Ultrasound Assessment of Spastic Muscles in Ambulatory Chronic Stroke Survivors Reveals Function-Dependent Changes.
Javier González-Buonomo, Alexander H Pham, Jaskiran Ghuman and 5 others
PMID 36254740WHAT IT FOUND
Ambulatory chronic stroke survivors had thinner muscles on the affected side than on the unaffected side, especially in the arm.
Greater wrist flexor muscle loss tracked weaker grip, and greater thigh muscle loss tracked worse walking times.
Key findings
01Muscle thickness was significantly lower on the affected side than on the unaffected side in both upper and lower limb muscles, and the reduction was greater in the upper limb.
02A larger percentage decrease in wrist flexor muscle thickness on the affected side was associated with weaker grip strength.
03A larger percentage decrease in thigh muscle thickness on the affected side was associated with worse Timed Up and Go and 6-metre walk test times.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTs
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What it does not show
Only ambulatory stroke survivors were included, so the findings may not apply to patients who cannot walk. The study used 28 participants from a single outpatient clinic. Most participants had prior botulinum toxin injections, which can temporarily affect muscle structure, and a smaller number had prior phenol injections. The unaffected side was used as the comparison instead of healthy people, and it may itself have some muscle loss. Because the design was cross-sectional, it cannot show that muscle loss caused weaker grip or slower walking. Diet, habitual physical activity, and other comorbidities were not measured. The modified Heckmatt scale may not be sensitive enough to detect echogenicity differences that relate to function.
Declared interests
The authors declared no conflicts of interest.
The easy way to misread this
Do not read these ultrasound differences as proof that muscle loss caused the functional deficits or that ultrasound-guided therapy will improve them. The study was cross-sectional, only included ambulatory stroke survivors, and most participants had prior botulinum toxin injections that can alter muscle structure.