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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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Autores principales: Cosenza, Lucia, Picelli, Alessandro, Azzolina, Danila, Minetto, Marco Alessandro, Invernizzi, Marco, Bertoni, Michele, Santamato, Andrea, Baricich, Alessio
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7472004/
https://www.ncbi.nlm.nih.gov/pubmed/32751934
http://dx.doi.org/10.3390/toxins12080490
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author Cosenza, Lucia
Picelli, Alessandro
Azzolina, Danila
Minetto, Marco Alessandro
Invernizzi, Marco
Bertoni, Michele
Santamato, Andrea
Baricich, Alessio
author_facet Cosenza, Lucia
Picelli, Alessandro
Azzolina, Danila
Minetto, Marco Alessandro
Invernizzi, Marco
Bertoni, Michele
Santamato, Andrea
Baricich, Alessio
author_sort Cosenza, Lucia
collection PubMed
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.
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spelling pubmed-74720042020-09-17 Rectus Femoris Characteristics in Post Stroke Spasticity: Clinical Implications from Ultrasonographic Evaluation Cosenza, Lucia Picelli, Alessandro Azzolina, Danila Minetto, Marco Alessandro Invernizzi, Marco Bertoni, Michele Santamato, Andrea Baricich, Alessio Toxins (Basel) Article 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. MDPI 2020-07-31 /pmc/articles/PMC7472004/ /pubmed/32751934 http://dx.doi.org/10.3390/toxins12080490 Text en © 2020 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Cosenza, Lucia
Picelli, Alessandro
Azzolina, Danila
Minetto, Marco Alessandro
Invernizzi, Marco
Bertoni, Michele
Santamato, Andrea
Baricich, Alessio
Rectus Femoris Characteristics in Post Stroke Spasticity: Clinical Implications from Ultrasonographic Evaluation
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 Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7472004/
https://www.ncbi.nlm.nih.gov/pubmed/32751934
http://dx.doi.org/10.3390/toxins12080490
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