Changes in Post-Stroke Skeletal Muscles: an Ultrasonographic Evaluation

Background: Stroke is the second leading cause of death worldwide, with chronic disability remaining in up to 50% of survivors. Ultrasonography studies to examine disruptions in the normative architecture of post-stroke muscles have documented changes in muscle thickness, fascicle length, pennation angle, and echo intensity (EI) in patients in chronic patients Purpose: Assessing early modification in paretic muscles could ameliorate the comprehension of the prognosis and address a better rehabilitation program. Methods: Adult patients admitted in Physical Medicine and Rehabilitation with acute ischemic stroke from January 2019 to January 2022 were identified as the study population. Muscle thickness (MT), ACSA (anatomical cross sectional area) in Biceps Brachii (BB), Rectus Femoris(RF), Gastrocnemius Medialis (GM) in the both sides were assessed with ultrasound at admission, after 60, 90 days and at 6 months. The influence of comorbidities and echo intensity was also assessed. Results: Twenty-two patients were finally enrolled. Most of patients were male (54,5%), the mean age was 71 (55-83). BB thickness decreased during the first 30 days and in the following time intervals. At 6 months, mean thickness decreased with a variation of 12.66% in the paretic side. RF thickness decreased from 15.95 to 14.75, with a difference of 7.52% from baseline to T3 [95% CI, .0272; 0.817], p < 0.001. GM thickness decreased from 15.86 to 14,39, with a difference of 9.27% from baseline to T3 [95% CI, . ,033; 0. ,058], p = 0.001. No significant different was found in T2-T3 and T0-T3. The age had a significant negative correlations with MT RF and ACSA RF. Charlson index had a negative correlation with MT GM. Conclusion: Early research at the patient's bedside for insights that can improve the outcome and prevent irreversible and useless muscle modification in paretic side in post-stroke patients.