Reliability and diagnostic accuracy of corrected slack angle derived from 2D-SWE in quantitating muscle spasticity of stroke patients

Journal of NeuroEngineering and Rehabilitation

Junyan Cao¹  Jie Ren¹  Yanling Zhang¹  Rongqin Zheng¹  Zhaocong Chen²  Weihong Qiu²  Zulin Dou²  Yang Xiao³  Hairong Zheng⁴ 

[1] Department of Medical Ultrasonics, The Third Affiliated Hospital of Sun Yat-Sen University, Sun Yat-Sen University, 600 Tianhe Road, 510630, Guangzhou, China;Department of Rehabilitation Medicine, The Third Affiliated Hospital of Sun Yat-Sen University, Sun Yat-Sen University, 600 Tianhe Road, 510630, Guangzhou, China;Institute of Biomedical and Health Engineering, Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, 1068 Xueyuan Avenue, 518055, Shenzhen, China;Paul C. Lauterbur Research Center for Biomedical Imaging, Institute of Biomedical and Health Engineering, Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, 1068 Xueyuan Avenue, 518055, Shenzhen, China;

关键词: Corrected slack angle;    Stroke;    Muscle spasticity;    Medial gastrocnemius;    Two-dimensional shear wave elastography;   

DOI  :  10.1186/s12984-022-00995-8

来源: Springer

【 摘 要 】

BackgroundTo explore the feasibility of corrected slack angle acquired from two-dimensional shear wave elastography (2D-SWE) for quantitating the spasticity of medial gastrocnemius (MG) in stroke patients.MethodsConsecutive stroke patients with spastic MG and matched healthy controls were recruited. Intra- and interobserver reliability of 2D-SWE measurement were evaluated, and the correlation between corrected slack angle and modified Ashworth scale (MAS) score was examined. The corrected slack angle before and after botulinum toxin A (BoNT-A) injection was compared and its diagnostic performance in classifying the severity of spasticity were assessed with receiver operating characteristic (ROC) curve analysis.ResultsThe intra- (0.791 95% CI 0.432–0.932) and interobserver (0.751 95% CI 0.382–0.916) reliability of slack angle acquired with 2D-SWE were good. Significant correlation was found between corrected slack angle and MAS score (R = − 0.849, p < 0.001). The corrected slack angle increased after BoNT-A injection. The cutoff value of MAS ≥ 3 had the highest sensitivity (100%) and specificity (93.33%). The positive predictive value (PPV) for classification of MAS ≥ 1+ and the negative predictive value (NPV) for classification of MAS ≥ 3 were greater than 90%.Conclusion2D-SWE was a reliable method to quantitate the post-stroke spasticity. The corrected slack angle had advantage in classifying the severity of spasticity, especially in early identification of mild spasticity and confirmation of severe spasticity.

【 授权许可】

CC BY