Change of Muscle Architecture following Body Weight Support Treadmill Training for Persons after Subacute Stroke: Evidence from Ultrasonography

Although the body weight support treadmill training (BWSTT) in rehabilitation therapy has been appreciated for a long time, the biomechanical effects of this training on muscular system remain unclear. Ultrasonography has been suggested to be a feasible method to measure muscle morphological changes after neurological diseases such as stroke, which may help to enhance the understanding of the mechanism underlying the impaired motor function. This study investigated the muscle architectural changes of tibialis anterior and medial gastrocnemius in patients after subacute stroke by ultrasound. As expected, we found the effect of BWSTT on the muscular system. Specifically, the results showed larger pennation angle and muscle thickness of tibialis anterior and longer fascicle length of medial gastrocnemius after the training. The findings of this study suggest that the early rehabilitation training of BWSTT in subacute stage of stroke provides positive changes of the muscle architecture, leading to the potential improvement of the force generation of the muscle. This may not only help us understand changes of subacute stroke in muscular system but also have clinical implications in the evaluation of rehabilitation training after neurological insults.

[1]  L. Ada,et al.  Stroke patients have selective muscle weakness in shortened range. , 2003, Brain : a journal of neurology.

[2]  Aaas News,et al.  Book Reviews , 1893, Buffalo Medical and Surgical Journal.

[3]  S. H. Hayes,et al.  Early intervention care in the acute stroke patient. , 1986, Archives of physical medicine and rehabilitation.

[4]  D. Wade,et al.  Walking after stroke. Measurement and recovery over the first 3 months. , 2020, Scandinavian journal of rehabilitation medicine.

[5]  Shawn Baker,et al.  Locomotor treadmill training with partial body-weight support before overground gait in adults with acute stroke: a pilot study. , 2008, Archives of physical medicine and rehabilitation.

[6]  S Hesse,et al.  Treadmill walking with partial body weight support versus floor walking in hemiparetic subjects. , 1999, Archives of physical medicine and rehabilitation.

[7]  T. Fukunaga,et al.  Architectural and functional features of human triceps surae muscles during contraction. , 1998, Journal of applied physiology.

[8]  E. Protas,et al.  Gait outcomes after acute stroke rehabilitation with supported treadmill ambulation training: a randomized controlled pilot study. , 2002, Archives of physical medicine and rehabilitation.

[9]  P. Trueblood Partial body weight treadmill training in persons with chronic stroke. , 2001, NeuroRehabilitation.

[10]  B. Dobkin,et al.  Human lumbosacral spinal cord interprets loading during stepping. , 1997, Journal of neurophysiology.

[11]  A. Nilsdotter,et al.  A six-week hand exercise programme improves strength and hand function in patients with rheumatoid arthritis. , 2009, Journal of rehabilitation medicine.

[12]  T. Fukunaga,et al.  Muscle volume is a major determinant of joint torque in humans. , 2001, Acta physiologica Scandinavica.

[13]  P. Neilson,et al.  Spasticity and muscle contracture following stroke. , 1996, Brain : a journal of neurology.

[14]  Nicholas D Gill,et al.  Training-specific muscle architecture adaptation after 5-wk training in athletes. , 2003, Medicine and science in sports and exercise.

[15]  X L Hu,et al.  Incorporating ultrasound-measured musculotendon parameters to subject-specific EMG-driven model to simulate voluntary elbow flexion for persons after stroke. , 2009, Clinical biomechanics.

[16]  Colleen G Canning,et al.  The strength of the ankle dorsiflexors has a significant contribution to walking speed in people who can walk independently after stroke: an observational study. , 2012, Archives of physical medicine and rehabilitation.

[17]  Yasuo Kawakami,et al.  Architecture of contracting human muscles and its functional significance , 2000 .

[18]  W. Stolov,et al.  Gastrocnemius muscle belly and tendon length in stroke patients and able-bodied persons. , 1978, Archives of physical medicine and rehabilitation.

[19]  J. Nielsen,et al.  Increased power generation in impaired lower extremities correlated with changes in walking speeds in sub-acute stroke patients. , 2012, Clinical biomechanics.

[20]  O. Rutherford,et al.  Human muscle strength training: the effects of three different regimens and the nature of the resultant changes. , 1987, The Journal of physiology.

[21]  E. Otten Concepts and Models of Functional Architecture in Skeletal Muscle , 1988, Exercise and sport sciences reviews.

[22]  C. English,et al.  Reliability of real-time ultrasound for measuring skeletal muscle size in human limbs in vivo: a systematic review , 2012, Clinical rehabilitation.

[23]  P. Cerretelli,et al.  In vivo human gastrocnemius architecture with changing joint angle at rest and during graded isometric contraction. , 1996, The Journal of physiology.

[24]  N. Ichihashi,et al.  Atrophy of the lower limbs in elderly women: is it related to walking ability? , 2011, European Journal of Applied Physiology.

[25]  Carlo Cisari,et al.  Walking After Stroke: What Does Treadmill Training With Body Weight Support Add to Overground Gait Training in Patients Early After Stroke?: A Single-Blind, Randomized, Controlled Trial , 2009, Stroke.

[26]  Dustyn P. Roberts,et al.  Optimal pennation angle of the primary ankle plantar and dorsiflexors: variations with sex, contraction intensity, and limb. , 2006, Journal of applied biomechanics.

[27]  T. Fukunaga,et al.  Muscle architecture and function in humans. , 1997, Journal of biomechanics.

[28]  K. Tong,et al.  The effect of poststroke impairments on brachialis muscle architecture as measured by ultrasound. , 2007, Archives of physical medicine and rehabilitation.

[29]  S. Hesse,et al.  Influence of walking speed on lower limb muscle activity and energy consumption during treadmill walking of hemiparetic patients. , 2001, Archives of physical medicine and rehabilitation.

[30]  Stefan Hesse,et al.  Treadmill training with partial body weight support after stroke: a review. , 2008, NeuroRehabilitation.

[31]  R. Stephenson A and V , 1962, The British journal of ophthalmology.

[32]  R. Shephard Atrophy of the lower limbs in elderly women: is it related to walking ability? , 2012 .

[33]  Fan Gao,et al.  Changes in passive mechanical properties of the gastrocnemius muscle at the muscle fascicle and joint levels in stroke survivors. , 2009, Archives of physical medicine and rehabilitation.

[34]  J. Hides,et al.  Validity of real-time ultrasound imaging to measure anterior hip muscle size: a comparison with magnetic resonance imaging. , 2010, The Journal of orthopaedic and sports physical therapy.

[35]  J. Harlaar,et al.  Passive stiffness characteristics of ankle plantar flexors in hemiplegia. , 2000, Clinical biomechanics.

[36]  W. Marsden I and J , 2012 .

[37]  Marco V. Narici,et al.  Influence of muscle architecture on the torque and power–velocity characteristics of young and elderly men , 2007, European Journal of Applied Physiology.

[38]  Vasilios Baltzopoulos,et al.  Predictability of in vivo changes in pennation angle of human tibialis anterior muscle from rest to maximum isometric dorsiflexion , 1999, European Journal of Applied Physiology and Occupational Physiology.

[39]  S. Rossignol,et al.  Recovery of locomotion after chronic spinalization in the adult cat , 1987, Brain Research.

[40]  S. Gandevia,et al.  Measurement of muscle contraction with ultrasound imaging , 2003, Muscle & nerve.

[41]  H. Hislop,et al.  Daniel's and Worthingham's muscle testing : techniques of manual examination , 1995 .

[42]  Olavi Airaksinen,et al.  Effects of intensive therapy using gait trainer or floor walking exercises early after stroke. , 2009, Journal of rehabilitation medicine.

[43]  D. Pradon,et al.  Relationship between lower limb muscle strength and 6-minute walk test performance in stroke patients. , 2013, Journal of rehabilitation medicine.