{"id":284364,"date":"2025-11-14T17:04:08","date_gmt":"2025-11-14T17:04:08","guid":{"rendered":"https:\/\/www.newsbeep.com\/au\/284364\/"},"modified":"2025-11-14T17:04:08","modified_gmt":"2025-11-14T17:04:08","slug":"reliability-of-muscle-architecture-assessment-using-clinical-ultrasound-in-post-stroke-patients-a-systematic-review-bmc-musculoskeletal-disorders","status":"publish","type":"post","link":"https:\/\/www.newsbeep.com\/au\/284364\/","title":{"rendered":"Reliability of muscle architecture assessment using clinical ultrasound in post-stroke patients: a systematic review | BMC Musculoskeletal Disorders"},"content":{"rendered":"

A total of 130,484 records were identified. After screening titles and abstracts and removing duplicates, 44 studies underwent full-text review, with 12 deemed eligible for analysis. Additionally, 1 eligible study was identified through manual references screening. Thus, 13 studies were included for the final analysis. The studies screening and selection process is illustrated in Fig. 1<\/a>.<\/p>\n

Fig. 1\"figure<\/a><\/p>\n

Flowchart of identification and screening of the included and excluded studies following the PRISMA 2020 guideline<\/p>\n

Study characteristicsBaseline of the study<\/p>\n

As presented in Table 2<\/a>, the 13 studies were published between 2011 and 2024, originating from Hong Kong of China [32<\/a>, 33<\/a>], Japan [34<\/a>,35<\/a>,36<\/a>,37<\/a>], Turkey [38<\/a>], Korea [39<\/a>,40<\/a>,41<\/a>,42<\/a>], Belgium [43<\/a>], and France [44<\/a>]. A total of 440 post-stroke patients, aged between 48.0 and 80.5, were investigated. Of the selected studies, 9 investigated inter-rater reliability and 9 assessed intra-rater reliability.<\/p>\n

Table 2. Characteristics of the included studies [33<\/a>,34<\/a>,35<\/a>,36<\/a>,37<\/a>,38<\/a>,39<\/a>,40<\/a>,41<\/a>,42<\/a>,43<\/a>,44<\/a>]Ultrasound-based assessment<\/p>\n

In these 13 studies, the gastrocnemius [33<\/a>, 36<\/a>, 39<\/a>, 42<\/a>,43<\/a>,44<\/a>] and tibialis anterior TA) [32<\/a>, 40<\/a>, 43<\/a>, 44<\/a>] were the most frequently studied. Other commonly examined muscles included the deltoid muscle [34<\/a>], flexor digitorum superficialis and flexor digitorum profundus (FDS\/FDP) [38<\/a>], plantar fascia, abductor hallucis (AbH), flexor hallucis brevis (FHB), flexor digitorum brevis (FDB) [38<\/a>], transversus abdominis, obliquus externus abdominis, obliquus internus abdominis [41<\/a>], and supraspinatus [35<\/a>], biceps brachii (BB) lateralis [37<\/a>], vastus intermedius [37<\/a>]. Additionally, muscle thickness MT) [32<\/a>, 35<\/a>,36<\/a>,37<\/a>, 40<\/a>,41<\/a>,42<\/a>, 44<\/a>, 45<\/a>]\u00a0were the most commonly analyzed parameter, followed by pennation angle (PA) [33<\/a>, 39<\/a>, 40<\/a>, 42<\/a>], muscle cross-sectional area (CSA) [33<\/a>, 38<\/a>, 45<\/a>], muscle volume (MV) [43<\/a>], and muscle length (ML) [43<\/a>].<\/p>\n

The 3D Ultrasound (frequency: 10 MHz) [43<\/a>], Medison Mysono P-US system (frequency: 6\u201214 MHz) [39<\/a>], and 2D B-mode ultrasound (frequency: 7.5 MHz [32<\/a>, 34<\/a>, 40<\/a>, 42<\/a>], 6\u201218 MHz [38<\/a>], 4\u201215 MHz [46<\/a>], 10 MHz [33<\/a>] 13 MHz [36<\/a>, 37<\/a>], and 12 MHz employed in the selected studies. A linear probe was utilized and positioned transversely for assessing MV [43<\/a>], ML [33<\/a>, 43<\/a>], CSA [33<\/a>, 38<\/a>], MT [33<\/a>, 35<\/a>,36<\/a>,37<\/a>, 41<\/a>, 44<\/a>] and longitudinally for assessing MT [32<\/a>, 34<\/a>, 40<\/a>, 42<\/a>], PA [33<\/a>, 36<\/a>, 39<\/a>, 40<\/a>, 42<\/a>], CSA [33<\/a>]. A probe was commonly set at the origin over the muscle belly to the distal muscle-tendon junction of TA [43<\/a>], the muscle bully of MG and TA [32<\/a>], the midpoint of the joint between the later al acromion edge of the shoulder peak and deltoid tuberosity of deltoid [34<\/a>], the mid-forearm which is halfway from the ventral midline to the medial of FDS and FDP [38<\/a>], the muscle 30% proximal between the medial malleolus of the fibula and the medial condyle of the tibia of gastrocnemius [33<\/a>, 36<\/a>, 39<\/a>] and 20% of the distance from the head of the fibula to the tip of the lateral malleolus of TA [40<\/a>, 44<\/a>], BB was found at the distal third (i.e., 66%) of the total humeral length between the coracoid process of the scapula and the crease of the cubital fossa on the radial side or. at two-thirds of the position from the acromion to the crease of the elbow [33<\/a>, 36<\/a>], vastus lateralis and vastus intermedius was defined between the anterior superior iliac spine and the proximal end of the patella [37<\/a>].<\/p>\n

Quality assessment<\/p>\n

Of the 13 included studies, 12 were of high quality (scores 6\u20139), while 1 was of low quality (score 4), as summarized in Table 3<\/a>. The main reasons for point deductions included inadequate or missing descriptions of assessor blinding [32<\/a>, 34<\/a>,35<\/a>,36<\/a>,37<\/a>, 39<\/a>,40<\/a>,41<\/a>,42<\/a>,43<\/a>,44<\/a>], and information reporting during reproducibility procedures [32<\/a>, 34<\/a>, 35<\/a>, 39<\/a>, 41<\/a>, 43<\/a>], as well as inappropriate minimization of contact pressure during ultrasound scanning [16<\/a>, 31<\/a>,32<\/a>,33<\/a>,34<\/a>,35<\/a>,36<\/a>, 38<\/a>,39<\/a>,40<\/a>,41<\/a>,42<\/a>, 44<\/a>, 47<\/a>].<\/p>\n

Table 3. Methodological quality of the included studies [33<\/a>,34<\/a>,35<\/a>,36<\/a>,37<\/a>,38<\/a>,39<\/a>,40<\/a>,41<\/a>,42<\/a>,43<\/a>,44<\/a>]Reliability of ultrasound-based measurements<\/p>\n

As summarized in Table 4<\/a>, ultrasound demonstrated excellent intra- and inter-rater reliability (ICC >0.90) in assessing MT of the MG [32<\/a>, 42<\/a>], and moderate-to-excellent intra- (ICC = 0.74\u20130.92 [40<\/a>]) and inter-rater (ICC = 0.69\u20130.96 [43<\/a>]) reliability in measuring the MT of TA. Additionally, good-to-excellent inter-rater reliability was also observed in assessing MT of the deltoid (ICC = 0.84\u20130.93) [34<\/a>], supraspinatus (ICC >0.98) [35<\/a>], and abdominal muscles (ICC >0.92) [41<\/a>].<\/p>\n

Table 4. Reliability of muscle architectural measurements obtained from ultrasound [33<\/a>,34<\/a>,35<\/a>,36<\/a>,37<\/a>,38<\/a>,39<\/a>,40<\/a>,41<\/a>, 43<\/a>, 44<\/a>]<\/p>\n

Regarding PA, ultrasound exhibited moderate-to-excellent intra-rater (ICC = 0.69\u20130.99) and inter-rater (ICC = 0.70\u20130.98) reliability in MG assessment [39<\/a>, 42<\/a>]. Similarly, good-to-excellent intra-rater (ICC = 0.92\/0.99 [40<\/a>]) and inter-rater (ICC = 0.81\u20130.93 [18<\/a>]) reliability were observed in TA.<\/p>\n

For CSA, ultrasound also presented good-to-excellent intra-rater reliability in measuring CSA of the FDS (ICC = 0.82) [39<\/a>], BB (ICC = 0.95) [33<\/a>], and MG (ICC = 0.97) [33<\/a>], as well as good-to-excellent inter-rater reliability in evaluating CSA of the FDS (ICC = 0.76\/0.96) [39<\/a>]. Furthermore, ultrasound demonstrated excellent intra- and inter-rater reliability for measuring MV in the TA, with all ICC values >0.9 ML assessment, it showed excellent intra- and inter-rater reliability (ICC >0.9) in the TA [43<\/a>], along with good intra-rater reliability in the MG and BB, each with ICC values of 0.89 [33<\/a>].<\/p>\n

Table 5<\/a> summarizes the evidence for the reliability of ultrasound-based muscle measurements in post-stroke patients. Strong evidence supports moderate-to-excellent reliability for MT and PA. Moderate evidence indicates good-to-excellent reliability for CSA and ML and excellent reliability for MV.<\/p>\n

Table 5. Level of evidence [33<\/a>,34<\/a>,35<\/a>,36<\/a>,37<\/a>,38<\/a>,39<\/a>,40<\/a>,41<\/a>,42<\/a>,43<\/a>,44<\/a>]<\/p>\n","protected":false},"excerpt":{"rendered":"A total of 130,484 records were identified. After screening titles and abstracts and removing duplicates, 44 studies underwent…\n","protected":false},"author":2,"featured_media":284365,"comment_status":"","ping_status":"","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[6],"tags":[64,63,7274,27394,164277,96141,29199,79683,27395,9932,11617,105,14110],"class_list":["post-284364","post","type-post","status-publish","format-standard","has-post-thumbnail","category-technology","tag-au","tag-australia","tag-epidemiology","tag-internal-medicine","tag-muscle-assessment","tag-orthopedics","tag-rehabilitation","tag-reliability","tag-rheumatology","tag-sports-medicine","tag-stroke","tag-technology","tag-ultrasound"],"_links":{"self":[{"href":"https:\/\/www.newsbeep.com\/au\/wp-json\/wp\/v2\/posts\/284364","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.newsbeep.com\/au\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.newsbeep.com\/au\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.newsbeep.com\/au\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/www.newsbeep.com\/au\/wp-json\/wp\/v2\/comments?post=284364"}],"version-history":[{"count":0,"href":"https:\/\/www.newsbeep.com\/au\/wp-json\/wp\/v2\/posts\/284364\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.newsbeep.com\/au\/wp-json\/wp\/v2\/media\/284365"}],"wp:attachment":[{"href":"https:\/\/www.newsbeep.com\/au\/wp-json\/wp\/v2\/media?parent=284364"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.newsbeep.com\/au\/wp-json\/wp\/v2\/categories?post=284364"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.newsbeep.com\/au\/wp-json\/wp\/v2\/tags?post=284364"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}