Stroke, a serious neurological condition, can lead to significant motor impairments and a reduced quality of life for those affected. One of the key contributors to these impairments is the alteration of skeletal muscle architecture, which often occurs as a result of stroke-induced neural damage. While ultrasound has shown promise as a tool for muscle assessment, its reliability in evaluating muscle changes in post-stroke patients has not been thoroughly examined.
This systematic review aims to address this gap by synthesizing available data on the reliability of ultrasound-based measurements of muscle architecture in post-stroke patients. By doing so, we hope to provide valuable insights into the clinical application of ultrasound in this specific population.
Our review included 13 studies, which collectively demonstrated that ultrasound is a reliable method for assessing various muscle architecture parameters, including muscle thickness, pennation angle, cross-sectional area, muscle volume, and length. The reliability of ultrasound was found to be moderate to excellent across different muscles and measurement parameters, with supporting evidence ranging from moderate to strong.
One interesting finding was that the reliability of ultrasound can be influenced by muscle state and joint angle. For example, the ICC values for pennation angle were lower at rest compared to during muscle contraction. Additionally, the ICC values for muscle thickness of the deltoid muscle varied depending on the shoulder joint angle.
The clinical implications of these findings are significant. Accurate assessment of muscle changes is crucial for developing effective rehabilitation plans for post-stroke patients. Ultrasound, with its moderate to excellent reliability, can play a vital role in promptly evaluating these changes and guiding personalized treatment approaches.
To ensure the effective clinical application of ultrasound, several recommendations were synthesized from the included studies. These include standardizing measurement postures, ensuring accurate probe placement and pressure, utilizing stabilization techniques when necessary, and implementing comprehensive operator training programs.
While this review provides valuable insights, it is important to acknowledge its limitations. The inclusion of only English-language, full-text publications may have resulted in the omission of relevant non-English literature. Additionally, the limited number of available studies and significant heterogeneity among them prevented the conduct of a meta-analysis, thus limiting the synthesis to a qualitative analysis. Furthermore, the absence of validity data highlights the need for further investigation in future studies.
Despite these limitations, this systematic review provides a comprehensive overview of the clinical application of ultrasound in post-stroke patients and highlights its potential as a reliable tool for muscle assessment in this population. Further research and validation studies are warranted to enhance our understanding and optimize the clinical utility of ultrasound in stroke rehabilitation.
