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European Journal of Physical and Rehabilitation Medicine 2020 Dec 11

DOI: 10.23736/S1973-9087.20.06462-X

Copyright © 2020 EDIZIONI MINERVA MEDICA

language: English

Muscle and tendon properties of the spastic lower leg after stroke defined by ultrasonography: a systematic review

Fabienne SCHILLEBEECKX 1 , An DE GROEF 2, Nathalie DE BEUKELAER 2, Kaat DESLOOVERE 2, Geert VERHEYDEN 2, Koen PEERS 1, 3

1 Department of Physical Medicine and Rehabilitation, University Hospital Leuven, Leuven, Belgium; 2 Department of Rehabilitation Sciences, University of Leuven, Leuven, Belgium; 3 Department of Development and Regeneration, University of Leuven, Leuven, Belgium


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INTRODUCTION: Peripheral muscle and tendon changes after stroke can influence the functional outcome of patients. The aim of this systematic review was to summarize the evidence of ultrasonographic changes in morphological muscle and tendon properties of the spastic hemiparetic lower leg in patients with first ever stroke.
EVIDENCE ACQUISITION: A systematic search was conducted through PubMed, Embase, Scopus, Cinahl, Cochrane Library, and manual searches from inception until 1st of May 2020. Observational case control or cohort studies were included. Risk of bias was evaluated by using the Newcastle-Ottawa Quality Assessment Scale. Outcome parameters of interest included muscle thickness, muscle and tendon length, fascicle length, pennation angle and echo-intensity.
EVIDENCE SYNTHESIS: Nine studies investigated outcome parameters beyond one-month after stroke. We are unable to make a comprehensive statement. Nevertheless, there are some arguments for reduced muscle thickness and reduced fascicle length of the hemiplegic, spastic leg.
CONCLUSIONS: Despite the fact that objective assessment by ultrasonography holds promise for diagnosis and follow-up of spastic hemiparesis after stroke, more evidence is needed to determine how changes in morphological muscle and tendon properties are related to muscle weakness, severity of spasticity and compensation strategies such as disuse or overuse in longitudinal studies starting early after stroke.


KEY WORDS: Stroke; Muscle spasticity; Ultrasonography; Lower extremity; Systematic review

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