Assessment of forearm muscle spasticity with sonoelastography in patients with stroke

Abstract

Objective: The aim of the study was to investigate the feasibility of sonoelastography to show muscle stiffness in post-stroke spasticity, and the relationship between sonoelastography findings and clinical spasticity scores in the spastic forearm muscles. Methods: This study was carried out in a university rehabilitation centre. 23 patients with stroke with forearm muscle spasticity ($11 using the Modified Ashworth scale score and $1 using the Tardieu scale) were included. Sonoelastography parameters (elasticity index and elasticity ratio) were measured from the flexor digitorum superficialis, flexor digitorum profundus, flexor carpi radialis and flexor carpi ulnaris muscles on the affected and unaffected sides. Results: Both elasticity index and elasticity ratio of the wrist and finger flexors on the hemiplegic side were significantly increased compared with those on the healthy side (p , 0.05). The Tardieu angle of finger flexors was negatively correlated with the elasticity index and elasticity ratio measured in the spastic flexor digitorum profundus (r 5 20.418 and r 5 20.469, respectively). Tardieu angle of finger flexors was negatively correlated with the elasticity index measured in the spastic flexor digitorum superficialis (r 5 20.435). There was no correlation between other parameters. Conclusion: Sonoelastography may provide objective assessment of spasticity both in diagnosis and followup. To strengthen this prediction, further studies are necessary. Advances in knowledge:The results of this study represent that sonoelastography is a promising evaluation method for forearm muscle spasticity.

Correlation between Pathological Characteristics and Young’s Modulus Value of Spastic Gastrocnemius in a Spinal Cord Injury Rat Model

“…In the ankle flexion position, Young's modulus value of SCI rats in each subgroup was significantly higher than that of the control rats. Previous studies showed that the hardness of spasmodic muscle is significantly higher than normal controls [ 6 , 7 ]. In addition, we found that Young's modulus value in the state of ankle flexion was significantly higher than the value in the state of ankle extension for each SCI subgroup.…”

“…This imaging method further promotes the comparison of elastic properties under various physiological conditions [ 6 ]. Despite its known advantages, this technique has been applied for the evaluation of spastic muscles stiffness following UMN injury [ 5 , 7 ].…”

Contribution of Single-Fiber Evaluation on Monitoring Outcomes Following Injection of Botulinum Toxin-A: A Narrative Review of the Literature

“…Several instrumental [ 20 , 30 , 31 , 32 ] and non-instrumental [ 33 , 34 , 35 ] scales have also been proposed, including some designed to objectively quantify muscle tone alterations in spasticity and their modifications induced by BoNT-A injection. Indeed, some describe mechanical and structural properties via ultrasound imaging [ 36 , 37 ] and MRI [ 38 ], viscoelastic properties via elastography [ 39 , 40 , 41 , 42 ], and Myoton ® technology. Others report mechanical properties via mechanography and electrophysiological properties via electromyography (EMG) such as the M response and the H and F waves [ 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 ] induced by a peripheral nerve electrical stimulus.…”

Quantitative Evaluation of Post-stroke Spasticity Using Neurophysiological and Radiological Tools: A Pilot Study

“…The MAS scores of spastic GCM muscles reveal a weak positive correlation with sonoelastographic findings. In the study by Yasar et al [ 29 ], Tardieu angle of finger flexors was negatively correlated with the elasticity index measured in the spastic finger flexors.…”