Rectus Femoris Characteristics in Post Stroke Spasticity: Clinical Implications from Ultrasonographic Evaluation
In stroke survivors, rectus femoris (RF) spasticity is often implicated in gait pattern alterations such as stiff knee gait (SKG). Botulinum toxin type A (BoNT-A) is considered the gold standard for focal spasticity treatment. However—even if the accuracy of injection is crucial for BoNT-A efficacy—...
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| Format: | Article |
| Language: | English |
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MDPI AG
2020-07-01
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| Series: | Toxins |
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| Online Access: | https://www.mdpi.com/2072-6651/12/8/490 |
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| author | Lucia Cosenza Alessandro Picelli Danila Azzolina Marco Alessandro Minetto Marco Invernizzi Michele Bertoni Andrea Santamato Alessio Baricich |
| author_facet | Lucia Cosenza Alessandro Picelli Danila Azzolina Marco Alessandro Minetto Marco Invernizzi Michele Bertoni Andrea Santamato Alessio Baricich |
| author_sort | Lucia Cosenza |
| collection | DOAJ |
| description | In stroke survivors, rectus femoris (RF) spasticity is often implicated in gait pattern alterations such as stiff knee gait (SKG). Botulinum toxin type A (BoNT-A) is considered the gold standard for focal spasticity treatment. However—even if the accuracy of injection is crucial for BoNT-A efficacy—instrumented guidance for BoNT-A injection is not routinely applied in clinical settings. In order to investigate the possible implications of an inadequate BoNT-A injection on patients’ clinical outcome, we evaluated the ultrasound-derived RF characteristics (muscle depth, muscle thickness, cross-sectional area and mean echo intensity) in 47 stroke survivors. In our sample, we observed wide variability of RF depth in both hemiparetic and unaffected side of included patients (0.44 and 3.54 cm and between 0.25 and 3.16 cm, respectively). Moreover, our analysis did not show significant differences between treated and non-treated RF in stroke survivors. These results suggest that considering the inter-individual variability in RF muscle depth and thickness, injection guidance should be considered for BoNT-A treatment in order to optimize the clinical outcome of treated patients. In particular, ultrasound guidance may help the clinicians in the long-term follow-up of muscle quality. |
| first_indexed | 2024-03-10T18:04:24Z |
| format | Article |
| id | doaj.art-9a7d4d2e05e3490795800d2e32dfb2ff |
| institution | Directory Open Access Journal |
| issn | 2072-6651 |
| language | English |
| last_indexed | 2024-03-10T18:04:24Z |
| publishDate | 2020-07-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Toxins |
| spelling | doaj.art-9a7d4d2e05e3490795800d2e32dfb2ff2023-11-20T08:39:13ZengMDPI AGToxins2072-66512020-07-0112849010.3390/toxins12080490Rectus Femoris Characteristics in Post Stroke Spasticity: Clinical Implications from Ultrasonographic EvaluationLucia Cosenza0Alessandro Picelli1Danila Azzolina2Marco Alessandro Minetto3Marco Invernizzi4Michele Bertoni5Andrea Santamato6Alessio Baricich7Physical and Rehabilitation Medicine, Department of Scienze della Salute, University of Piemonte Orientale, 28100 Novara, ItalyNeuromotor and Cognitive Rehabilitation Research Center, Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, 37134 Verona, ItalyDepartment of Translational Medicine, University of Piemonte Orientale, 28100 Novara, ItalyDivision of Physical Medicine and Rehabilitation, Department of Surgical Sciences, University of Turin, 10126 Turin, ItalyPhysical and Rehabilitation Medicine, Department of Scienze della Salute, University of Piemonte Orientale, 28100 Novara, ItalyPhysical Medicine and Rehabilitation, ASST Sette Laghi, 21100 Varese, ItalyPhysical Medicine and Rehabilitation Section, “OORR” Hospital, University of Foggia, 71122 Foggia, ItalyPhysical and Rehabilitation Medicine, Department of Scienze della Salute, University of Piemonte Orientale, 28100 Novara, ItalyIn stroke survivors, rectus femoris (RF) spasticity is often implicated in gait pattern alterations such as stiff knee gait (SKG). Botulinum toxin type A (BoNT-A) is considered the gold standard for focal spasticity treatment. However—even if the accuracy of injection is crucial for BoNT-A efficacy—instrumented guidance for BoNT-A injection is not routinely applied in clinical settings. In order to investigate the possible implications of an inadequate BoNT-A injection on patients’ clinical outcome, we evaluated the ultrasound-derived RF characteristics (muscle depth, muscle thickness, cross-sectional area and mean echo intensity) in 47 stroke survivors. In our sample, we observed wide variability of RF depth in both hemiparetic and unaffected side of included patients (0.44 and 3.54 cm and between 0.25 and 3.16 cm, respectively). Moreover, our analysis did not show significant differences between treated and non-treated RF in stroke survivors. These results suggest that considering the inter-individual variability in RF muscle depth and thickness, injection guidance should be considered for BoNT-A treatment in order to optimize the clinical outcome of treated patients. In particular, ultrasound guidance may help the clinicians in the long-term follow-up of muscle quality.https://www.mdpi.com/2072-6651/12/8/490muscle spasticitybotulinum toxin type Aultrasonographystrokerehabilitationstiff knee gait |
| spellingShingle | Lucia Cosenza Alessandro Picelli Danila Azzolina Marco Alessandro Minetto Marco Invernizzi Michele Bertoni Andrea Santamato Alessio Baricich Rectus Femoris Characteristics in Post Stroke Spasticity: Clinical Implications from Ultrasonographic Evaluation Toxins muscle spasticity botulinum toxin type A ultrasonography stroke rehabilitation stiff knee gait |
| title | Rectus Femoris Characteristics in Post Stroke Spasticity: Clinical Implications from Ultrasonographic Evaluation |
| title_full | Rectus Femoris Characteristics in Post Stroke Spasticity: Clinical Implications from Ultrasonographic Evaluation |
| title_fullStr | Rectus Femoris Characteristics in Post Stroke Spasticity: Clinical Implications from Ultrasonographic Evaluation |
| title_full_unstemmed | Rectus Femoris Characteristics in Post Stroke Spasticity: Clinical Implications from Ultrasonographic Evaluation |
| title_short | Rectus Femoris Characteristics in Post Stroke Spasticity: Clinical Implications from Ultrasonographic Evaluation |
| title_sort | rectus femoris characteristics in post stroke spasticity clinical implications from ultrasonographic evaluation |
| topic | muscle spasticity botulinum toxin type A ultrasonography stroke rehabilitation stiff knee gait |
| url | https://www.mdpi.com/2072-6651/12/8/490 |
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