Relationship of Quadriceps Muscle Thickness with Motor Paralysis and Muscle Echo Intensity in Post-Stroke Patients

2019 ◽  
Vol 81 (1-2) ◽  
pp. 56-62 ◽  
Author(s):  
Hisashi Maeda ◽  
Ken Imada ◽  
Koji Ishida ◽  
Hiroshi Akima
Keyword(s):  
Muscle Thickness ◽  
Quadriceps Muscle ◽  
Muscle Quality ◽  
Quality Loss ◽  
Echo Intensity ◽  
Stroke Patients ◽  
Post Stroke ◽  
Paretic Limb ◽  
Motor Paralysis ◽  
Relationship Of

Introduction: Quadriceps muscle atrophy and quality loss, defined as an increased ratio of intramuscular fat and/or connective tissue, are often observed especially in the paretic limb of post-stroke patients. This study was performed to examine the relationship of quadriceps muscle thickness (MT) with muscle echo intensity (EI) and the severity of motor paralysis after stroke. Methods: Thirty-six hemiparetic subacute post-stroke patients were enrolled. We examined the MT (index of muscle quantity) and the EI (index of muscle quality) at the anterior mid-thigh in both limbs. We also assessed the Brunnstrom stage (BR stage), subcutaneous adipose tissue thickness, time since stroke, age, body weight, sex, number of medications, and nutritional and inflammation status. Results: The MT in the paretic limb was explained by the BR stage (β = –0.26, p < 0.01), body weight (β = 0.68, p < 0.01), and serum albumin (β = 0.34, p < 0.01), with an adjusted R2 of 0.81. The MT in the non-paretic limb was explained by the muscle EI (β = –0.55, p < 0.01) and age (β = –0.40, p < 0.01), with an adjusted R2 of 0.69. The muscle EI was explained by the MT in the paretic limb (β = –0.34, p < 0.01) and non-paretic limb (β = –0.69, p < 0.01). Conclusions: Our results suggest that motor paralysis, aging, and malnutrition contribute to quadriceps atrophy in post-stroke patients. Moreover, a potential countermeasure to diminish muscle quality loss is maintenance of muscle quantity.

Unique Characteristics of Quadriceps Muscle Morphology and Function in Older Tennis Players

2021 ◽  
pp. 1-8
Author(s):  
Akito Yoshiko ◽  
Moroe Beppu ◽  
Naoki Chosa ◽  
Kohei Watanabe
Keyword(s):  
Vastus Lateralis ◽  
Muscle Thickness ◽  
Peak Torque ◽  
Quadriceps Muscle ◽  
Knee Extension ◽  
Muscle Quality ◽  
Muscle Size ◽  
Echo Intensity ◽  
Tennis Players ◽  
Vastus Intermedius

We investigated the quadriceps muscle size and quantitative characteristics in older tennis players. Thirty-eight senior tennis players (70.8 ± 5.3 years) and 38 controls (71.6 ± 5.1 years) were included. To measure the muscle size and quality, we measured muscle thickness in the rectus femoris (RF), vastus lateralis, and vastus intermedius, and muscle echo intensity in the RF and vastus lateralis using B-mode transverse ultrasound, respectively. We measured knee extension peak torque for muscle function. Muscle thickness in the RF, vastus lateralis, and vastus intermedius were significantly larger in tennis players than in controls. Tennis players had a lower echo intensity in RF and a higher knee extension peak torque compared to controls. Stepwise multiple linear regression analysis implied that echo intensity and muscle thickness were predictors of knee extension peak torque. Higher muscle quality contributes to a higher knee extension peak torque in tennis players. Playing tennis may prevent age-related muscle atrophy and maintain muscle quality in older individuals.

Abstract 90: Socioeconomic Status Is Associated With Disability Following Acute Ischemic Stroke: Findings From The Adherence eValuation After Ischemic stroke-Longitudinal (AVAIL) Registry

Stroke ◽  
2012 ◽  
Vol 43 (suppl_1) ◽  
Author(s):  
Janet Prvu Bettger ◽  
Xin Zhao ◽  
Cheryl Bushnell ◽  
Louise Zimmer ◽  
Ying Xian ◽  
...  
Keyword(s):  
Socioeconomic Status ◽  
Ischemic Stroke ◽  
Household Income ◽  
Work Status ◽  
Stroke Patients ◽  
Level Of Education ◽  
Post Stroke ◽  
Relationship Of ◽  
The Relationship ◽  
Education Work

Background: Socioeconomic status (SES) is widely recognized as an area of inequity that affects health outcomes. However, social determinants of health are less frequently measured in longitudinal studies of acute stroke patients. The relationship of SES on disability 3-months post-stroke is unknown. Methods: We analyzed ischemic stroke patients in the AVAIL registry who were enrolled at 98 hospitals participating in Get With The Guidelines-Stroke. Patients who died (n=64) or did not complete a modified Rankin Scale (mRS) at 3-months (n=154) were excluded. Multivariable logistic regression was used to examine the relationship of SES (defined by level of education, work status, and perceived adequacy of household income to meet needs) and disability (mRS scores 3-5). Results: Among the 2092 stroke patients who met eligibility criteria, the mean age was 65.5 ± 13.7, 44.2% were female, and 82.7% were White. Fifty seven percent had a high school or less education, 11.4% were not working post-stroke and were home not by choice, and 25.7% were without an adequate household income. A third of the sample had some level of disability at 3-months (34.6% mRS 3-5). Those with disability were more likely to be older, non-White, female, single, less educated, have inadequate income, and were home not by choice. In the multivariable analysis, lower education, inadequate income, and being home but not by choice (compared with those who returned to work) were independently associated with disability (p<0.01; Table ). Conclusion: In this national cohort of stroke survivors, socioeconomic status as measured by level of education, work status, and income were independently associated with post-stroke disability.

scholarly journals The Intention-behavior Relationship of Social Activities among Post-stroke Patients

2014 ◽  
Vol 29 (5) ◽  
pp. 679-682
Author(s):  
Kayo KONUMA ◽  
Takashi SHIMAZAKI ◽  
Yuri YAHAGI ◽  
Koji TAKENAKA
Keyword(s):  
Social Activities ◽  
Stroke Patients ◽  
Post Stroke ◽  
Relationship Of

scholarly journals Evaluation of spatio-temporal parameters of the non-paretic limb in the gait performance of post stroke patients

2021 ◽  
Author(s):  
Rodrigo Andreola Serraglio ◽  
Ana Carolina Pauleto ◽  
Guilherme Augusto de Oliveira
Keyword(s):  
Functional Dependence ◽  
Step Length ◽  
The Body ◽  
Stroke Patients ◽  
Post Stroke ◽  
Swing Time ◽  
Paretic Limb ◽  
Spatio Temporal ◽  
High Level ◽  
Support Phase

The objective of this study is to evaluate the compensation of the non-paretic side in the gait of post-stroke hemiparetic patients submitted to computerized gait analysis in the Centro Hospitalar de Reabilitação Ana Carolina Moura Xavier, Curitiba - PR, in a study carried out in 2015. Spatio-temporal data were evaluated: speed, stride and step length, swing time and support of both members. The sample consisted of twenty individuals with a mean time after stroke of 6.9 months. The results showed that the median speed was equivalent to 16.17% of the normal standard value, stride length to 31.22%, step length of the non-paretic limb to 31.69%. The swing time on the nonparetic side corresponded to 35% of the total cycle and the support time corresponded to 86%. There is a favoring of the paretic limb over the non-paretic one, as a compensation mechanism for weakness and impaired balance. Thus, the non-paretic limb spends more time in the support phase to allow a longer step length of the paretic limb while in swing. In contrast, the paretic limb is unable to support the body in the support phase for a long time, reducing the step length of the non-paretic limb. The significant reduction in gait speed indicates the high level of functional dependence in these patients. If there is an opportunity to act early in the rehabilitation of post-stroke patients, still in the acute phase, it is possible to quantify the improvement in the ability to walk.

Relationships of Muscle Echo Intensity with Walking Ability and Physical Activity in the Very Old Population

2017 ◽  
Vol 25 (2) ◽  
pp. 189-195 ◽  
Author(s):  
Yusuke Osawa ◽  
Yasumichi Arai ◽  
Yuko Oguma ◽  
Takumi Hirata ◽  
Yukiko Abe ◽  
...  
Keyword(s):  
Physical Activity ◽  
Muscle Thickness ◽  
Functional Mobility ◽  
Muscle Quality ◽  
Walking Ability ◽  
Echo Intensity ◽  
Triaxial Accelerometer ◽  
Timed Up And Go ◽  
Very Old ◽  
Functional Morbidity

This study investigated the relationships between muscle echo intensity (EI), physical activity (PA), and functional mobility in 108 Japanese (88–92 years). We measured EI and muscle thickness (MT) at the midpoint of the anterior superior iliac spine and patella using B-mode ultrasound. Light and moderate-to-vigorous PA (LPA and MVPA) were assessed with a triaxial accelerometer. The timed up and go (TUG) test was used to measure for functional mobility. EI, but not MT, was significantly associated with both TUG scores (β = 0.17, p = .047) and MVPA (β = –0.31, p = .01) when adjusted by potential confounders. However, association between EI and TUG disappeared after adjusted for MVPA. Meanwhile, MVPA was significantly associated with TUG scores independent of EI (β = –0.35, p < .001). Although EI of anterior thigh muscles might be a weaker predictor of functional morbidity than MVPA, it is a noninvasive and practical approach for assessing muscle quality in the very old.

scholarly journals The effects of early neurodevelopmental Bobath approach and mobilization on quadriceps muscle thickness in stroke patients

2019 ◽  
Vol 49 (1) ◽  
pp. 318-326
Author(s):  
Arzu GÜÇLÜ GÜNDÜZ ◽  
Gökhan YAZICI ◽  
Çağla ÖZKUL ◽  
Hamit KÜÇÜK ◽  
Hale Zeynep BATUR ÇAĞLAYAN
Keyword(s):  
Muscle Thickness ◽  
Quadriceps Muscle ◽  
Stroke Patients

Quadriceps Thickness and Echo Intensity Predict Gait Independence in Individuals with Severe and Mild Hemiparetic Stroke

2020 ◽  
Vol 83 (2) ◽  
pp. 167-173 ◽  
Author(s):  
Hisashi Maeda ◽  
Ken Imada ◽  
Koji Ishida ◽  
Hiroshi Akima
Keyword(s):  
Functional Independence Measure ◽  
Muscle Thickness ◽  
Intramuscular Fat ◽  
Functional Independence ◽  
Quadriceps Femoris ◽  
Limiting Factors ◽  
Muscle Size ◽  
Echo Intensity ◽  
Paretic Limb ◽  
Hemiparetic Stroke

Introduction: Smaller muscle size and higher adipose tissue ratio of the quadriceps femoris are often observed after stroke. However, it is unclear whether muscle size and the intramuscular fat ratio of the quadriceps measured with ultrasonography (US) reflect gait independence in individuals with mild or severe hemiparetic stroke. Objective: The present study was performed to examine the relationships of gait independence with muscle thickness (MT) and echo intensity (EI) of the quadriceps femoris in individuals with hemiparesis after stroke. Methods: We examined 43 individuals with hemiparetic stroke. We assessed functional independence measure (FIM) gait scores and measured thickness and EI of the quadriceps using US. The relationships of FIM gait scores with MT and EI were examined using Spearman’s correlation coefficients in mild (n = 21) and severe (n = 22) hemiparetic stroke groups. Results: In the mild hemiparetic group, FIM gait scores were correlated with paretic limb MT (rho = 0.60, p < 0.01) and EI (rho = −0.57, p < 0.01). In the severe hemiparetic group, FIM gait scores were correlated with paretic limb MT (rho = 0.67, p < 0.01) and EI (rho = −0.43, p < 0.05), as well as non-paretic limb MT (rho = 0.86, p < 0.01) and EI (rho = −0.56, p < 0.01). Conclusions: Quadriceps thickness and EI were associated with the degree of gait independence. Atrophy and increased intramuscular fat of the quadriceps may be limiting factors for achieving gait independence.

scholarly journals Ultrasonographic Evaluation of Botulinum Toxin Injection Site for the Medial Approach to Tibialis Posterior Muscle in Chronic Stroke Patients with Spastic Equinovarus Foot: An Observational Study

Toxins ◽  
2017 ◽  
Vol 9 (11) ◽  
pp. 375 ◽  
Author(s):  
Alessandro Picelli ◽  
Alessio Baricich ◽  
Elena Chemello ◽  
Nicola Smania ◽  
Carlo Cisari ◽  
...  
Keyword(s):  
Botulinum Toxin ◽  
Injection Site ◽  
Botulinum Toxin Injection ◽  
Muscle Thickness ◽  
Chronic Stroke ◽  
Tibialis Posterior ◽  
Anatomical Landmarks ◽  
Echo Intensity ◽  
Stroke Patients ◽  
Medial Approach

The tibialis posterior muscle is a frequent target for injection of botulinum toxin during the management of spastic equinovarus foot in adults with post-stroke spasticity. Although it is deep-seated, the needle insertion into the tibialis posterior muscle is usually performed using anatomical landmarks and safety information obtained from healthy subjects and cadavers. Our aim was to evaluate the botulinum toxin injection site for the medial approach to the tibialis posterior muscle in chronic stroke patients with spastic equinovarus foot. Forty-six patients were evaluated at the affected middle lower leg medial surface with ultrasonography according to the following parameters: tibialis posterior muscle depth, thickness, and echo intensity. As to the spastic tibialis posterior, we found a mean muscle depth of 26.5 mm and a mean muscle thickness of 10.1 mm. Furthermore we observed a median tibialis posterior muscle echo intensity of 3.00 on the Heckmatt scale. The tibialis posterior muscle thickness was found to be inversely associated with its depth (p < 0.001) and echo intensity (p = 0.006). Furthermore, tibialis posterior muscle depth was found to be directly associated with its echo intensity (p = 0.004). Our findings may usefully inform manual needle placement into the tibialis posterior for the botulinum toxin treatment of spastic equinovarus foot in chronic stroke patients.

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