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Boissonnault È, Jeon A, Munin MC, Filippetti M, Picelli A, Haldane C, Reebye R. Assessing muscle architecture with ultrasound: implications for spasticity. Eur J Transl Myol 2024; 34. [PMID: 38818772 DOI: 10.4081/ejtm.2024.12397] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2024] [Accepted: 04/21/2024] [Indexed: 06/01/2024] Open
Abstract
Botulinum Neurotoxin Type A (BoNT-A) injections using Ultrasound (US) guidance have led to research evaluating changes in muscle architecture. Controversy remains as to what constitutes increased Echo-Intensity (EI) in spastic muscles and whether this may affect outcomes. We aim to provide a narrative review of US muscle architecture changes following Central Nervous System (CNS) lesions and explore their relationship to spasticity. Medline, CINAHL, and Embase databases were searched with keywords: ultrasonography, hypertonia, spasticity, fibrosis, and Heckmatt. Three physicians reviewed the results of the search to select relevant papers. Reviews identified in the search were used as a resource to identify additional studies. A total of 68 papers were included. Four themes were identified, including histopathological changes in spastic muscle, effects of BoNT-A on the muscle structure, available US modalities to assess the muscle, and utility of US assessment in clinical spasticity. Histopathological studies revealed atrophic and fibro-fatty changes after CNS lesions. Several papers described BoNT-A injections contributing to those modifications. These changes translated to increased EI. The exact significance of increased muscle EI remains unclear. The Modified Heckmatt Scale (MHS) is a validated tool for grading muscle EI in spasticity. The use of the US may be an important tool to assess muscle architecture changes in spasticity and improve spasticity management. Treatment algorithms may be developed based on the degree of EI. Further research is needed to determine the incidence and impact of these EI changes in spastic muscles.
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Affiliation(s)
- Ève Boissonnault
- Faculty of Medicine, Université de Montréal, Montreal, Canada; Canadian Advances in Neuro-Orthopedics for Spasticity Consortium (CANOSC), Kingston.
| | - April Jeon
- Canadian Advances in Neuro-Orthopedics for Spasticity Consortium (CANOSC), Kingston, Canada; Physical Medicine and Rehabilitation School of Medicine, University of Pittsburgh School of Medicine, Pittsburgh.
| | - Michael C Munin
- Canadian Advances in Neuro-Orthopedics for Spasticity Consortium (CANOSC), Kingston, Canada; Physical Medicine and Rehabilitation School of Medicine, University of Pittsburgh School of Medicine, Pittsburgh.
| | - Mirko Filippetti
- Canadian Advances in Neuro-Orthopedics for Spasticity Consortium (CANOSC), Kingston, Canada; Physical and Rehabilitation Medicine section, Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona.
| | - Alessandro Picelli
- Canadian Advances in Neuro-Orthopedics for Spasticity Consortium (CANOSC), Kingston, Canada; Physical and Rehabilitation Medicine section, Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona.
| | - Chloe Haldane
- Canadian Advances in Neuro-Orthopedics for Spasticity Consortium (CANOSC), Kingston, Canada; Division of Physical Medicine and Rehabilitation, University of British Columbia, Vancouver.
| | - Rajiv Reebye
- Canadian Advances in Neuro-Orthopedics for Spasticity Consortium (CANOSC), Kingston, Canada; Division of Physical Medicine and Rehabilitation, University of British Columbia, Vancouver.
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García-Rueda L, Cabanas-Valdés R, Salgueiro C, Rodríguez-Sanz J, Pérez-Bellmunt A, López-de-Celis C. Immediate Effects of TECAR Therapy on Gastrocnemius and Quadriceps Muscles with Spastic Hypertonia in Chronic Stroke Survivors: A Randomized Controlled Trial. Biomedicines 2023; 11:2973. [PMID: 38001972 PMCID: PMC10668938 DOI: 10.3390/biomedicines11112973] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2023] [Revised: 10/31/2023] [Accepted: 11/02/2023] [Indexed: 11/26/2023] Open
Abstract
BACKGROUND The aim of this study was to assess changes in muscle properties after a single session of capacitive and resistive energetic transfer (TECAR) therapy on spastic gastrocnemius and quadriceps muscles in chronic post-stroke. METHODS A total of 36 chronic stroke survivors with lower limb hypertonia were enrolled in a double-blind randomized controlled trial. The experimental group (n = 18) received a single 30 min session of TECAR therapy in combination with functional massage (FM) on the gastrocnemius and quadriceps muscles. The control group (n = 18) received a sham treatment of TECAR therapy (without electrical stimulation) in combination with real FM. The primary outcome was muscle tone of the lower limb muscles assessed with the Modified Ashworth Scale (MAS). The secondary outcomes were goniometric degrees of the MAS (goniometer), neuromuscular properties of the gastrocnemius/quadriceps (myotonometer), and passive range of motion (inclinometer). All measurements were performed at baseline (T0), immediately after treatment (T1), and at 30 min post-treatment (T2) by a blinded assessor. RESULTS The MAS score ankle dorsiflexion significantly decreased at T0-T1 (p = 0.046), and the change was maintained at T0-T2 (p = 0.019) in the experimental group. Significant improvements were noted in the passive range of motion for knee flexion (p = 0.012) and ankle dorsiflexion (p = 0.034) at T2. In addition, knee flexion improved at T1 (p = 0.019). CONCLUSION A single session of Tecar therapy at the same time with FM on the gastrocnemius and rectus femoris immediately reduces muscle tone and increases the passive range of motion of both ankle and knee in chronic stroke survivors. There were no significant changes in the neuromuscular properties measured with myotonometer.
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Affiliation(s)
- Laura García-Rueda
- Faculty of Medicine and Health Sciences, Universitat Internacional de Catalunya, 08195 Barcelona, Spain;
| | - Rosa Cabanas-Valdés
- Department of Physiotherapy, Faculty of Medicine and Health Sciences, Universitat International de Catalunya, 08195 Barcelona, Spain;
| | - Carina Salgueiro
- Clínica de Neurorehabilitación Sant Cugat del Vallés, 08195 Barcelona, Spain;
| | - Jacobo Rodríguez-Sanz
- Department of Basic Sciences, Faculty of Medicine and Health Sciences, Universitat International de Catalunya, 08195 Barcelona, Spain;
- ACTIUM Functional Anatomy Group, 08195 Barcelona, Spain
| | - Albert Pérez-Bellmunt
- Department of Basic Sciences, Faculty of Medicine and Health Sciences, Universitat International de Catalunya, 08195 Barcelona, Spain;
- ACTIUM Functional Anatomy Group, 08195 Barcelona, Spain
| | - Carlos López-de-Celis
- Department of Physiotherapy, Faculty of Medicine and Health Sciences, Universitat International de Catalunya, 08195 Barcelona, Spain;
- ACTIUM Functional Anatomy Group, 08195 Barcelona, Spain
- Fundació Institut Universitari per a la Recerca a l’Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), 08007 Barcelona, Spain
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Haelewijn N, Peters Dickie JL, Staes F, Vereecke E, Deschamps K. Current evidence regarding 2D ultrasonography monitoring of intrinsic foot muscle properties: A systematic review. Heliyon 2023; 9:e18252. [PMID: 37520980 PMCID: PMC10374929 DOI: 10.1016/j.heliyon.2023.e18252] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2023] [Revised: 07/10/2023] [Accepted: 07/12/2023] [Indexed: 08/01/2023] Open
Abstract
Background Ultrasonography can discriminate between intrinsic and extrinsic foot muscle properties and has therefore gained considerable popularity as an indirect strength evaluation. However, an overview on the use of ultrasound for assessing intrinsic foot musculature (IFM) is currently lacking. Research question What is the current evidence regarding (1) 2D ultrasonography protocols and its reliability? (2) Reference values for cross-sectional area and dorso-plantar thickness evaluation in asymptomatic and symptomatic persons? Methods The PRISMA guidelines were used to conduct this systematic review. Eight databases (PubMed, Embase, Web of Science, Cochrane Library, Scopus, CINAHL, SPORTDiscus and EuropePMC) were searched up to November 1, 2021. Studies reporting quantitative 2D ultrasound findings of the intrinsic foot muscles with no limitation to sex, BMI, ethnicity or physical activity were included. Studies were assessed for methodological quality using the Downs and Black checklist. Results Fifty-three studies were retained. Protocols showed an overall good to great reliability, suggesting limits of agreement between 8 and 30% of relative muscle size with minimal detectable changes varying from 0.10 to 0.29 cm2 for cross-sectional area and 0.03-0.23 cm for thickness. Reference values are proposed for both cross-sectional area and thickness measurements of the abductor hallucis, flexor digitorum brevis, flexor hallucis brevis and quadratus plantae in asymptomatic persons. This could not be performed in the symptomatic studies due to a limited number of relevant studies addressing the symptomatic population, therefore a clinical overview is outlined. Clinically, IFM properties have been studied in ten distinct pathological conditions, predominantly pointing towards decreased muscle properties of the abductor hallucis. Significance We provide a clear and comprehensive overview of the literature regarding 2D ultrasonography of the IFM, making the available evidence more accessible to decision makers and researchers.
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Affiliation(s)
- Nicolas Haelewijn
- Department of Rehabilitation Sciences, Musculoskeletal Rehabilitation Research Group, KU Leuven, Spoorwegstraat 12, 8200 Brugge, Belgium
| | - Jean-Louis Peters Dickie
- Neuromusculoskeletal Lab (NMSK), Secteur des Sciences de la Santé, Institut de Recherche Expérimentale et Clinique, Université Catholique de Louvain, Brussels, Belgium
| | - Filip Staes
- Department of Rehabilitation Sciences, Musculoskeletal Rehabilitation Research Group, KU Leuven, Tervuursevest 101, 3000 Leuven, Belgium
| | - Evie Vereecke
- Department of Development & Regeneration, Muscles & Movement Group, KU Leuven, Etienne Sabbelaan 53, 8500 Kortrijk, Belgium
| | - Kevin Deschamps
- Department of Rehabilitation Sciences, Musculoskeletal Rehabilitation Research Group, KU Leuven, Spoorwegstraat 12, 8200 Brugge, Belgium
- Haute Ecole Leonard De Vinci, Division of Podiatry, Avenue E. Mounier 84, 1200 Sint-Lambrechts-Woluwe, Belgium
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Ikuta E, Koshiyama M, Watanabe Y, Banba A, Yanagisawa N, Nakagawa M, Ono A, Seki K, Kambe H, Godo T, Sakamoto SI, Hara Y, Nakajima A. A Histogram Analysis of the Pixel Grayscale (Luminous Intensity) of B-Mode Ultrasound Images of the Subcutaneous Layer Predicts the Grade of Leg Edema in Pregnant Women. Healthcare (Basel) 2023; 11:healthcare11091328. [PMID: 37174870 PMCID: PMC10178771 DOI: 10.3390/healthcare11091328] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2023] [Revised: 04/10/2023] [Accepted: 04/29/2023] [Indexed: 05/15/2023] Open
Abstract
The technique most widely used to quantitatively measure leg edema is only a pitting edema method. It has recently become possible to digitize B-mode ultrasound images and accurately quantify their brightness using an image-analysis software program. The purpose of this study was to find new indices of the grade of leg skin, to study whether or not analyses of the subcutaneous layer of leg skin on ultrasound images using image-editing software program can be used to evaluate it and to digitize it. Images of 282 subcutaneous layers of leg skin in 141 pregnant women were obtained using a B-scan portable ultrasound device. Rectangular photographs (vertical: skin thickness; horizontal: width of probe) were obtained using an image-editing program, and the luminous intensity (pixel grayscale: 0-255) and thickness of the skin were calculated using a histogram. We investigated the correlation between these parameters and the grade of pitting edema (0-3). There was a significant positive correlation between the grade of pitting edema and the average luminous intensity value, its standard deviation, and the skin thickness (ρ = 0.36, ρ = 0.22, ρ = 0.51, p < 0.0001, respectively). In particular, there was strong positive correlation between the grade of pitting edema and both the total number of pixels in a rectangle × (multiplied by) the average luminous intensity value and the total number of pixels in a rectangle × the standard deviation of the average luminous intensity value (ρ = 0.58 and ρ = 0.59, p < 0.0001, respectively). We could quantitatively evaluate the grade of leg edema by analyzing ultrasound photographs of the subcutaneous layer of the leg skin using an image-editing software program and found new indices to digitize it.
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Affiliation(s)
- Eri Ikuta
- Graduate School of Human Nursing, The University of Shiga Prefecture, Hikone 522-8533, Japan
| | - Masafumi Koshiyama
- Department of Women's Health, Graduate School of Human Nursing, The University of Shiga Prefecture, Hikone 522-8533, Japan
| | - Yumiko Watanabe
- Department of Women's Health, Graduate School of Human Nursing, The University of Shiga Prefecture, Hikone 522-8533, Japan
| | - Airi Banba
- Graduate School of Human Nursing, The University of Shiga Prefecture, Hikone 522-8533, Japan
| | - Nami Yanagisawa
- School of Nursing, Tsuruga Nursing University, Tsuruga 914-0814, Japan
| | - Miwa Nakagawa
- Graduate School of Human Nursing, The University of Shiga Prefecture, Hikone 522-8533, Japan
| | - Ayumi Ono
- Graduate School of Human Nursing, The University of Shiga Prefecture, Hikone 522-8533, Japan
| | - Keiko Seki
- Graduate School of Human Nursing, The University of Shiga Prefecture, Hikone 522-8533, Japan
| | - Haruki Kambe
- Department of Electronic Systems Engineering, School of Engineering, The University of Shiga Prefecture, Hikone 522-0057, Japan
| | - Taiki Godo
- Department of Electronic Systems Engineering, School of Engineering, The University of Shiga Prefecture, Hikone 522-0057, Japan
| | - Shin-Ichi Sakamoto
- Department of Electronic Systems Engineering, School of Engineering, The University of Shiga Prefecture, Hikone 522-0057, Japan
| | - Yoko Hara
- Iris Women's Clinic, Hikone 522-0057, Japan
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Meng G, Ma X, Chen P, Xu S, Li M, Zhao Y, Jin A, Liu X. Effect of early integrated robot-assisted gait training on motor and balance in patients with acute ischemic stroke: a single-blinded randomized controlled trial. Ther Adv Neurol Disord 2022; 15:17562864221123195. [PMID: 36147622 PMCID: PMC9486263 DOI: 10.1177/17562864221123195] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2022] [Accepted: 08/12/2022] [Indexed: 11/17/2022] Open
Abstract
Background: Gait disruption is a common poststroke problem. Robot-assisted gait training
(RAGT) might improve motor function, balance, and activities of daily
living. Objective: We compared the clinical effectiveness of early integrated RAGT using the
Walkbot robotic gym with an intensity-matched enhanced lower limb therapy
(ELLT) program and with conventional rehabilitation therapy (CRT) in
patients with acute ischemic stroke. Methods: A total of 192 patients with acute ischemic stroke were randomly assigned
(1:1:1) to receive RAGT, ELLT, or CRT. All three groups received 45 min of
training daily, 3 days a week, for 4 weeks consecutively. Before and after
the 4-week treatment, the patients were assessed based on a 6-minute walking
test (6MWT), functional ambulation classification (FAC), timed up and go
(TUG) test, dual-task walking (DTW) test, Tinetti’s test, Barthel’s index
(BI), stroke-specific quality of life (SS-QOL) scale, and gait analysis
parameters. Results: After the 4-week intervention, the results of the 6MWT, FAC, TUG, DTW,
Tinetti’s test, BI, SS-QOL, and gait in the three groups significantly
improved. Compared with ELLT and CRT groups, participants in the RAGT group
had a better performance in 6MWT (199.11 ± 60.72 versus
182.47 ± 59.72 versus 173.69 ± 40.58,
p = 0.035), FAC (4.10 ± 0.91 versus
3.69 ± 0.88 versus 3.58 ± 0.81,
p = 0.044), DTW (10.29 ± 2.38 versus
12.92 ± 2.64 versus 13.89 ± 2.62,
p = 0.031), SS-QOL (184.46 ± 20.53 versus
165.39 ± 20.49 versus 150.72 ± 20.59,
p = 0.012), velocity (0.66 ± 0.22 versus
0.55 ± 0.23 versus 0.51 ± 0.20,
p = 0.008), cycle duration (1.38 ± 0.40
versus 1.50 ± 0.38 versus 1.61 ± 0.30,
p = 0.040), and swing phase symmetry ratio (SPSR,
1.10 ± 0.33 versus 1.21 ± 0.22 versus
1.48 ± 0.25, p = 0.021). The TUG, Tinetti’s test, BI, and
RMT results were similar, however. Conclusion: In the acute stroke phase, early integrated RAGT showed greater performance
in gait rehabilitation than CRT and ELLT. Registration: ChiCTR1900026225
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Affiliation(s)
- Guilin Meng
- Neurorehabilitation Center, Department of Neurology, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai, China
| | - Xiaoye Ma
- Neurorehabilitation Center, Department of Neurology, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai, China
| | - Pengfei Chen
- Neurorehabilitation Center, Department of Neurology, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai, China
| | - Shaofang Xu
- Neurorehabilitation Center, Department of Neurology, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai, China
| | - Mingliang Li
- Neurorehabilitation Center, Department of Neurology, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai, China
| | - Yichen Zhao
- Neurorehabilitation Center, Department of Neurology, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai, China
| | - Aiping Jin
- Neurorehabilitation Center, Department of Neurology, Shanghai Tenth People's Hospital, Tongji University School of Medicine, No. 301 Yanchang Road, Shanghai 200072, China
| | - Xueyuan Liu
- Neurorehabilitation Center, Department of Neurology, Shanghai Tenth People's Hospital, Tongji University School of Medicine, No. 301 Yanchang Road, Shanghai 200072, China
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Necessity and Content of Swing Phase Gait Coordination Training Post Stroke; A Case Report. Brain Sci 2021; 11:brainsci11111498. [PMID: 34827497 PMCID: PMC8615654 DOI: 10.3390/brainsci11111498] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2021] [Revised: 10/28/2021] [Accepted: 11/05/2021] [Indexed: 11/17/2022] Open
Abstract
Background/Problem: Standard neurorehabilitation and gait training has not proved effective in restoring normal gait coordination for many stroke survivors. Rather, persistent gait dyscoordination occurs, with associated poor function, and progressively deteriorating quality of life. One difficulty is the array of symptoms exhibited by stroke survivors with gait deficits. Some researchers have addressed lower limb weakness following stroke with exercises designed to strengthen muscles, with the expectation of improving gait. However, gait dyscoordination in many stroke survivors appears to result from more than straightforward muscle weakness. PURPOSE Thus, the purpose of this case study is to report results of long-duration gait coordination training in an individual with initial good strength, but poor gait swing phase hip/knee and ankle coordination. METHODS Mr. X was enrolled at >6 months after a left hemisphere ischemic stroke. Gait deficits included a 'stiff-legged gait' characterized by the absence of hip and knee flexion during right mid-swing, despite the fact that he showed good initial strength in right lower limb quadriceps, hamstrings, and ankle dorsiflexors. Treatment was provided 4 times/week for 1.5 h, for 12 weeks. The combined treatment included the following: motor learning exercises designed for coordination training of the lower limb; functional electrical stimulation (FES) assisted practice; weight-supported coordination practice; and over-ground and treadmill walking. The FES was used as an adjunct to enhance muscle response during motor learning and prior to volitional recovery of motor control. Weight-supported treadmill training was administered to titrate weight and pressure applied at the joints and to the plantar foot surface during stance phase and pre-swing phase of the involved limb. Later in the protocol, treadmill training was administered to improve speed of movement during the gait cycle. Response to treatment was assessed through an array of impairment, functional mobility, and life role participation measures. RESULTS At post-treatment, Mr. X exhibited some recovery of hip, knee, and ankle coordination during swing phase according to kinematic measures, and the stiff-legged gait was resolved. Muscle strength measures remained essentially constant throughout the study. The modified Ashworth scale showed improved knee extensor tone from baseline of 1 to normal (0) at post-treatment. Gait coordination overall improved by 12 points according to the Gait Assessment and Intervention Tool, Six Minute Walk Test improved by 532', and the Stroke Impact Scale improved by 12 points, including changes in daily activities; mobility; and meaningful activities. DISCUSSION Through the combined use of motor learning exercises, FES, weight-support, and treadmill training, coordination of the right lower limb improved sufficiently to exhibit a more normal swing phase, reducing the probability of falls, and subsequent downwardly spiraling dysfunction. The recovery of lower limb coordination during swing phase illustrates what is possible when strength is sufficient and when coordination training is targeted in a carefully titrated, highly incrementalized manner. Conclusions/Contribution to the Field: This case study contributes to the literature in several ways: (1) illustrates combined interventions for gait training and response to treatment; (2) provides supporting case evidence of relationships among knee flexion coordination, swing phase coordination, functional mobility, and quality of life; (3) illustrates that strength is necessary, but not sufficient to restore coordinated gait swing phase after stroke in some stroke survivors; and (4) provides details regarding coordination training and progression of gait training treatment for stroke survivors.
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Quantitative Ultrasound Changes in Echotexture and Functional Parameters after a Multicomponent Training Program in Pre-Frailty Individuals: A Pilot Randomized Clinical Trial. Healthcare (Basel) 2021; 9:healthcare9101279. [PMID: 34682959 PMCID: PMC8535283 DOI: 10.3390/healthcare9101279] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2021] [Revised: 09/13/2021] [Accepted: 09/24/2021] [Indexed: 11/16/2022] Open
Abstract
Objective: Currently, ultrasound imaging (USI) is considered a feasible tool in the evaluation of structural and textural muscle differences due to aging. The main aim of this study was to evaluate sonographic changes in muscular structure and function after a 12-week multicomponent training program in pre-frailty individuals. Design: A prospective, randomized, clinical trial was carried out. Participants: Thirty-two pre-frailty subjects were recruited and randomly divided into a multicomponent training program group (n = 16; Multicomponent group) and a conventional care group (n = 14; Control group) with a 12-week follow up. Main outcome measures: Rectus femoris thickness, cross-sectional area (CSA), echointensity, echovariation and vastus lateralis pennation angle tests were carried out to assess the structure and echotexture, and the force-velocity (F-V) profile for muscle power and muscle strength was employed to assess the functional parameters. Results: Statistically significant differences (p < 0.05) were shown for the left rectus femoris echointensity and in the functional parameter of muscle power after a 12-week program for the multicomponent training group compared to the conventional care group. Conclusions: Pre-frailty elderly subjects showed a decrease in rectus femoris echointensity (RF-EI) and an increase in the functional parameter of muscle power after a 12-week multicomponent training program compared to the control group.
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In TS, Jung JH, Jung KS, Cho HY. Effect of Sit-to-Stand Training Combined with Taping on Spasticity, Strength, Gait Speed and Quality of Life in Patients with Stroke: A Randomized Controlled Trial. Life (Basel) 2021; 11:life11060511. [PMID: 34073094 PMCID: PMC8226448 DOI: 10.3390/life11060511] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2021] [Revised: 05/20/2021] [Accepted: 05/29/2021] [Indexed: 11/17/2022] Open
Abstract
Background and Objectives: Spasticity is one of the factors that make it more difficult to control posture in stroke patients. Taping has been used to manage muscle stiffness in various musculoskeletal disorders. Recently, it has been used to decrease spasticity in stroke patients, but the effect of taping combined with therapeutic exercise is still unclear. The purpose of the present study was to determine whether the sit-to-stand (STS) training combined with taping improves the ankle spasticity, muscle strength, gait speed, and quality of life in stroke patients. Material and Methods: The study recruited 40 stroke patients, who were randomly divided into two groups: the taping and STS training (TSTS) group (n = 20) and the STS group (n = 20). The subjects in the TSTS group underwent STS training with Kinesio taping on the tibialis anterior, calf and ankle joint, whereas the subjects in the STS group underwent only STS training. All participants underwent 30 sessions of STS training (30 minutes, 5 days per week for 6 weeks). The present study evaluated the spasticity of ankle plantar flexors by the mean of the composite spasticity score; the muscle strength and gait speed were evaluated using the handheld dynamometer and the 10-meter walk test, respectively, and the quality of life was assessed using the stroke-specific quality of life scale. Result: The TSTS group and the STS group showed significant improvements in spasticity, muscle strength, walking speed, and quality of life after the intervention (p < 0.05). The level of improvement in the TSTS group was significantly higher in spasticity, muscle strength, and walking speed compared to the STS group (p < 0.05). Conclusions: The present study demonstrated that STS training is effective for decreasing spasticity in stroke patients and suggested that additional taping intervention further improved this effect. In addition, improvement of muscle strength and gait function was observed with a significant decrease of ankle spasticity.
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Affiliation(s)
- Tae-sung In
- Department of Physical Therapy, Gimcheon University, Gimcheon 39528, Korea;
| | - Jin-hwa Jung
- Department of Occupational Therapy, Semyung University, Jecheon 27136, Korea;
| | - Kyoung-sim Jung
- Department of Physical Therapy, Gimcheon University, Gimcheon 39528, Korea;
- Correspondence: (K.-s.J.); (H.-y.C.)
| | - Hwi-young Cho
- Department of Physical Therapy, College of Health Science, Gachon University, Incheon 21936, Korea
- Correspondence: (K.-s.J.); (H.-y.C.)
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De-la-Cruz-Torres B, Barrera-García-Martín I, Almazán-Polo J, Jaén-Crespo G, Romero-Morales C. Ultrasound imaging evaluation of structural and textural features in asymptomatic achilles tendons in pre-professional dancers: A cross-sectional study. Phys Ther Sport 2020; 44:85-91. [PMID: 32460220 DOI: 10.1016/j.ptsp.2020.05.008] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2020] [Revised: 04/20/2020] [Accepted: 05/15/2020] [Indexed: 02/06/2023]
Abstract
OBJECTIVE To evaluate performance descriptors, sociodemographics variables and tendon echogenicity of asymptomatic Achilles tendons and to compare the echotexture from different classification subgroups. DESIGN A prospective, randomized cross-sectional study was carried out. SETTING laboratory of university. PARTICIPANTS Forty-two Achilles tendons (AT) were recruited from pre-professional dancers. Based on the echogenicity pattern, the sample was divided into two groups (n = 21, Heterogeneous group; n = 21, Homogeneous group). MAIN OUTOCOME MEASURES Ultrasound images and ImageJ measurements were performed to evaluate thickness (AT-TH), echointensity (EI) and echovariation (EV), in addition to a balance and endurance test were measured as performance parameter. RESULTS EI (p = 0.001) and EV (p = 0.001) reported statistically significant differences between groups. AT-TH, endurance test, balance test, years of dance, training hours per week and average pointe hours per week did not showed differences between groups. A multivariate prediction model between groups and the echotexture variables (EI (R2 = 0.569; EV (R2 = 0.341)) were determined. CONCLUSION Asymptomatic AT of heterogeneous group showed a lower EI and a higher EV compared to homogeneous group. Tendon echogenicity did not interact with performance variables.
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Affiliation(s)
| | | | - Jaime Almazán-Polo
- Faculty of Sport Sciences, Universidad Europea de Madrid, c/Tajo s/n, Villaviciosa de Odón, 28670, Madrid, Spain.
| | - Gonzalo Jaén-Crespo
- Faculty of Sport Sciences, Universidad Europea de Madrid, c/Tajo s/n, Villaviciosa de Odón, 28670, Madrid, Spain.
| | - Carlos Romero-Morales
- Faculty of Sport Sciences, Universidad Europea de Madrid, c/Tajo s/n, Villaviciosa de Odón, 28670, Madrid, Spain.
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Wang Z, Lin Z, Zhang Y, Gao X, Xing Y, Hu XY, Robinson N. Motor entry point acupuncture for shoulder abduction dysfunction after stroke: A randomized controlled trial. Eur J Integr Med 2020. [DOI: 10.1016/j.eujim.2020.101073] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Kołcz A, Urbacka-Josek J, Kowal M, Dymarek R, Paprocka-Borowicz M. Evaluation of Postural Stability and Transverse Abdominal Muscle Activity in Overweight Post-Stroke Patients: A Prospective, Observational Study. Diabetes Metab Syndr Obes 2020; 13:451-462. [PMID: 32110078 PMCID: PMC7039244 DOI: 10.2147/dmso.s235015] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/17/2019] [Accepted: 01/22/2020] [Indexed: 01/11/2023] Open
Abstract
PURPOSE Post-stroke hemiparesis has a significant impact on postural stability. The transversus abdominis (TrA) muscle contributes to the stability of the spine. The aim was to assess both the postural stability and the activity of the TrA muscle in overweight post-stroke patients. METHODS A group of 56 participants (61.12 ± 11.5 years) was divided into the study group (n=28 post-stroke patients, 63.7 ± 10.9 years) and control group (n= 23 healthy participants (58.5 ± 12.2 years). The Berg Balance Scale (BBS) and the Timed Up and Go Test (TUG) were used to evaluate postural stability and risk of falls. The Pressure Bio-Feedback Stabilizer (PBFS) device was used to assess functional stability. RESULTS Stroke had a significantly negative effect on the BBS (p < 0.001) and TUG (p = 0.001). The older age negatively affected the BBS (p = 0.001), TUG (p = 0.017), and the TrA muscle activity (p = 0.017). Higher values of body mass index (BMI) negatively affected the BBS (p = 0.028), however there were no changes of TUG results (p = 0.141), and the TrA muscle activity (p = 0.808). Also, BBS and TUG results were not associated with TrA muscle activity (p = 0.541 and p = 0.411, respectively). The results of the BBS, TUG, and PBFS did not differ according to gender (p < 0.05). Time from stroke negatively affected the TUG (p = 0.001), but had no effect on the TrA muscle activity (p < 0.05). The side of hemiparesis did not affect the postural stability (p < 0.05). CONCLUSION The consequences of a stroke have an essential negative effect on postural stability. Factors such as age, gender, time from stroke, and the side of the hemiparesis have not negatively affected postural stability in overweight post-stroke patients.
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Affiliation(s)
- Anna Kołcz
- Laboratory of Ergonomics and Biomedical Monitoring, Department of Physiotherapy, Faculty of Health Sciences, Wroclaw Medical University, Wroclaw, Poland
- Department of Neurological Rehabilitation, Regional Specialized Hospital in Wroclaw, Wroclaw, Poland
| | - Justyna Urbacka-Josek
- Laboratory of Ergonomics and Biomedical Monitoring, Department of Physiotherapy, Faculty of Health Sciences, Wroclaw Medical University, Wroclaw, Poland
| | - Mateusz Kowal
- Laboratory of Ergonomics and Biomedical Monitoring, Department of Physiotherapy, Faculty of Health Sciences, Wroclaw Medical University, Wroclaw, Poland
| | - Robert Dymarek
- Department of Nervous System Diseases, Faculty of Health Sciences, Wroclaw Medical University, Wroclaw, Poland
- Correspondence: Robert Dymarek Department of Nervous System Diseases, Faculty of Health Sciences, Wroclaw Medical University, Wroclaw, PolandTel +48 71 784 18 39Fax +48 71 343 20 86 Email
| | - Małgorzata Paprocka-Borowicz
- Laboratory of Ergonomics and Biomedical Monitoring, Department of Physiotherapy, Faculty of Health Sciences, Wroclaw Medical University, Wroclaw, Poland
- Department of Neurological Rehabilitation, Regional Specialized Hospital in Wroclaw, Wroclaw, Poland
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