Quantitative Analysis of Intrinsic Muscle Stiffness in Biceps Brachii of Post-stroke Patients

Galvão, Silvana; Xerez, Denise Rodrigues; Lima, Renato de; Pino, Alexandre Visintainer; Oliveira, Líliam Fernandes de; Menegaldo, Luciano Luporini

doi:10.1007/978-981-13-2119-1_53

Cited by 3 publications

(2 citation statements)

References 12 publications

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“…Akagi et al (2015) measured a significant increase in stiffness in all regions of the triceps before and after resistance exercise by SWE, and the stiffness varied in different regions. Galvão et al (2022) found that the elasticity index and strain ratio of spastic muscles were significantly higher in stroke patients than in control subjects. Increased muscle tone in PD patients is one of the main symptoms.…”

Section: Discussionmentioning

confidence: 90%

The value of ultrasound measurement of muscle thickness at different sites and shear wave elastography in Parkinson’s disease with sarcopenia: a pilot study

Chen,

Liu,

Liu

et al. 2023

Front. Neurosci.

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BackgroundPatients with Parkinson’s disease (PD) and sarcopenia often exhibit resilience, frailty, disability, and depression, highlighting the complex and interrelated nature of these conditions.ObjectiveDespite the presence of clinical manifestations of muscle atrophy in both PD and sarcopenia, accurately discerning the coexistence of sarcopenia in PD patients remains a challenging task with significant implications for treatment strategies and prognostic assessments. This study aims to elucidate the specific ultrasonic diagnostic parameters associated with PD accompanied by sarcopenia through a comparative analysis of muscle ultrasound parameters in patients with PD, thereby presenting a novel approach for rapid identification of this condition.MethodsA total of 110 participants were enrolled in this study, including patients with PD and control subjects. Demographic data, clinical characteristics, physical performance tests, appendicular skeletal muscle mass index (ASMI), bioelectrical impedance analysis and muscle ultrasound measurements were collected from all participants. The muscle ultrasound measurements encompassed assessments of muscle thickness, pennation angle and shear wave elastography at various anatomical sites.ResultsParkinson’s disease patients exhibited decreased muscle strength and physical performance, and increased shear wave elastography value. In PD patients with sarcopenia, body circumference, including calf circumference, mid-arm circumference, Waist-to-Hip Ratio and body mass index (BMI) were all significantly decreased. Biceps brachii muscle thickness (MT) and gastrocnemius MT decreased in PD patients with sarcopenia and low ASMI. Binary logistic regression analysis revealed that male PD patients, BMI and gastrocnemius MT were predictive factors for ASMI in PD patients.ConclusionBiceps brachii MT and gastrocnemius MT are important indicators for distinguishing whether PD patients have sarcopenia. Male patients, low BMI and gastrocnemius MT were identified as valid predictors of low ASMI in PD patients. The findings of this study provide important insights into the use of muscle ultrasound in the diagnosis of PD with sarcopenia.

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Section: Discussionmentioning

confidence: 90%

The value of ultrasound measurement of muscle thickness at different sites and shear wave elastography in Parkinson’s disease with sarcopenia: a pilot study

Chen,

Liu,

Liu

et al. 2023

Front. Neurosci.

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“…Studies by Chung et al, Rydahl et al, and Galvão et al ( 9 , 47 , 48 ) observed that stroke survivors exhibited higher passive stiffness, which was potentially attributed to connective tissue changes and collagen accumulation leading to fibrosis within the hypertonic muscle. Our stiffness analysis also exhibited a higher passive stiffness in the elbow flexors among all our participants.…”

Section: Discussionmentioning

confidence: 97%

Effect of Stretching of Spastic Elbow Under Intelligent Control in Chronic Stroke Survivors—A Pilot Study

et al. 2021

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Objective: To assess the short-term effects of strenuous dynamic stretching of the elbow joint using an intelligent stretching device in chronic spastic stroke survivors.Methods: The intelligent stretching device was utilized to provide a single session of intensive stretching to the spastic elbow joint in the sagittal plane (i.e., elbow flexion and extension). The stretching was provided to the extreme range, safely, with control of the stretching velocity and torque to increase the joint range of motion (ROM) and reduce spasticity and joint stiffness. Eight chronic stroke survivors (age: 52.6 ± 8.2 years, post-stroke duration: 9.5 ± 3.6 years) completed a single 40-min stretching intervention session. Elbow passive and active ROM, strength, passive stiffness (quantifying the non-reflex component of spasticity), and instrumented tendon reflex test of the biceps tendon (quantifying the reflex component of the spasticity) were measured before and after stretching.Results: After stretching, there was a significant increase in passive ROM of elbow flexion (p = 0.021, r = 0.59) and extension (p = 0.026, r = 0.59). Also, elbow active ROM and the spastic elbow flexors showed a trend of increase in their strength.Conclusion: The intelligent stretching had a short-term positive influence on the passive movement ROM. Hence, intelligent stretching can potentially be used to repeatedly and regularly stretch spastic elbow joints, which subsequently helps to reduce upper limb impairments post-stroke.

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Ultrasound elastography in the assessment of post-stroke muscle stiffness: a systematic review

2022

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Background Post-stroke muscle stiffness is a major challenge in the rehabilitation of stroke survivors, with no gold standard in clinical assessment. Muscle stiffness is typically evaluated by the Modified Ashworth Scale or the Tardieu Scale; however, these can have low reliability and sensitivity. Ultrasound elastography is an advanced imaging technology that can quantitatively measure the stiffness of a tissue and has been shown to have good construct validity when compared to clinically assessed muscle stiffness and functional motor recovery. Objective The purpose of this article is to systematically review the literature regarding the change in muscle stiffness as measured by ultrasound elastography in stroke survivors. Methods Scopus, PubMed, Embase, CINAHL, MEDLINE and Cochrane Library were searched for relevant studies that assessed the change in stiffness of post-stroke muscle stiffness measured by ultrasound elastography following the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines. Results In total, 29 articles were identified, using either strain elastography and shear wave elastography to measure the stiffness of muscles in stroke survivors, most frequently in the biceps and medial gastrocnemius muscles. The stiffness was typically higher in the paretic compared to the non-paretic or healthy control. Other variations that increased the stiffness include increasing the joint angle and introducing a passive stretch or muscle activation. The paretic muscle has also been assessed pre- and post-treatment demonstrating a decrease in stiffness. Conclusion Ultrasound elastography is a promising imaging technology for determining the muscle stiffness in stroke survivors with need for a standardized imaging protocol.

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Quantitative Analysis of Intrinsic Muscle Stiffness in Biceps Brachii of Post-stroke Patients

Cited by 3 publications

References 12 publications

The value of ultrasound measurement of muscle thickness at different sites and shear wave elastography in Parkinson’s disease with sarcopenia: a pilot study

The value of ultrasound measurement of muscle thickness at different sites and shear wave elastography in Parkinson’s disease with sarcopenia: a pilot study

Effect of Stretching of Spastic Elbow Under Intelligent Control in Chronic Stroke Survivors—A Pilot Study

Ultrasound elastography in the assessment of post-stroke muscle stiffness: a systematic review

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