Ann Rehabil Med.  2020 Aug;44(4):273-283. 10.5535/arm.19125.

Ultrasound Imaging of the Trunk Muscles in Acute Stroke Patients and Relations With Balance Scales

• Kim Y
• Kim J
• Nam H
• Kim HD
• Eom MJ
• Jung SH
• Han N

• KMID: 2505387
• DOI: http://doi.org/10.5535/arm.19125

Abstract

Objective
To examine the correlation between ultrasonographic trunk muscle parameters and balance scales in mild acute stroke patients.
Methods
A total of 55 stroke patients with hemiparesis and motor power grade ≥4 in the manual motor test were included. The Scale for the Assessment and Rating of Ataxia (SARA), Berg Balance Scale (BBS), Timed Up and Go Test (TUG), and Trunk Control Test (TCT) were used to evaluate patient balance function. Ultrasonographic parameters were measured on both non-paretic and paretic sides of the rectus abdominis, external oblique, internal oblique, transversus abdominis, and erector spinae muscles. Resting thickness and contraction thickness were measured in all muscles, and contractility and contractility ratio were calculated based on measured thicknesses. The differences between paretic and non-paretic muscle parameters, and the correlation between ultrasonographic parameters and balance scales were analyzed. Stroke patients were divided into two groups according to their fall risk. Ultrasonographic measurements between the two groups were compared.
Results
All muscles’ contraction thickness and contractility were significantly different between paretic and non-paretic sides (p<0.001). Contractility ratios of all trunk muscles showed a significant correlation with SARA, BBS, TUG, and TCT (p<0.05). Contractility ratios of all muscles were significantly different between high- and low-risk fall groups (p<0.05).
Conclusion
The contractility ratio in stroke patients reflects their balance disturbance and fall risk and it may serve as a new parameter for ultrasound imaging of trunk muscles.

Keyword

Ultrasonography; Postural balance; Stroke; Paraspinal muscles; Abdominal muscles

Figure

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  Fig. 1. Flow chart of the study design. A total of 55 patients were selected as study participants. BBS, Berg Balance Scale.

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  Fig. 2. Ultrasonographic images of the RA muscle (A), lateral abdominal muscle (B), and ES muscle (C). Thickness was measured in the resting and contraction states. RA, rectus abdominis; EO, external oblique; IO, internal oblique; TrA, transversus abdominis; ES, erector spinae.

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