The Findings of Ultrasound Elastography and ARFI in Strokes Patients With Spastic Elbow Flexor

Study Overview
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Brief Summary
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The aim of this study: 1. To evaluate the correlation between the clinic tools and ultrasound elastography/ ARFI imaging in stroke patients. 2. To assess the reliability of elastography/ ARFI imaging in spasticity evaluation of stroke patients.

Detailed Description
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Modified Ashworth Scale (MAS) and Modified Tardieu Scale (MTS) are the most commonly used tools for spasticity assessment. But these clinic methods cannot reveal the architecture and stiffness of muscles. In recent years, ultrasound elastography and acoustic radiation force impulse (ARFI) are used in musculoskeletal disorders, including spasticity. There are no studies about the correlation between spasticity and ultrasound elastography /ARFI imaging in stroke patients. The investigators will enroll 50 stroke patients with hemiplegia and biceps brachii muscle spasticity. One physical therapist will measure MAS and MTS for spasticity of biceps brachii muscle. Two physiatrists will perform ultrasound elastography and ARFI for intra-rater and inter-rater reliability evaluation. The evaluations of B-mode ultrasound, elastography and ARFI included Heckmatt scale, biceps brachii ratio, strain ratio, dynamic sonoelastography score, color intensity, and shear wave velocity. After performing all assessments, the investigators will analyze the correlation between the clinic tools and elastography/ ARFI imaging and evaluate the reliability of elastography/ ARFI imaging in spasticity evaluation.

Official Title
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The Correlation Between Clinical Examination and Ultrasound Elastography Acoustic Radiation Force Impulse Findings in Hemiplegic Patients With Elbow Flexor Spasticity After Stroke

Conditions
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Cerebrovascular Accident

Intervention / Treatment
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* Device: ultrasound elastography, acoustic radiation force impulse


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: stroke patients with hemiplegia and biceps brachii muscle spasticity. Exclusion Criteria: elbow joint contracture deformity combined other neuromuscular system disease affected upper extremity has local infection patient who can't follow instruction, who is restlessness and whose elbow can't meet the positioning criteria
Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Arms and Interventions

| Intervention/Treatment |
| --- |
|Device: ultrasound elastography, acoustic radiation force impulse|Two physiatrists will perform ultrasound elastography and ARFI for intra-rater and inter-rater reliability evaluation.|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Modified Ashworth Scale (MAS), Modified Tardieu Scale (MTS) |  | patients will be evaluated within 1 month after basic history taking and consent signing | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| the thickness of biceps brachii |  | patients will be evaluated within 1 month after basic history taking and signing consent | 
| Heckmatt scale |  | patients will be evaluated within 1 month after finishing history taking and consent signing | 
| strain ratio |  | patients will be evaluated within 1 month after finishing history taking and consent signing | 
| Dynamic Sonoelastography Score(DS score) |  | patients will be evaluated within 1 month after finishing history taking and consent signing | 
| The mean values of the intensity of red, green, and blue on histogram of bicep brachii |  | patients will be evaluated within 1 month after finishing history taking and consent signing | 
| shear wave velocity within region of interest between biceps brachii and brachialis |  | patients will be evaluated within 1 month after finishing history taking and consent signing | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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spasticity, stroke, ultrasound elastography, acoustic radiation force impulse