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Open AccessArticle

Rectus Femoris Characteristics in Post Stroke Spasticity: Clinical Implications from Ultrasonographic Evaluation

1
Physical and Rehabilitation Medicine, Department of Scienze della Salute, University of Piemonte Orientale, 28100 Novara, Italy
2
Physical and Rehabilitation Medicine, “Maggiore della Carità” University Hospital, 28100 Novara, Italy
3
Rehabilitation Unit, Department of Rehabilitation, “Santi Antonio e Biagio e Cesare Arrigo” National Hospital, 15121 Alessandria, Italy
4
Neuromotor and Cognitive Rehabilitation Research Center, Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, 37134 Verona, Italy
5
Department of Translational Medicine, University of Piemonte Orientale, 28100 Novara, Italy
6
Division of Physical Medicine and Rehabilitation, Department of Surgical Sciences, University of Turin, 10126 Turin, Italy
7
Physical Medicine and Rehabilitation, ASST Sette Laghi, 21100 Varese, Italy
8
Physical Medicine and Rehabilitation Section, “OORR” Hospital, University of Foggia, 71122 Foggia, Italy
*
Author to whom correspondence should be addressed.
Toxins 2020, 12(8), 490; https://doi.org/10.3390/toxins12080490
Received: 26 June 2020 / Revised: 26 July 2020 / Accepted: 29 July 2020 / Published: 31 July 2020
(This article belongs to the Special Issue Botulinum Neurotoxin Injection)
In stroke survivors, rectus femoris (RF) spasticity is often implicated in gait pattern alterations such as stiff knee gait (SKG). Botulinum toxin type A (BoNT-A) is considered the gold standard for focal spasticity treatment. However—even if the accuracy of injection is crucial for BoNT-A efficacy—instrumented guidance for BoNT-A injection is not routinely applied in clinical settings. In order to investigate the possible implications of an inadequate BoNT-A injection on patients’ clinical outcome, we evaluated the ultrasound-derived RF characteristics (muscle depth, muscle thickness, cross-sectional area and mean echo intensity) in 47 stroke survivors. In our sample, we observed wide variability of RF depth in both hemiparetic and unaffected side of included patients (0.44 and 3.54 cm and between 0.25 and 3.16 cm, respectively). Moreover, our analysis did not show significant differences between treated and non-treated RF in stroke survivors. These results suggest that considering the inter-individual variability in RF muscle depth and thickness, injection guidance should be considered for BoNT-A treatment in order to optimize the clinical outcome of treated patients. In particular, ultrasound guidance may help the clinicians in the long-term follow-up of muscle quality. View Full-Text
Keywords: muscle spasticity; botulinum toxin type A; ultrasonography; stroke; rehabilitation; stiff knee gait; rectus femoris muscle spasticity; botulinum toxin type A; ultrasonography; stroke; rehabilitation; stiff knee gait; rectus femoris
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MDPI and ACS Style

Cosenza, L.; Picelli, A.; Azzolina, D.; Minetto, M.A.; Invernizzi, M.; Bertoni, M.; Santamato, A.; Baricich, A. Rectus Femoris Characteristics in Post Stroke Spasticity: Clinical Implications from Ultrasonographic Evaluation. Toxins 2020, 12, 490. https://doi.org/10.3390/toxins12080490

AMA Style

Cosenza L, Picelli A, Azzolina D, Minetto MA, Invernizzi M, Bertoni M, Santamato A, Baricich A. Rectus Femoris Characteristics in Post Stroke Spasticity: Clinical Implications from Ultrasonographic Evaluation. Toxins. 2020; 12(8):490. https://doi.org/10.3390/toxins12080490

Chicago/Turabian Style

Cosenza, Lucia; Picelli, Alessandro; Azzolina, Danila; Minetto, Marco A.; Invernizzi, Marco; Bertoni, Michele; Santamato, Andrea; Baricich, Alessio. 2020. "Rectus Femoris Characteristics in Post Stroke Spasticity: Clinical Implications from Ultrasonographic Evaluation" Toxins 12, no. 8: 490. https://doi.org/10.3390/toxins12080490

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