Assessing Hand Muscle Structural Modifications in Chronic Stroke

Zong, Ya; Shin, Henry; Wang, Ying Chih; Li, Sheng; Zhou, Ping; Li, Xiaoyan

doi:10.3389/fneur.2018.00296

Cited by 10 publications

(8 citation statements)

References 38 publications

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“…Significantly lower X and θ values were observed in the affected than in unaffected TA muscle. This outcome was in line with the findings of previous studies that θ could be a sensitive biomarker in the measurement of muscle structure and component properties (Li X. et al, 2017; Zong et al, 2018). However, there was no significant difference in the ultrasound parameters between the affected and unaffected sides.…”

Section: Discussionsupporting

confidence: 92%

Correlation Between Muscle Structures and Electrical Properties of the Tibialis Anterior in Subacute Stroke Survivors: A Pilot Study

Mai

et al. 2019

Front. Neurosci.

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Electrical impedance myography (EIM) is a non-invasive diagnostic tool that assesses the muscle inherent properties, whereas ultrasonography can assess the alteration in muscle architecture. This study aimed to combine EIM with ultrasonography to assess the changes of the tibialis anterior (TA) muscle properties during passive plantar/dorsiflexion in stroke survivors. Fifteen patients with subacute stroke were recruited. The muscle structures were simultaneously assessed by EIM and ultrasonography at five different extension angles (−10°, 0°, 10°, 20°, and 30°) of the ankle joint. The EIM parameters measured were resistance (R), reactance (X), and phase angle (θ). The parameters recorded by ultrasonography were pennation angle (PA), muscle thickness (MT), and fascicle length (FL). Two-way repeated ANOVA was performed to compare the differences between the affected and unaffected sides as well as the parameters that changed with joint angle. Linear correlation analysis was conducted to assess the association between muscle parameters and clinical scores. The results showed that as the ankle was passively plantarflexed, the θ (P = 0.003) and PA (P < 0.001) values decreased, and the X (P < 0.001), R (P < 0.001), and FL (P < 0.001) values increased. Significant correlations were found between the FL and R values (r = 0.615, P = 0.015), MT and R values (r = 0.522, P = 0.046), and FL and θ values (r = 0.561, P = 0.03), as well as between the PA and the Fugl–Meyer Assessment of Lower Extremity score (r = 0.615, P = 0.015), the R and the Modified Ashworth Scale (MAS) score (r = 0.58, P = 0.023), and the PA and the manual muscle testing (MMT) score (r = −0.575, P = 0.025). This study demonstrated a correlation between the EIM and the ultrasonography parameters at different joint angles. Therefore, both methods could jointly be applied in patients with stroke to detect changes in the muscle inherent properties and muscle architecture. This could assist clinicians to quantitatively evaluate the muscle condition in people with subacute stroke. The study was registered on the Chinese Clinical Trial Registry (trial registration number: ChiCTR-IOR-17012299, http://www.chictr.org.cn/showprojen.aspx?proj=19818).Clinical Trial Registration Number: ChiCTR-IOR-17012299.

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Section: Discussionsupporting

confidence: 92%

Correlation Between Muscle Structures and Electrical Properties of the Tibialis Anterior in Subacute Stroke Survivors: A Pilot Study

Mai

et al. 2019

Front. Neurosci.

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“…We would therefore anticipate patient/healthy differences in EIM phase angle to manifest at frequencies in which the current crosses the capacitance of the sarcolemma, which was indeed the case. Some recent studies have indicated that EIM may be able to detect muscle changes secondary to UMN dysfunction (Li et al , 2017, Zong et al , 2018. While a mixed UMN/LMN dysarthria is the most common pattern encountered in ALS (Aronson et al , 1992), it remains to be determined if dual pathology can be separated or quantified, either in the tongue or limb muscles.…”

Section: Resultsmentioning

confidence: 99%

Multi-dimensional electrical impedance myography of the tongue as a potential biomarker for amyotrophic lateral sclerosis

Alix

McDonough

Sonbas

et al. 2020

Clinical Neurophysiology

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In amyotrophic lateral sclerosis (ALS) bulbar disease biomarkers are lacking. We evaluated a novel tongue electrical impedance myography (EIM) system, utilising both 2D and 3D electrode configurations for detection of tongue pathology. MethodsLongitudinal multi-frequency phase angle spectra were recorded from 41 patients with ALS (baseline, 3 and 6 months) and 30 healthy volunteers (baseline and 6 months). . ALS functional rating scalerevised (ALSFRS-R) data and quantitative tongue strength measurements were collected. EIM data were analysed for reliability (intra-class correlation coefficient; ICC) and differences between patients and volunteers ascertained using both univariate (Mann-Whitney U test) and multivariate techniques (feature selection and L2 norm). ResultsThe device produced highly reliable data (pooled ICC: 0.836). Significant EIM differences were apparent between ALS patients and healthy volunteers (P<0.001). EIM data demonstrated a significant relationship to tongue strength and bulbar ALSFRS-R scores (P<0.015). The EIM recordings revealed a group level longitudinal change over 6 months and consistently identified patients in whom symptoms or tongue strength changed. ConclusionsThe novel EIM tongue system produces reliable data and can differentiate between healthy muscle and ALS-related disease. SignificanceTongue EIM utilising multiple frequencies and electrode configurations has potential as a bulbar disease biomarker in ALS. HighlightsNovel electrical impedance myography system uses electrodes on both surfaces of the tongue.The device produces reliable data, even in inexperienced hands.The results differentiate between healthy and ALS muscle and reveal change over time.

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“…Previous studies have reported the alteration of muscle impedance of the biceps brachii (Li et al, 2017) and the hypothenar muscle (Zong et al, 2018) after the occurrence of stroke. These findings supported that reactance (X) and phase angle (θ) were stable and sensitive biomarkers in the assessment of muscle intrinsic properties.…”

Section: Electrical Impedance Myographymentioning

confidence: 99%

The Effects of Extracorporeal Shock Wave Therapy on Spastic Muscle of the Wrist Joint in Stroke Survivors: Evidence From Neuromechanical Analysis

Leng

et al. 2021

Front. Neurosci.

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Background: This study combined neuromechanical modeling analysis, muscle tone measurement from mechanical indentation and electrical impedance myography to assess the neural and peripheral contribution to spasticity post stroke at wrist joint. It also investigated the training effects and explored the underlying mechanism of radial extracorporeal shock wave (rESW) on spasticity.Methods: People with first occurrence of stroke were randomly allocated to rESW intervention or control group. The intervention group received one session of rESW therapy, followed by routine therapy which was the same frequency and intensity as the control group. Outcome measures were: (1) NeuroFlexor method measured neural component (NC), elastic component (EC) and viscosity component (VC), and (2) myotonometer measured muscle tone (F) and stiffness (S), (3) electrical impedance myography measured resistance (R), reactance (X) and phase angle (θ); (4) modified Asworth scale; (5) Fugl Meyer Upper limb scale. All outcome measures were recorded at baseline, immediately post rESW and at 1-week follow-up. The differences between the paretic and non-paretic side were assessed by t-test. The effectiveness of rESW treatment were analyzed by repeated-measures one-way analysis of variance (ANOVA) at different time points.Results: Twenty-seven participants completed the study. NC, EC, and VC of the Neuroflexor method, F and S from myotonometer were all significantly higher on the paretic side than those from the non-paretic side. R, X, and θ from electrical impedance were significantly lower on the paretic side than the non-paretic side. Immediately after rESW intervention, VC, F, and S were significantly reduced, and X was significantly increased. The clinical scores showed improvements immediate post rESW and at 1-week follow-up.Conclusions: The observed changes in upper limb muscle properties adds further support to the theory that both the neural and peripheral components play a role in muscle spasticity. ESW intervention may be more effective in addressing the peripheral component of spasticity in terms of muscle mechanical properties changes. The clinical management of post stroke spasticity should take into consideration of both the neural and non-neural factors in order to identify optimal intervention regime.

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Assessing Hand Muscle Structural Modifications in Chronic Stroke

Cited by 10 publications

References 38 publications

Correlation Between Muscle Structures and Electrical Properties of the Tibialis Anterior in Subacute Stroke Survivors: A Pilot Study

Correlation Between Muscle Structures and Electrical Properties of the Tibialis Anterior in Subacute Stroke Survivors: A Pilot Study

Multi-dimensional electrical impedance myography of the tongue as a potential biomarker for amyotrophic lateral sclerosis

The Effects of Extracorporeal Shock Wave Therapy on Spastic Muscle of the Wrist Joint in Stroke Survivors: Evidence From Neuromechanical Analysis

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