Examination of evaluation indicators for spasticity in stroke patients using ultrasound imaging equipment.
Takahiro Okazaki, Shota Nagai
PMID 39624345WHAT IT FOUND
Ultrasound measurement of muscle-tendon junction displacement correlated with spasticity severity in the arm and leg.
The paretic side showed greater displacement than the non-paretic side. Other ultrasound indices did not track spasticity, suggesting displacement is a potential objective alternative to the subjective Ashworth scale.
Key findings
01Muscle-tendon junction displacement on the paretic side was significantly greater than on the non-paretic side for both the biceps brachii and the gastrocnemius muscles.
02Muscle-tendon junction displacement showed a moderate to strong correlation with Modified Ashworth Scale scores, suggesting potential criterion-related validity.
03Muscle thickness, echo intensity, and pennation angles correlated with age or disease duration but not with spasticity or motor recovery stage, indicating they reflect disuse rather than spasticity.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTsWhat it means for SLPs
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What it does not show
The study used convenience sampling with only 23 participants, limiting generalizability. It was cross-sectional, so causality cannot be inferred. Only intra-rater reliability was assessed; inter-rater reliability remains unknown. The sample size had low statistical power (0.61) for some outcomes, increasing the risk that significant findings were false positives. Ultrasound measurements are operator-dependent and may vary between different equipment types, particularly for echo intensity.
Declared interests
The authors declare no conflicts of interest.
The easy way to misread this
Do not assume ultrasound indices are ready for routine clinical use. The study had low statistical power and only assessed one rater, so the reliability across different therapists and machines is unproven. The correlation with spasticity was moderate, not perfect, and other indices like thickness and echo intensity did not track spasticity at all.