Relationship Between Ultrasonographic, Electromyographic, and Clinical Parameters in Adult Stroke Patients With Spastic Equinus: An Observational Study

Picelli, Alessandro; Tamburin, Stefano; Cavazza, Stefano; Scampoli, Claudia; Manca, M.; Cosma, M.; Berto, G.; Vallies, Gabriella; Roncari, Laura; Melotti, Camilla; Santilli, Valter; Smania, Nicola

doi:10.1016/j.apmr.2014.04.011

Cited by 41 publications

(47 citation statements)

References 27 publications

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“…The tibial nerve motor branches were located in the space (vertical, horizontal and deep) according to the position of the fibular head (upper end) and a virtual line extending from the middle of the popliteal fossa to the Achilles tendon insertion (8). In addition, the spastic calf muscle echo intensity was graded semiquantitatively according to the Heckmatt scale (grade 1: normative; grade 2: increase in muscle echo intensity while bone echo is still distinct; grade 3: marked increase in muscle echo intensity and reduced bone echo; grade 4: very high muscle echo intensity and complete loss of bone echo) (18).…”

Section: Ultrasonographic Evaluationmentioning

confidence: 99%

Anatomical landmarks for tibial nerve motor branches in the management of spastic equinovarus foot after stroke: An ultrasonographic study

Picelli¹,

Chemello²,

Verzini³

et al. 2019

J Rehabil Med

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This study aimed to identify the motor nerve branches to the main calf muscles, in order to assist in the management of spastic foot. Twenty-five chronic stroke patients with spastic foot were evaluated with ultrasonography. The nerve branches to the gastrocnemii, soleus and tibialis posterior muscles were located in space (vertical, horizontal and deep), based on the position of the fibular head (proximal/distal) and a posterior line in the middle of the leg (medial/lateral). The coordinates for the gastrocnemius medialis motor branch were: 1.5 cm proximal, 1.7 cm medial, 1.1 cm deep; for the gastrocnemius lateralis motor branch: 0.9 cm proximal, 1.8 cm lateral, 1.0 cm deep; for the soleus motor branch: 1.4 cm distal, 1.6 cm lateral, 2.8 cm (SD 0.7) deep; and for the tibialis posterior motor branch: 4.3 cm distal, 1.9 cm lateral, 4.2 cm deep. These findings may help in the management of spastic foot. Objective: To identify the anatomical landmarks of tibial motor nerve branches to the gastrocnemii, soleus and tibialis posterior muscles for selective motor nerve blocks in the management of spastic equinovarus foot. Design: Observational study. Patients: Twenty-five chronic stroke patients with spastic equinovarus foot. Methods: Motor nerve branches to the gastrocnemii, soleus and tibialis posterior muscles were tracked in the affected leg, using ultrasonography, and located in the space (vertical, horizontal and deep) according to the position of the fibular head (proximal/distal) and a virtual line from the middle of the popliteal fossa to the Achilles tendon insertion (medial/lateral). Results: Mean coordinates for the gastrocnemius medialis motor branch were: 1.5 cm (standard deviation (SD) 2.7) vertical (proximal), 1.7 cm (SD 1.3) horizontal (medial), 1.1 cm (SD 0.4) deep; for the gastrocnemius lateralis motor branch: 0.9 cm (SD 2.2) vertical (proximal), 1.8 cm (SD 1.7) horizontal (lateral), 1.0 cm (SD 0.3) deep; for the soleus motor branch: 1.4 cm (SD 1.1) vertical (distal), 1.6 cm (SD 0.7) horizontal (lateral), 2.8 cm (SD 0.7) deep; and for the tibialis posterior motor branch: 4.3 cm (SD 1.5) vertical (distal), 1.9 cm (SD 0.9) horizontal (lateral), 4.2 cm (SD 0.8) deep. Conclusion: These findings may help in the identification of tibial motor nerve branches to the gastrocnemii, soleus and tibialis posterior muscles for selective motor nerve blocks in the management of spastic equinovarus foot.

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Section: Ultrasonographic Evaluationmentioning

confidence: 99%

Anatomical landmarks for tibial nerve motor branches in the management of spastic equinovarus foot after stroke: An ultrasonographic study

Picelli¹,

Chemello²,

Verzini³

et al. 2019

J Rehabil Med

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“…The thickest part of the muscle was found “at the center of the muscle between its medial and posterior borders.” We believe that tracking a paretic and spastic GM muscle sometimes must take the disturbed organization of the muscle into account. Having taken into consideration the anatomy, our experience has shown that deployment of the GM muscle may be more medial and/or more proximal. Muscle fibers may appear disorganized because of fibrosis and fatty infiltration.…”

Section: Discussionmentioning

confidence: 99%

Two‐dimensional and shear wave elastography ultrasound: A reliable method to analyse spastic muscles?

et al. 2017

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“…Combination studies in patients are much less frequent and relatively new. EMG has been used to confirm that sonographic muscle contractility is a reliable parameter to evaluate muscles in phrenic neuropathy or in patients with amyotrophic lateral sclerosis or stroke …”

Section: Discussionmentioning

confidence: 99%

“…EMG has been used to confirm that sonographic muscle contractility is a reliable parameter to evaluate muscles in phrenic neuropathy or in patients with amyotrophic lateral sclerosis or stroke. [15][16][17] A strength of facial muscle ultrasonography is that it allows for static and dynamic analysis of facial muscles. This is advantageous because the face at rest and during mimetic movements can be examined separately in the clinical routine.…”

Section: Discussionmentioning

confidence: 99%

Correlation between electromyography and quantitative ultrasonography of facial muscles in patients with facial palsy

2016

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Relationship Between Ultrasonographic, Electromyographic, and Clinical Parameters in Adult Stroke Patients With Spastic Equinus: An Observational Study

Cited by 41 publications

References 27 publications

Anatomical landmarks for tibial nerve motor branches in the management of spastic equinovarus foot after stroke: An ultrasonographic study

Anatomical landmarks for tibial nerve motor branches in the management of spastic equinovarus foot after stroke: An ultrasonographic study

Two‐dimensional and shear wave elastography ultrasound: A reliable method to analyse spastic muscles?

Correlation between electromyography and quantitative ultrasonography of facial muscles in patients with facial palsy

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