, MEDLINE, and Embase was conducted using the search terms stroke, hemiparesis, muscle structure, cross sectional area, atrophy, force, velocity, and torque. There were 27 articles included in this review. Results: Three changes occur in the muscle after stroke: a decrease in muscle mass, a decrease in fibre length, and a smaller pennation angle. In addition, the tendon is stretched and becomes more compliant. All of these factors reduce the affected muscle's ability to generate forces similar to controls or to non-paretic muscles. The result is a leftward shift in the length-tension curve, a downward shift in the torque-angle curve, and a downward shift in the force-velocity curve. Conclusion: Changes in muscle architecture contributing to weakness, such as muscle-fibre length, pennation angle, muscle atrophy, and tendon compliance, should be prevented or reversed by means of an appropriate rehabilitation programme.

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Section: Muscle Sizementioning

confidence: 99%

Section: Architectural Changes In Muscle After Strokementioning

confidence: 99%

Section: Muscle Sizementioning

confidence: 99%

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Factors That Influence Muscle Weakness Following Stroke and Their Clinical Implications: A Critical Review

Gray¹,

Rice

Garland

2012

Physiotherapy Canada

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“…[34][35][36] Musculoskeletal dysfunction is relatively common in patients with chronic conditions such as chronic obstructive pulmonary disease, 37,38 chronic heart failure, 39,40 and stroke. 41,42 This decline in muscle function reduces functional mobility and physical capacity, which, in turn, can result in a limited ability to maintain muscle activity and decreased levels of protein synthesis. [43][44][45][46] However, the exact aetiology of this deterioration is not yet clear.…”

Section: Introductionmentioning

confidence: 99%

Eccentric Exercise in Patients with Chronic Health Conditions: A Systematic Review

Roig

Shadgan

Reid³

2008

Physiotherapy Canada

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Purpose: The capacity of eccentric actions to produce muscle hypertrophy, strength gains, and neural adaptations without stressing the cardiopulmonary system has led to the prescription of eccentric training programmes in patients with low tolerance to exercise, such as elders or those with chronic health conditions. The purpose of this systematic review was to analyze the evidence regarding the effectiveness and suitability of eccentric training to restore musculoskeletal function in patients with chronic diseases. Summary of Key Points: Relevant articles were identified from nine databases and from the reference lists of key articles. Articles were assessed to determine level of evidence and scientific rigour. Nine studies met the inclusion criteria. According to Sackett's levels of evidence, 7 studies were graded at level IIb, 1 study at level IV, and the remaining study at level V. Articles were also graded for scientific rigour according to the PEDro scale. One study was rated as high quality, 4 studies were rated as moderate, and 2 studies were graded as poor quality. Conclusions: Eccentric training may be safely used to restore musculoskeletal function in patients with some specific chronic conditions. However, the heterogeneity of diseases makes it very difficult to extrapolate results and to standardize clinical recommendations for adequate implementation of this type of exercise. More studies are needed to establish the potential advantages of eccentric training in chronic conditions. Key Words: atrophy, chronic disease, eccentric training, muscle dysfunction RÉ SUMÉObjectif: La capacité des actions excentriques de produire l'hypertrophie musculaire, une masse osseuse accrue et des adaptations neurales sans exercer de fatigue sur le systè me cardiopulmonaire a mené à la prescription de programmes d'entraînement excentrique chez les patients ayant une tolé rance faible à l'exercice, comme les aîné s ou ceux qui sont atteints d'é tats de santé chroniques. Cette é tude mé thodique a pour but d'analyser les preuves scientifiques concernant l'efficacité et la pertinence de l'entraînement excentrique dans le ré tablissement de la fonction musculosquelettique chez les patients atteints de maladies chroniques. Re´sume´des points cle´s: Des articles pertinents ont é té identifié s à partir de 11 bases de donné es et listes de ré fé rence d'articles clé s. Les articles ont é té é valué s afin de dé terminer le niveau de preuves scientifiques et la rigueur scientifique. Neuf é tudes ont satisfait aux critè res d'inclusion. Selon les niveaux de preuve de Sackett, sept é tudes ont é té classé es au niveau IIb, une é tude au niveau IV et la derniè re é tude au niveau V. Des articles ont aussi é té classé s pour leur rigueur scientifique selon l'é chelle PEDro. Une é tude a é té classé e comme é tant de haute qualité , quatre é tudes comme é tant de qualité moyenne et deux é tudes ont é té classé es comme é tant de qualité mé diocre. Conclusions: L'entraînement excentrique peut ê tre utilisé en toute sé curi...

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“…The structural properties of chronic stroke patients' skeletal muscles of the paretic side change as a result of a reduction in muscle volume, the shortening of muscle fibers, and a decrease in the activity unit number on the affected side 2,17) . These changes are associated with muscle weakness, spasticity, contracture, and atrophy on the paretic side 3) .…”

Section: Discussionmentioning

confidence: 99%

Analysis of Ultrasonographic Architectural Properties of Muscles of Chronic Stroke Patients during Different Muscle Activities

Kim

Bae²,

Kim

et al. 2012

J Phys Ther Sci

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Abstract.[Purpose] The purpose of this study was to analyze the architectural properties of muscles on ultrasonographic images of chronic stroke patients taken during different muscle activities.[Methods] Thirty chronic stroke patients were equally divided into three groups according to their Modified Ashworth Scale grade (1 to 3). Ultrasonographic equipment was used to measure structural properties of their skeletal muscles (muscle thickness, muscle pennation angle, and length of muscle fascicles).[Results] Muscle thickness, pennation angle, and fascicle length significantly decreased both at rest and during MVIC (Maximum Voluntary Isometric Contraction) as muscle spasticity increased. Each group's muscle pennation angle markedly increased during MVIC compared to at rest. Each group's muscle thickness and fascicle length decreased during MVIC compared to at rest. [Conclusion] Changes in structural properties of the skeletal muscles influenced architectural properties of the muscles on ultrasonographic images. Our results indicate that understanding the structural properties of the skeletal muscles of chronic stroke patients needs to take into consideration the ultrasonographic architectural properties of the muscles.

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Muscular Atrophy in the Hemiplegic Thigh in Patients After Stroke

Abstract: Muscle volume decreases in the hemiplegic side in stroke patients.

Cited by 60 publications

References 15 publications

Factors That Influence Muscle Weakness Following Stroke and Their Clinical Implications: A Critical Review

Factors That Influence Muscle Weakness Following Stroke and Their Clinical Implications: A Critical Review

Eccentric Exercise in Patients with Chronic Health Conditions: A Systematic Review

Analysis of Ultrasonographic Architectural Properties of Muscles of Chronic Stroke Patients during Different Muscle Activities

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