Stroke, Tibialis Anterior Architecture
Conditions
Keywords
Ultrasonography, Stroke, Muscle Architecture, Pennation Angle, Fascicle Length, Muscle Thickness
Brief summary
This study aims to investigate the structural architectural changes of the Tibialis Anterior muscle in patients with subacute and chronic stroke using ultrasonography. The study will compare the morphological parameters (pennation angle, fascicle length, and muscle thickness) of the paretic side with the non-paretic side and analyze the relationship between these structural changes and the patients' clinical and demographic data.
Detailed description
Stroke is a serious neurological disease characterized by high mortality, morbidity, and disability rates. Post-stroke motor and sensory impairments significantly limit patients' independence. A common impairment is hemiparesis, specifically weakness in the paretic leg leading to reduced dorsiflexion range of motion (foot drop). It remains unclear whether this weakness stems solely from neurological impairment or also involves changes in muscle architecture. Muscle fascicle length and pennation angle are critical architectural parameters influencing force production capacity.
Interventions
None listed
Sponsors
Istanbul Physical Medicine Rehabilitation Training and Research Hospital
Study design
Observational model
CASE_CONTROL
Time perspective
CROSS_SECTIONAL
Eligibility
Sex/Gender
ALL
Age
40 Years to 80 Years
Healthy volunteers
No
Inclusion criteria
* Male and female patients aged 40-80 years. * History of ischemic or hemorrhagic Cerebrovascular Accident (CVA). * Being in the subacute or chronic phase post-stroke. * Absence of communication deficits; ability to follow verbal commands. * Voluntary agreement to participate and provision of written informed consent. * Ability to ambulate without physical assistance from another person (use of assistive devices such as leg orthoses or tripods is permitted).
Exclusion criteria
* Presence of other comorbidities affecting gait (e.g., Parkinson's disease, hip surgery, etc.). * History of dyspnea (shortness of breath) during activities of daily living within the last 6 months. * Presence of bone or joint-related pain or pathology in the spine or hips. * Presence of psychiatric or cognitive disorders (e.g., learning disabilities, mental disorders, autism, etc.). * Decompensated cardiac, renal, or hepatic failure. * Presence of malignancy.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Pennation Angle | at baseline assessment | The Pennation Angle is the angle formed between muscle fascicles and the deep aponeurosis, serving as a critical determinant of muscle force-generating capacity. Measured via longitudinal ultrasonography on the Tibialis Anterior, this parameter quantifies structural remodeling. In stroke survivors, alterations in this angle reflect muscle atrophy and directly impact functional recovery and gait potential. |
| Muscle Thickness | at baseline assessment | Muscle Thickness is defined as the perpendicular distance between the superficial and deep aponeuroses at the widest point of the muscle belly. Measured via ultrasonography on the Tibialis Anterior, it serves as a direct indicator of muscle volume. In stroke survivors, reduced thickness quantifies the extent of muscle atrophy, providing insight into the loss of contractile mass and associated weakness. |
| Muscle Fascicle Length | at baseline assessment | Muscle Fascicle Length is defined as the linear distance between the superficial and deep aponeuroses along the muscle fiber path. Assessed via ultrasonography in the Tibialis Anterior, this parameter is a key determinant of muscle shortening velocity and excursion range. In post-stroke patients, shortened fascicles often indicate structural adaptations related to spasticity and reduced functional mobility. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| The Brunnstrom Recovery Stage | at baseline assessment | The Brunnstrom Recovery Stage is a standardized clinical tool used to evaluate motor recovery in stroke survivors. It classifies the progression of motor function into six sequential stages, ranging from flaccidity (Stage 1) to isolated, near-normal movement (Stage 6). In this study, it quantifies lower extremity motor impairment to correlate functional recovery status with the structural architectural changes observed in the Tibialis Anterior muscle. |
| The Functional Ambulation Scale (FAS) | at baseline assessment | The Functional Ambulation Scale (FAS) is a clinical instrument used to categorize gait ability based on the level of physical assistance required by the patient. Classifications range from 0 (non-functional) to 5 (independent). In this study, FAS is utilized to quantify walking dependence, facilitating the analysis of the relationship between functional mobility levels and the structural remodeling of the Tibialis Anterior muscle. |
Countries
Turkey (Türkiye)
Outcome results
None listed