Okazaki Takahiro, Nagai Shota
Rehabilitation Center, Kaga Medical Center: Ri-36 Sakumi, Kaga City, Ishikawa 922-8522, Japan.
Master's Program, Graduate School of Rehabilitation, Kinjo University, Japan.
J Phys Ther Sci. 2024 Dec;36(12):776-781. doi: 10.1589/jpts.36.776. Epub 2024 Dec 1.
[Purpose] To compare the muscle evaluation indices obtained by scanning the spastic muscles of stroke patients between the paretic and non-paretic sides using ultrasound imaging equipment, determine whether any features can be detected, and verify whether the evaluation indices that detect differences are valid for measuring the degree of spasticity. [Participants and Methods] The participants were 23 first-ever stroke patients with motor paralysis in one upper or lower limb, admitted to our hospital between 1 and 6 months after onset. The biceps brachii muscle and medial head of the gastrocnemius muscle were evaluated on both sides using ultrasound imaging equipment. The muscle evaluation indices were muscle thickness, muscle echo intensity, muscle stiffness, and muscle-tendon junction displacement. Pennation angles were also measured at the medial head of the gastrocnemius muscle. [Results] Significant differences were found between the paretic and nonparetic sides in the muscle-tendon junction displacement of the biceps brachii muscle and edial head of the gastrocnemius muscle. No significant differences were found in the other muscle evaluation indices. [Conclusion] Muscle-tendon junction displacement was the only index that showed significant differences between the non-paretic and paretic sides. It showed a moderate-to-strong correlation with the Modified Ashworth Scale, suggesting its potential as an alternative evaluation index for muscle strain.
[目的] 使用超声成像设备比较对首次发生卒中且一侧上肢或下肢存在运动麻痹的患者痉挛肌肉进行双侧扫描所获得的肌肉评估指标,确定是否能检测到任何特征,并验证检测到差异的评估指标对于测量痉挛程度是否有效。[参与者与方法] 参与者为23例首次发生卒中的患者,在发病后1至6个月入院,其一侧上肢或下肢存在运动麻痹。使用超声成像设备对双侧肱二头肌和腓肠肌内侧头进行评估。肌肉评估指标包括肌肉厚度、肌肉回声强度、肌肉硬度和肌腱结合部位移。还在腓肠肌内侧头测量了羽状角。[结果] 肱二头肌和腓肠肌内侧头的肌腱结合部位移在患侧和健侧之间存在显著差异。其他肌肉评估指标未发现显著差异。[结论] 肌腱结合部位移是唯一在健侧和患侧之间显示出显著差异的指标。它与改良Ashworth量表呈中度至强相关性,表明其作为肌肉紧张度替代评估指标的潜力。