Ann Rehabil Med.  2015 Jun;39(3):393-400. 10.5535/arm.2015.39.3.393.

Evaluation of Stiffness of the Spastic Lower Extremity Muscles in Early Spinal Cord Injury by Acoustic Radiation Force Impulse Imaging

• Cho KH
• Nam JH

• KMID: 2165642
• DOI: http://doi.org/10.5535/arm.2015.39.3.393

Abstract

OBJECTIVE
To investigate intrinsic viscoelastic changes using shear wave velocities (SWVs) of spastic lower extremity muscles in patients with early spinal cord injury (SCI) via acoustic radiation force impulse (ARFI) imaging and to evaluate correlation between the SWV values and spasticity.
METHODS
Eighteen patients with SCI within 3 months and 10 healthy adults participated. We applied the ARFI technique to measure SWV of gastrocnemius muscle (GCM) and long head of biceps femoris muscle. Spasticity of ankle and knee joint was assessed by original Ashworth Scale.
RESULTS
Ten patients with SCI had spasticity. Patients with spasticity had significantly faster SWV for GCM and biceps femoris muscle than those without spasticity (Mann-Whitney U test, p=0.007 and p=0.008) and normal control (p=0.011 and p=0.037, respectively). The SWV values of GCM correlated with the ankle spasticity (Spearman rank teat, p=0.026). There was significant correlation between the SWV values for long head of biceps femoris muscle and knee spasticity (Spearman rank teat, p=0.022).
CONCLUSION
ARFI demonstrated a difference in muscle stiffness in the GCM between patients with spastic SCI and those without spasticity. This finding suggested that stiffness of muscles increased in spastic lower extremity of early SCI patients. ARFI imaging is a valuable tool for noninvasive assessment of the stiffness of the spastic muscle and has the potential to identify pathomechanical changes of the tissue associated with SCI.

Keyword

Muscle spasticity; Spinal cord injuries; Ultrasonography

MeSH Terms

Acoustics
Adult
Ankle
Elasticity Imaging Techniques*
Head
Humans
Knee
Knee Joint
Lower Extremity*
Muscle Spasticity*
Muscle, Skeletal
Muscles*
Spinal Cord Injuries*
Ultrasonography

Figure

• 

  Fig. 1 B-mode ultrasound image of medial gastrocnemius (GCM) (A) and the long head of biceps femoris (BFLH) muscle (B). Shear wave velocity of medial GCM and the BFLH with spasticity (C, D) and without spasticity (E, F).

• 

  Fig. 2 Shear wave velocity (SWV) of medial gastrocnemius muscle (A) in 3 groups and the long head of biceps femoris muscle (B) in 3 groups. *p<0.05 in Mann-Whitney U test.

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