Department of Physical Medicine and Rehabilitation, University Hospital Leuven, Leuven, Belgium -
Department of Rehabilitation Sciences, University of Leuven, Leuven, Belgium.
Eur J Phys Rehabil Med. 2021 Aug;57(4):495-510. doi: 10.23736/S1973-9087.20.06462-X. Epub 2020 Dec 11.
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.
A systematic search was conducted through PubMed, Embase, Scopus, Cinahl, Cochrane Library, and manual searches from inception until May 1, 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.
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.
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.
中风后周围肌肉和肌腱的变化会影响患者的功能预后。本系统综述的目的是总结首次中风后痉挛性偏瘫下肢形态学肌肉和肌腱特性的超声变化证据。
通过 PubMed、Embase、Scopus、Cinahl、Cochrane 图书馆以及 2020 年 5 月 1 日之前的手动搜索进行了系统搜索。纳入了观察性病例对照或队列研究。使用纽卡斯尔-渥太华质量评估量表评估偏倚风险。感兴趣的结局参数包括肌肉厚度、肌肉和肌腱长度、束长、羽状角和回声强度。
九项研究调查了中风后一个月以上的结局参数。我们无法做出全面的陈述。然而，有一些论点认为偏瘫、痉挛性腿部的肌肉厚度和束长减少。
尽管超声检查的客观评估有望对中风后痉挛性偏瘫进行诊断和随访，但仍需要更多证据来确定形态学肌肉和肌腱特性的变化如何与肌肉无力、痉挛严重程度以及在开始后的纵向研究中失用或过度使用等补偿策略相关。
