Assessment of Post-Stroke Biceps Brachialis Muscle Stiffness by Shear-Wave Elastography: a Pilot Study

Abstract

Objectives. Spasticity following stroke tend to increase muscle stiffness. Recent clinical measures of post-stroke biceps brachialis muscle spasticity are subjective. We aimed to measure post-stroke biceps brachialis muscle stiffness quantitatively by using shearwave elastography (SWE). Methods. This prospective study included 24 post-stroke patients with unilateral biceps brachialis muscle spasticity. The Modified Ashworth Scale of the biceps muscle, Brunnstrom stages of the upper extremity of the patients were evaluated as the clinical outcomes. Biceps brachialis muscle stiffness was compared among affected and non-affected upper extremities by SWE. The correlations between SWE findings and clinical outcomes were analyzed. Results. Shear Wave Velocity (SWV) on the spastic side did not show any significant differences from those on the non-spastic side (p>0.05). SWV findings were not correlated with clinical outcomes (r ≤ 0.3, p>0.05). Conclusions. Biceps brachialis muscle stiffness was found similar among the affected and non-affected extremities. In addition, SWV was not correlated with clinical outcomes. SWE may not be helpful in detecting the changes in biceps muscle stiffness following stroke.

A Novel and Clinically Feasible Instrument for Quantifying Upper Limb Muscle Tone and Motor Function via Indirect Measure Methods

“…The quick-stretch technique is a simple way to induce spasticity. However, previous studies have suggested that using this technique may lead to insufficient repeatability and efficacy [11] , [13] – [16] . The ACMES uses a robotic-type design that can continuously produce steady motion and speed that will allow simulation of the same quick-stretch every time.…”

“…For clinicians, a proper assessment that can be used to quantify muscle tone, especially abnormal muscle tone, is always an important issue that must be done before applying suitable interventions. Although the quick-stretch technique is an easy, common strategy by which clinicians can induce abnormal muscle tone, and the MAS assessment is widely used clinically as well, the inconsistency of the force applied from the examiners and the subjective scoring are concerns that should not be ignored [11] , [13] – [16] . To solve the problems related to the current muscle tone scoring system, previous researchers have used EMG, torque, or force sensors to quantify muscle tone [10] , [12] , [17] – [27] .…”

“…Several reports have thus mentioned the inadequate reliability and validity of these techniques to represent either hypotonic or hypertonic conditions of patients after a stroke [11] , [13] – [16] . Based on these drawbacks and a lack of objective quantification of muscle tone, in some former studies, attempts were made to use a motor or robot in conjunction with a torque transducer or electromyograph (EMG) to guide the target joint and limb movements directly and then to measure the triggered spasticity.…”

Incidence of Accessory Brachialis Muscle, Variations in its Insertion and Relation with Surrounding Neurovascular Structures

“…Future implications of this study include studying the AcBr in vivo by using ultrasound, MRI and electromyogram methods. Elastography is a newly established North American based technique to assess the tissue stiffness (26). The AcBr can be studied in vivo by using elastography and the stiffness of the arm can be evaluated.…”

“…The AcBr can be studied in vivo by using elastography and the stiffness of the arm can be evaluated. Analan and Ozdemir (26) reported that, neurological disorders are not the only etiological factors for the muscle stiffness, few more factors like anatomical variations, posture, gender and exercise also have a role.…”