scholarly journals The Value of Real-Time Shear Wave Elastography before and after Rehabilitation of Upper Limb Spasm in Stroke Patients

2020 ◽  
Vol 2020 ◽  
pp. 1-7
Author(s):  
Jun Liu ◽  
Huijuan Pan ◽  
Yong Bao ◽  
Yanna Zhao ◽  
Li Huang ◽  
...  
Keyword(s):  
Shear Wave ◽  
Upper Limb ◽  
Biceps Brachii ◽  
Shear Wave Elastography ◽  
Stroke Patients ◽  
Rehabilitation Treatment ◽  
Modified Ashworth Scale ◽  
Significant Difference ◽  
Before And After ◽  
Ashworth Scale

Objective. Our goal was to evaluate the efficacy of muscle spasm before and after rehabilitation by comparing shear wave propagation velocity (SWV) and Young’s modulus (YM) in the normal and spastic biceps brachii in stroke patients. Methods. A study of 60 stroke patients with upper limb spasm was performed; these patients were admitted from April 2018 to September 2019. The modified Ashworth scale (MAS) scores of the spastic biceps brachii before and after rehabilitation treatment were compared. SWV and YM on the spastic and normal biceps brachii before rehabilitation treatment, SWV and YM on the spastic and normal biceps brachii after rehabilitation treatment, and SWV and YM on the spastic biceps brachii before and after rehabilitation treatment were compared. Whether SWV and YM on the spastic biceps brachii are related to MAS was compared. Results. There was a statistically significant difference in SWV and YM between the normal and spastic biceps brachii before (P<0.01) and after (P<0.05) the rehabilitation treatment. There was no statistically significant difference in SWV and YM in the normal biceps brachii before and after the rehabilitation treatment (P>0.05). There was a statistically significant difference in SWV and YM in the spastic biceps brachii before and after the rehabilitation treatment (P<0.01). SWV and FM of the spastic biceps brachii are correlated with MAS before and after rehabilitation treatment, and the correlation coefficient for SWV was 0.563 and 0.605 for YM (P<0.05). Conclusion. SWE can be used as a means of assessment before and after rehabilitation treatment.

scholarly journals An effective approach for botulinum toxin injection in patients with stroke for focal spasticity: dual guidance

2018 ◽  
Vol 5 (9) ◽  
pp. 326-330
Author(s):  
Emre Ata ◽  
Murat Kosem
Keyword(s):  
Botulinum Toxin ◽  
Upper Limb ◽  
Botulinum Toxin Injection ◽  
Stroke Patients ◽  
Modified Ashworth Scale ◽  
Significant Difference ◽  
Limb Muscles ◽  
Botulinum Toxin Injections ◽  
Ashworth Scale ◽  
Electrical Muscle

Objective: This study has aimed to compare the efficacy of botulinum toxin (BTX) injections, applied to the upper limb muscles of the stroke patients in our clinic who have being diagnosed with focal spasticity, that are performed via ultrasonography and ultrasonography + electrical muscle (EM) stimulator guidance. Literature didn’t include detailed crosscheck of ultrasound guided BTX and EM treatment applications for upper limb focal spasticity patients Materials and Methods: Electronic data on 62 hemiplegic stroke patients with grade 2 and 3 focal spasticity who had received botulinum toxin injections into their upper limb muscles by the same physician, who used similar protocol and recorded the results, were scanned retrospectively. The spasticity of the patients in both groups was assessed with the Modified Ashworth Scale at the end of two weeks and three months. Results: A statistically significant difference was found between the Modified Ashworth Scale values of both groups in terms of all muscles, compared to the values seen in the pre-treatment period (p<0.05). The Modified Ashworth Scale values at 3 months posttreatment in ultrasonography + electrical muscle stimulator group were not statistically different from those at 2 weeks posttreatment, with respect to wrist flexion and finger flexion. In intergroup comparison, there was no statistically significant difference between the Modified Ashworth Scale values of at pretreatment and 2 weeks posttreatment. However, statistically significant difference in all muscle groups was found in favor of the ultrasonography + electrical muscle stimulator group at 3 months posttreatment controls (p<0.05). Conclusion: Upper limb spasticity due to stroke can be substantially recovered with botulinum toxin injections that are applied via only ultrasonography guidance or via ultrasonography + electrical muscle stimulator guidance.. According to data from the assessment at 3 months posttreatment, the botulinum toxin injection performed via ultrasonography + electrical muscle stimulator guidance had more positive effects .

scholarly journals Effect of Resonant Frequency Vibration on Delayed Onset Muscle Soreness and Resulting Stiffness as Measured by Shear-Wave Elastography

2021 ◽  
Vol 18 (15) ◽  
pp. 7853
Author(s):  
Garrett C. Jones ◽  
Jonathan D. Blotter ◽  
Cameron D. Smallwood ◽  
Dennis L. Eggett ◽  
Darryl J. Cochrane ◽  
...  
Keyword(s):  
Resonant Frequency ◽  
Shear Wave ◽  
Time Course ◽  
Biceps Brachii ◽  
Shear Wave Elastography ◽  
Upper Body ◽  
Maximum Voluntary Isometric Contraction ◽  
Post Exercise ◽  
Significant Difference ◽  
Pain Ratings

This study utilized resonant frequency vibration to the upper body to determine changes in pain, stiffness and isometric strength of the biceps brachii after eccentric damage. Thirty-one participants without recent resistance training were randomized into three groups: a Control (C) group and two eccentric exercise groups (No vibration (NV) and Vibration (V)). After muscle damage, participants in the V group received upper body vibration (UBV) therapy for 5 min on days 1–4. All participants completed a visual analog scale (VAS), maximum voluntary isometric contraction (MVIC), and shear wave elastography (SWE) of the bicep at baseline (pre-exercise), 24 h, 48 h, and 1-week post exercise. There was a significant difference between V and NV at 24 h for VAS (p = 0.0051), at 24 h and 1-week for MVIC (p = 0.0017 and p = 0.0016, respectively). There was a significant decrease in SWE for the V group from 24–48 h (p = 0.0003), while there was no significant change in the NV group (p = 0.9341). The use of UBV resonant vibration decreased MVIC decrement and reduced VAS pain ratings at 24 h post eccentric damage. SWE was strongly negatively correlated with MVIC and may function as a predictor of intrinsic muscle state in the time course of recovery of the biceps brachii.

scholarly journals Brain-Computer Interface Coupled to a Robotic Hand Orthosis for Stroke Patients’ Neurorehabilitation: A Crossover Feasibility Study

2021 ◽  
Vol 15 ◽  
Author(s):  
Jessica Cantillo-Negrete ◽  
Ruben I. Carino-Escobar ◽  
Paul Carrillo-Mora ◽  
Marlene A. Rodriguez-Barragan ◽  
Claudia Hernandez-Arenas ◽  
...  
Keyword(s):  
Feasibility Study ◽  
Upper Limb ◽  
Conventional Therapy ◽  
Stroke Rehabilitation ◽  
Motor Evoked Potentials ◽  
Random Order ◽  
Robotic Hand ◽  
Stroke Patients ◽  
Significant Difference ◽  
Before And After

Brain-Computer Interfaces (BCI) coupled to robotic assistive devices have shown promise for the rehabilitation of stroke patients. However, little has been reported that compares the clinical and physiological effects of a BCI intervention for upper limb stroke rehabilitation with those of conventional therapy. This study assesses the feasibility of an intervention with a BCI based on electroencephalography (EEG) coupled to a robotic hand orthosis for upper limb stroke rehabilitation and compares its outcomes to conventional therapy. Seven subacute and three chronic stroke patients (M = 59.9 ± 12.8) with severe upper limb impairment were recruited in a crossover feasibility study to receive 1 month of BCI therapy and 1 month of conventional therapy in random order. The outcome measures were comprised of: Fugl-Meyer Assessment of the Upper Extremity (FMA-UE), Action Research Arm Test (ARAT), motor evoked potentials elicited by transcranial magnetic stimulation (TMS), hand dynamometry, and EEG. Additionally, BCI performance and user experience were measured. All measurements were acquired before and after each intervention. FMA-UE and ARAT after BCI (23.1 ± 16; 8.4 ± 10) and after conventional therapy (21.9 ± 15; 8.7 ± 11) were significantly higher (p &lt; 0.017) compared to baseline (17.5 ± 15; 4.3 ± 6) but were similar between therapies (p &gt; 0.017). Via TMS, corticospinal tract integrity could be assessed in the affected hemisphere of three patients at baseline, in five after BCI, and four after conventional therapy. While no significant difference (p &gt; 0.05) was found in patients’ affected hand strength, it was higher after the BCI therapy. EEG cortical activations were significantly higher over motor and non-motor regions after both therapies (p &lt; 0.017). System performance increased across BCI sessions, from 54 (50, 70%) to 72% (56, 83%). Patients reported moderate mental workloads and excellent usability with the BCI. Outcome measurements implied that a BCI intervention using a robotic hand orthosis as feedback has the potential to elicit neuroplasticity-related mechanisms, similar to those observed during conventional therapy, even in a group of severely impaired stroke patients. Therefore, the proposed BCI system could be a suitable therapy option and will be further assessed in clinical trials.

scholarly journals Quantitative Ultrasound to Assess Skeletal Muscles in Post Stroke Spasticity

2021 ◽  
Vol 13 ◽  
pp. 117957352199614
Author(s):  
Anthony Tran ◽  
Jing Gao
Keyword(s):  
Shear Wave ◽  
Quantitative Ultrasound ◽  
Skeletal Muscles ◽  
Shear Wave Elastography ◽  
Strain Ratio ◽  
Muscle Stiffness ◽  
Pixel Intensity ◽  
Post Stroke ◽  
Modified Ashworth Scale ◽  
Before And After

Quantitative ultrasound (QUS) techniques such as pixel intensity, ultrasound strain, and shear wave elastography have made it possible to identify the echogenicity (brightness) and mechanical properties (stiffness) of normal and pathological tissues. These techniques can be utilized as an alternative diagnosis tool to assess post stroke spasticity. Current clinical assessment methods include the Modified Ashworth Scale (MAS) and the Modified Tardieu Scale (MTS), which can result in inconsistencies due to their subjective nature. QUS provides robust approaches to assessing muscle stiffness associated with post stroke spasticity. Computer-aided pixel count quantifies tissue echogenicity in grayscale image. A strain ratio in ultrasound strain imaging compares the stiffness and movement (lengthening or shortening) of a spastic muscle with nonspecific muscle. In addition, shear wave elastography provides the shear wave velocity of an affected muscle that directly associated with the muscle stiffness before and after treatment for spasticity. This article reviews the theory behind these aforementioned concepts and discuss the relations between QUS and skeletal muscles in post stroke spasticity.

scholarly journals Acupuncture with Rehabilitation in the Treatment of Ischemic Stroke Recovery: A Randomized Controlled Trial

2019 ◽  
Author(s):  
Lixia Li ◽  
Weifeng Zhu ◽  
Guohua Lin ◽  
Chuyun Chen ◽  
Donghui Tang ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Controlled Trial ◽  
Stroke Recovery ◽  
Control Group ◽  
Acupuncture Points ◽  
Modified Ashworth Scale ◽  
Significant Difference ◽  
Scale Scores ◽  
Before And After ◽  
Ashworth Scale

Abstract Background: Acupuncture is a well known treatment for ischemic stroke recovery, but evidence of its effectiveness remains limited. Methods: Rehabilitation training was provided to a control group. In Arm 1 and Arm 2, acupoint schemes were determined by a consensus of acupuncture experts and previous clinical research. Arm 1 was based on an acupoint summary of ancient literature, and Arm 2 was based on the summary of effective acupuncture points from modern RCT literature. Acupuncture was given on the acupoint. After acupuncture, the needles were left in for 30 minutes, and checked every 10 minutes. The three groups received treatment once a day, 5 times a week, for 2 weeks. The primary outcome was the National Institute of Health stroke scale (NIHSS), and the secondary outcomes were the Barthel index (BI) and the modified Ashworth scale (MAS). Outcomes were observed in patients both before and after treatment. Results: A total of 497 patients with ischemic stroke were randomized into either Arm 1 (159 cases), Arm 2 (173 cases) or a control group (165 cases). After 2 weeks of treatment, the NIHSS scores for Arm 1 were lower than those of the control group (P=0.017); the BI scores were higher in Arm 2 than they were in the control group (P=0.020). Additionally, there was no significant difference between Arm 1 and the control group for either the BI scores or the modified Ashworth scale scores (P>0.05). Conclusion: The clinical efficacy of Arm 1 and Arm 2 (acupuncture groups) was superior to that of the control group.

Effects of a 3D-printed orthosis compared to a low-temperature thermoplastic plate orthosis on wrist flexor spasticity in chronic hemiparetic stroke patients: a randomized controlled trial

2019 ◽  
Vol 34 (2) ◽  
pp. 194-204
Author(s):  
Yanan Zheng ◽  
Gongliang Liu ◽  
Long Yu ◽  
Yanmin Wang ◽  
Yuan Fang ◽  
...  
Keyword(s):  
Low Temperature ◽  
Control Group ◽  
Subjective Feeling ◽  
Stroke Patients ◽  
Wrist Flexor ◽  
Modified Ashworth Scale ◽  
Significant Difference ◽  
Scale Scores ◽  
3D Printed ◽  
Ashworth Scale

Objective: The aim of this study was to compare the effects of two kinds of wrist-hand orthosis on wrist flexor spasticity in chronic stroke patients. Design: This is a randomized controlled trial. Setting: The study was conducted in a rehabilitation center. Participants: A total of 40 chronic hemiparetic stroke patients with wrist flexor spasticity were involved in the study. Interventions: Patients were randomly assigned to either an experimental group (conventional rehabilitation therapy + 3D-printed orthosis, 20 patients) or a control group (conventional rehabilitation therapy + low-temperature thermoplastic plate orthosis, 20 patients). The time of wearing orthosis was about 4–8 hours per day for six weeks. Main measures: Primary outcome measure: Modified Ashworth Scale was assessed three times (at baseline, three weeks, and six weeks). Secondary outcome measures: passive range of motion, Fugl-Meyer Assessment score, visual analogue scale score, and the swelling score were assessed twice (at baseline and six weeks). The subjective feeling score was assessed at six weeks. Results: No significant difference was found between the two groups in the change of Modified Ashworth Scale scores at three weeks (15% versus 25%, P = 0.496). At six weeks, the Modified Ashworth Scale scores (65% versus 30%, P = 0.02), passive range of wrist extension ( P < 0.001), ulnar deviation ( P = 0.028), Fugl-Meyer Assessment scores ( P < 0.001), and swelling scores ( P < 0.001) showed significant changes between the experimental group and the control group. No significant difference was found between the two groups in the change of visual analogue scale scores ( P = 0.637) and the subjective feeling scores ( P = 0.243). Conclusion: 3D-printed orthosis showed greater changes than low-temperature thermoplastic plate orthosis in reducing spasticity and swelling, improving motor function of the wrist and passive range of wrist extension for stroke patients.

scholarly journals Latihan Range of Motion Terhadap Rentang Gerak Sendi Ekstremitas Atas Pasien Stroke di RSUD M.Natsir

2021 ◽  
Vol 16 (2) ◽  
pp. 109-117
Author(s):  
Tintin - Sumarni ◽  
Yulastri Yulastri
Keyword(s):  
Range Of Motion ◽  
Upper Limb ◽  
Upper Extremities ◽  
Distributed Data ◽  
Functional Disorders ◽  
Stroke Patients ◽  
Significant Difference ◽  
Before And After ◽  
Upper And Lower Extremities ◽  
Quasi Experimental

Stroke patients who experience hemiparese who do not receive proper treatment can cause complications of functional disorders, impaired mobilization, disruption of daily activities and incurable disabilities. The purpose of this study was to determine the effect of passive Range Of Motion (ROM) exercise on increasing the range of motion of stroke patients in the Neurology Room at RSUD M.Natsir.This research design is quasi experimental with the design used is one group pretest - postest design.In this study, passive Range Of Motion (ROM) was performed on the upper extremities of stroke patients for five days, twice a day.The number of respondents in 30 stroke patients who experienced hemiparese,The data was collected by direct measurement using a measuring instrument for the degree of motion of the joints, namely the goniometer, and data analysis was carried out using the t dependent test (normally distributed data).The results showed a significant difference in the range of motion of the upper limb joints before and after passive ROM exercises. The conclusion that ROM exercises affect the range of motion of the upper limb joints in stroke patients.Passive ROM can be an alternative to increase the range of motion of the joints in the upper and lower extremities in stroke patients.

scholarly journals Association between Severe Upper Limb Spasticity and Brain Lesion Location in Stroke Patients

2014 ◽  
Vol 2014 ◽  
pp. 1-6 ◽  
Author(s):  
Alessandro Picelli ◽  
Stefano Tamburin ◽  
Francesca Gajofatto ◽  
Giampietro Zanette ◽  
Marialuigia Praitano ◽  
...  
Keyword(s):  
White Matter ◽  
Upper Limb ◽  
Brain Lesion ◽  
Mapping Method ◽  
Thalamic Nuclei ◽  
Stroke Patients ◽  
Lesion Location ◽  
Modified Ashworth Scale ◽  
Limb Spasticity ◽  
Ashworth Scale

Association between the site of brain injury and poststroke spasticity is poorly understood. The present study investigated whether lesion analysis could document brain regions associated with the development of severe upper limb poststroke spasticity. A retrospective analysis was conducted on 39 chronic stroke patients. Spasticity was assessed at the affected upper limb with the modified Ashworth scale (shoulder, elbow, wrist, and fingers). Brain lesions were traced from magnetic resonance imaging performed within the first 7 days after stroke and region of interest images were generated. The association between severe upper limb spasticity (modified Ashworth scale ≥2) and lesion location was determined with the voxel-based lesion-symptom mapping method implemented in MRIcro software. Colored maps representing thezstatistics were generated and overlaid onto the automated anatomical labeling and the Johns Hopkins University white matter templates provided with MRIcron. Thalamic nuclei were identified with the Talairach Daemon software. Injuries to the insula, the thalamus, the basal ganglia, and white matter tracts (internal capsule, corona radiata, external capsule, and superior longitudinal fasciculus) were significantly associated with severe upper limb poststroke spasticity. Further advances in our understanding of the neural correlates of spasticity may lead to early targeted rehabilitation when key regions are damaged.

Liver Elastography in Healthy Children Using Three Different Systems – How Many Measurements Are Necessary?

2020 ◽  
Author(s):  
Anders Batman Mjelle ◽  
Anesa Mulabecirovic ◽  
Roald Flesland Havre ◽  
Edda Jonina Olafsdottir ◽  
Odd Helge Gilja ◽  
...  
Keyword(s):  
Shear Wave ◽  
Transient Elastography ◽  
Intraclass Correlation ◽  
Age Groups ◽  
Liver Stiffness ◽  
Shear Wave Elastography ◽  
Healthy Children ◽  
Significant Difference ◽  
Pediatric Liver Disease ◽  
Liver Elastography

Abstract Purpose Liver elastography is increasingly being applied in screening for and follow-up of pediatric liver disease, and has been shown to correlate well with fibrosis staging through liver biopsy. Because time is of the essence when examining children, we wanted to evaluate if a reliable result can be achieved with fewer acquisitions. Materials and Methods 243 healthy children aged 4–17 years were examined after three hours of fasting. Participants were divided into four age groups: 4–7 years; 8–11 years; 12–14 years and 15–17 years. Both two-dimensional shear wave elastography (2D-SWE; GE Logiq E9) and point shear wave elastography (pSWE; Samsung RS80A with Prestige) were performed in all participants, while transient elastography (TE, Fibroscan) was performed in a subset of 87 children aged 8–17 years. Median liver stiffness measurement (LSM) values of 3, 4, 5, 6, 7, and 8 acquisitions were compared with the median value of 10 acquisitions (reference standard). Comparison was performed for all participants together as well as within every specific age group. We investigated both the intraclass correlation coefficient (ICC) with absolute agreement and all outliers more than 10 %, 20 % or ≥ 0.5 or 1.0 kPa from the median of 10 acquisitions. Results For all three systems there was no significant difference between three and ten acquisitions, with ICCs ≥ 0.97. All systems needed 4 acquisitions to achieve no LSM deviating ≥ 1.0 kPa of a median of ten. To achieve no LSM deviating ≥ 20 % of a median of ten acquisitions, pSWE and TE needed 4 acquisitions, while 2D-SWE required 6 acquisitions. Conclusion Our results contradict recommendations of 10 acquisitions for pSWE and TE and only 3 for 2D-SWE.

scholarly journals Decreased Size of Mammary Tumors Caused by Preoperative Treatment with Aglepristone in Female Domestic Dogs (Canis familiaris) Do Not Influence the Density of the Benign Neoplastic Tissue Measured Using Shear Wave Elastography Technique

Animals ◽  
2021 ◽  
Vol 11 (2) ◽  
pp. 527 ◽  
Author(s):  
Barbara Pieczewska ◽  
Kamila Glińska-Suchocka ◽  
Wojciech Niżański ◽  
Michał Dzięcioł
Keyword(s):  
Shear Wave ◽  
Tumor Size ◽  
Histopathological Examination ◽  
Shear Wave Elastography ◽  
Mammary Tumors ◽  
Needle Aspiration ◽  
Surgical Removal ◽  
Preoperative Treatment ◽  
Neoplastic Tissue ◽  
Before And After

Shear wave elastography (SWE) can be useful to discriminate between malignant and benign mammary tumors. In dogs with elevated progesterone levels compared to the baseline and fast-growing tumors, treatment with the use of aglepristone allows for tumor size reduction, which facilitates surgery. This study aimed to evaluate the influence of the preoperative treatment of benign mammary tumors (BMTs), performed with the use of aglepristone, on the density of the tumor tissue measured by SWE. Twelve female dogs with diagnosed BMTs and increased levels of progesterone were treated with aglepristone (Alizine, Virbac, France) at 10 mg/kg s.c. (Subcutaneous injection). twice, with a 24 h interval. The density of the tumor was evaluated by SWE before and after the treatment. The type of tumor was evaluated by fine needle aspiration cytology before treatment, and a histopathological examination was made after surgical removal, performed after the aglepristone treatment. In all the cases, a significant reduction in the mammary tumor’s size was observed following treatment, with no influence on the density of the tumor’s tissue measured by SWE. Similar studies on malignant mammary tumors are warranted to verify if in these cases, density will also be a constant parameter that is not dependent on the tumor size.

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