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Alterations of Elastic Property of Spastic Muscle With Its Joint Resistance Evaluated From Shear Wave Elastography and Biomechanical Model
Sun Yat Sen Univ, Affiliated Hosp 1, Dept Rehabil Med, Guangzhou, Guangdong, Peoples R China..
Sun Yat Sen Univ, Inst Diagnost & Intervent Ultrasound, Affiliated Hosp 1, Dept Med Ultrason, Guangzhou, Guangdong, Peoples R China..
Sun Yat Sen Univ, Affiliated Hosp 1, Dept Rehabil Med, Guangzhou, Guangdong, Peoples R China..
Sun Yat Sen Univ, Affiliated Hosp 1, Dept Rehabil Med, Guangzhou, Guangdong, Peoples R China..
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2019 (English)In: Frontiers in Neurology, ISSN 1664-2295, E-ISSN 1664-2295, Vol. 10, article id 736Article in journal (Refereed) Published
Abstract [en]

This study aims to quantify passive muscle stiffness of spastic wrist flexors in stroke survivors using shear wave elastography (SWE) and to correlate with neural and non-neural contributors estimated from a biomechanical model to hyper-resistance measured during passive wrist extension. Fifteen hemiplegic individuals after stroke with Modified Ashworth Scale (MAS) score larger than one were recruited. SWE were used to measure Young's modulus of flexor carpi radialis muscle with joint from 0 degrees (at rest) to 50 degrees flexion (passive stretch condition), with 10 degrees interval. The neural (NC) and non-neural components i.e., elasticity component (EC) and viscosity component (VC) of the wrist joint were analyzed from a motorized mechanical device NeuroFlexor (R) (NF). Combining with a validated biomechanical model, the neural reflex and muscle stiffness contribution to the increased resistance can be estimated. MAS and Fugl-Meyer upper limb score were also measured to evaluate the spasticity and motor function of paretic upper limb. Young's modulus was significantly higher in the paretic side of flexor carpi radialis than that of the non-paretic side (p < 0.001) and it increased significantly from 0 degrees to 50 degrees of the paretic side (p < 0.001). NC, EC, and VC on the paretic side were higher than the non-paretic side (p < 0.05). There was moderate significant positive correlation between the Young's Modulus and EC (r = 0.565, p = 0.028) and VC (r = 0.645, p = 0.009) of the paretic forearm flexor muscle. Fugl-Meyer of the paretic forearm flexor has a moderate significant negative correlation with NC (r = -0.578, p = 0.024). No significant correlation between MAS and shear elastic modulus or NF components was observed. This study demonstrated the feasibility of combining SWE and NF as a non-invasive approach to assess spasticity of paretic muscle and joint in stroke clinics. The neural and non-neural components analysis as well as correlation findings of muscle stiffness of SWE might provide understanding of mechanism behind the neuromuscular alterations in stroke survivors and facilitate the design of suitable intervention for them.

Place, publisher, year, edition, pages
Frontiers Media S.A., 2019. Vol. 10, article id 736
Keywords [en]
rehabilitation, stroke, spasticity, muscle, shear wave elastography
National Category
Neurology
Identifiers
URN: urn:nbn:se:kth:diva-255376DOI: 10.3389/fneur.2019.00736ISI: 000474785400001Scopus ID: 2-s2.0-85069776507OAI: oai:DiVA.org:kth-255376DiVA, id: diva2:1339396
Note

QC 20190729

Available from: 2019-07-29 Created: 2019-07-29 Last updated: 2019-10-04Bibliographically approved

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