Validity and reliability of myotonometry for assessing muscle viscoelastic properties in patients with stroke: a systematic review and meta-analysis

Abstract

There is a lack of consensus about the measurement of the muscle viscoelastic features in stroke patients. Additionally, the psychometric properties of the most-commonly used clinical tools remain controversial. Our objective is to investigate the validity and reliability of myotonometry to assess viscoelastic muscle features in stroke survivors. Pubmed, PEDro, Scopus and Cinahl were systematically searched to include studies reporting the psychometric properties of myotonometric devices used in people after stroke. The QUADAS-2 and the COSMIN checklists were used to assess the methodological quality of the studies and the psychometric properties of myotonometry. Nine studies were included in the qualitative synthesis and data from five of these were pooled in a meta-analysis. Overall, low to moderate risk of bias and applicability concerns were observed. Pooled data from intra-rater reliability for muscle tone showed a mean coefficient of correlation of 0.915 (95% CI: 0.880–0.940, I 2 = 69.2%) for upper limbs, and a mean coefficient of 0.785 (95%CI: 0.708–0.844, I 2 = 4.02%) for lower limbs. Myotonometry seems to be a valid and reliable complementary tool to assess muscle viscoelastic properties in stroke survivors, although definite conclusions about concurrent validity need further research.

Immediate effect of osteopathic techniques on human resting muscle tone in healthy subjects using myotonometry: A factorial randomized trial

“…This myotonometer assesses the muscle's tone, biomechanical and viscoelastic properties using five parameters by means of dynamic oscillation mechanosignals [81,111] (Table 3). The MyotonPRO is a valid and reliable measurement tool for healthy and diseased participants [112,113] (Box 4) that has been applied to evaluate muscle tone, muscle stiffness, and HRMT in multiple studies investigating various structures and conditions [71,81,93,[114][115][116]. The myotonometer measurements were carried out at all three sessions (t1-t3) before and after the treatment intervention.…”

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

“…Myotonometry is a valid and easy-to-use approach to objectively quantify muscle mechanical properties in people after stroke. 4,6 However, its high environmental sensitivity 4 and the large withinand between-participants variability 19 together with assessmentrelated aspects, such as muscle position and operator's experience, 4,20 stress the importance of agreeing on a standardized evaluation protocol.…”

“…The peripheral contribution to poststroke spasticity (PSS) can be quantified for clinical and research purposes using objective, noninvasive methods, for example, shear-wave elastography and myotonometry. 4,5 Myotonometry represents a valid, reliable, and convenient tool 4,6 that has proven to be useful to monitor PSS after conservative or invasive treatments. 7 However, current evidence on the ability of myotonometry to discriminate between spastic and nonspastic muscles after stroke is scarce and conflicting.…”

“…7 However, current evidence on the ability of myotonometry to discriminate between spastic and nonspastic muscles after stroke is scarce and conflicting. 6 It has been recommended to conduct myotonometry measurement of PSS at several muscle sites of testing and in different muscle positions, that is, relaxed or stretched, 6 to get a clear picture of how muscle mechanical properties may change after stroke 8 and in response to rehabilitation programs.…”

Influence of Spinal Movements Associated with Physical Evaluation on Muscle Mechanical Properties of the Lumbar Paraspinal in Subjects with Acute Low Back Pain

“…However, their high cost makes them inaccessible to a clinical setting, challenging the determination of the MMPs. Since a decade ago, the device MyotonPRO© emerged as a non-invasive and reliable alternative to assess and monitor MMPs with clinical applications Several studies have shown sufficient accuracy and precision to determine MMPs in spinal muscles [ 23 , 24 , 25 , 26 ] and other tissues and regions [ 23 , 27 , 28 , 29 ], although efforts to better determine the concurrent validity need further research [ 30 ]. Previous research has associated MMPs alterations, specifically an increase in stiffness and tone or a decrease in elasticity, and axial spondyloarthritis [ 24 ].…”