Measuring Mechanical Properties of Spastic Muscles After Stroke. Does Muscle Position During Assessment Really Matter?

García-Bernal, María-Isabel; González-García, Paula; Casuso-Holgado, María Jesús; Cortés-Vega, María-Dolores; Heredia-Rizo, Alberto Marcos

doi:10.1016/j.apmr.2022.05.012

Cited by 3 publications

(5 citation statements)

References 56 publications

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“…Myotonometry has been employed to assess the viscoelastic properties of muscles, including muscle tone, stiffness, and elasticity, in individuals affected by strokes [ 32 , 33 , 46 ]. Increased muscle stiffness has been observed in individuals with stroke, particularly those with restricted hypertonia [ 47 ] and chronic stroke [ 48 ], when compared to healthy subjects. Moreover, individuals with Parkinson’s disease have been observed to exhibit higher stiffness in the biceps brachii when compared to healthy controls [ 49 ].…”

Section: Discussionmentioning

confidence: 99%

Myoelectric, Myo-Oxygenation, and Myotonometry Changes during Robot-Assisted Bilateral Arm Exercises with Varying Resistances

Chan,

Meng,

Kao

et al. 2024

Sensors

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Robot-assisted bilateral arm training has demonstrated its effectiveness in improving motor function in individuals post-stroke, showing significant enhancements with increased repetitions. However, prolonged training sessions may lead to both mental and muscle fatigue. We conducted two types of robot-assisted bimanual wrist exercises on 16 healthy adults, separated by one week: long-duration, low-resistance workouts and short-duration, high-resistance exercises. Various measures, including surface electromyograms, near-infrared spectroscopy, heart rate, and the Borg Rating of Perceived Exertion scale, were employed to assess fatigue levels and the impacts of exercise intensity. High-resistance exercise resulted in a more pronounced decline in electromyogram median frequency and recruited a greater amount of hemoglobin, indicating increased muscle fatigue and a higher metabolic demand to cope with the intensified workload. Additionally, high-resistance exercise led to increased sympathetic activation and a greater sense of exertion. Conversely, engaging in low-resistance exercises proved beneficial for reducing post-exercise muscle stiffness and enhancing muscle elasticity. Choosing a low-resistance setting for robot-assisted wrist movements offers advantages by alleviating mental and physiological loads. The reduced training intensity can be further optimized by enabling extended exercise periods while maintaining an approximate dosage compared to high-resistance exercises.

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Section: Discussionmentioning

confidence: 99%

Myoelectric, Myo-Oxygenation, and Myotonometry Changes during Robot-Assisted Bilateral Arm Exercises with Varying Resistances

Chan,

Meng,

Kao

et al. 2024

Sensors

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“…This is a secondary analysis. The sample was the same as in a previous study investigating the influence of muscle position during assessment (relaxed vs. stretched) on the mechanical properties of spastic muscles [ 13 ]. Stroke participants were recruited from public and private settings and assigned to either group according to time after stroke.…”

Section: Methodsmentioning

confidence: 99%

“…Alternatively, direct measurement tools, such as ultrasound elastography and myotonometry, have emerged as promising procedures to provide quantitative useful information in patient populations [ 10 , 11 , 12 ]. Current literature suggests a non-uniform distribution of the muscle mechanical properties after stroke, with different adaptations in the upper and lower limbs [ 8 , 13 ]. However, it has been recommended to measure several spots within the muscle and tendon to better characterize PSS [ 13 ].…”

Section: Introductionmentioning

confidence: 99%

“…Current literature suggests a non-uniform distribution of the muscle mechanical properties after stroke, with different adaptations in the upper and lower limbs [ 8 , 13 ]. However, it has been recommended to measure several spots within the muscle and tendon to better characterize PSS [ 13 ]. Topographical mapping, based on multiple site assessments within an area of interest, has been used extensively for surface electromyography (SEMG) [ 14 ] and quantitative sensory testing [ 15 ] and, more recently, to report the spatial distribution of muscle stiffness in people with chronic pain [ 16 ].…”

Section: Introductionmentioning

confidence: 99%

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Characterization of the Structural and Mechanical Changes of the Biceps Brachii and Gastrocnemius Muscles in the Subacute and Chronic Stage after Stroke

García-Bernal

González-García

Madeleine

et al. 2023

IJERPH

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The objective of this study was to characterize the changes of muscle tone, stiffness, and thickness of upper and lower limb muscles in stroke survivors. Forty patients with subacute or chronic stroke and 31 controls were included and measured using myotonometry (MyotonPRO), with multiple site assessments at muscle belly (MB) and musculotendinous (MT) locations of the biceps brachii and gastrocnemius muscles. Muscle thickness (ultrasonography) was obtained for each muscle. Upper and lower limb motor performance was evaluated with the Fugl–Meyer Assessment for Upper Extremity and the Functional Ambulance Category. Overall, muscle tone and stiffness were significantly higher at MT than at MB sites. Among stroke patients, differences between the paretic and nonparetic limb were found for the biceps brachii, with lower muscle tone, stiffness, and thickness of the paretic side (all, p < 0.05). There were weak to moderate correlations between mechanical (myotonometry) and structural (ultrasound) muscular changes, regardless of the post-stroke stage. This suggests that myotonometry and ultrasonography assess similar, although different, constructs and can be combined in the clinical setting. Their discriminative ability between the paretic and nonparetic sides and between participants with and without stroke differs depending on the muscle, the functional level, and the stroke stage.

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“…A more frequently suggested choice is to use the Modified Tardieu Scale (MTS). Although subject to limitations in subjectivity, the Ashworth Scale and Modified Ashworth Scale persist in widespread use, given their rapidity and ease of completion [153,154]. The Tardieu Scale has been found to be superior to the Ashworth Scale in checking the outcome of treatment over spasticity.…”

Section: Reaching Performance Scale For Stroke (Rpss)mentioning

confidence: 99%

Objectivizing Measures of Post-Stroke Hand Rehabilitation through Multi-Disciplinary Scales

Marek,

Redlicka,

Miller

et al. 2023

JCM

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There is a wide variety of tools and measures for rehabilitation outcomes in post-stroke patients with impairments in the upper limb and hand, such as paralysis, paresis, flaccidity, and spasticity. However, there is a lack of general recommendations for selecting the most appropriate scales, tests, and instruments to objectively evaluate therapy outcomes. Reviews on upper limb and hand measurements reveal that clinicians’ choices of tools and methods are highly varied. Some clinicians and medical teams continue to employ non-standard and unverified metrics in their research and measurements. This review article aims to identify the key parameters, assessed by outcome measures and instruments, that play a crucial role in upper limb and hand rehabilitation for post-stroke patients, specifically focusing on the recovery of hand function. The review seeks to assist researchers and medical teams in selecting appropriate outcome measures when evaluating post-stroke patients. We analyze the measured factors and skills found in these outcome measures and highlight useful tools that diversify assessments and enhance result objectivity through graphical representation. The paper also describes trends and new possibilities in hand outcome measures. Clinicians frequently use proven devices, such as EMG, goniometers, and hand dynamometers. Still, there is a growing trend towards incorporating technologies, such as pose and position estimation, using artificial intelligence, or custom hand grip measurement devices. Researchers are increasingly adopting scales previously successful in orthopedic and surgical patients, recognizing their potential for objectivizing outcomes in neurological patients with post-stroke hand complications. The review included only adults over the age of 18. Outcome measures were tested for usefulness in the rehabilitation of stroke patients.

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Measuring Mechanical Properties of Spastic Muscles After Stroke. Does Muscle Position During Assessment Really Matter?

Cited by 3 publications

References 56 publications

Myoelectric, Myo-Oxygenation, and Myotonometry Changes during Robot-Assisted Bilateral Arm Exercises with Varying Resistances

Myoelectric, Myo-Oxygenation, and Myotonometry Changes during Robot-Assisted Bilateral Arm Exercises with Varying Resistances

Characterization of the Structural and Mechanical Changes of the Biceps Brachii and Gastrocnemius Muscles in the Subacute and Chronic Stage after Stroke

Objectivizing Measures of Post-Stroke Hand Rehabilitation through Multi-Disciplinary Scales

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