How Paretic and Non-Paretic Ankle Muscles Contract during Walking in Stroke Survivors: New Insight Using Novel Wearable Ultrasound Imaging and Sensing Technology

中风幸存者行走时患侧和非患侧踝关节肌肉的收缩方式:基于新型可穿戴超声成像和传感技术的新见解

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Abstract

Abnormal muscle tone and muscle weakness are related to gait asymmetry in stroke survivors. However, the internal muscle morphological changes that occur during walking remain unclear. To address this issue, this study investigated the muscle activity of the tibialis anterior (TA) and medial gastrocnemius (MG) of both the paretic and non-paretic sides during walking in nine stroke survivors, by simultaneously capturing electromyography (EMG), mechanomyography (MMG), and ultrasound images, and using a validated novel wearable ultrasound imaging and sensing system. Statistical analysis was performed to examine the test−retest reliability of the collected data, and both the main and interaction effects of each “side” (paretic vs. non-paretic) and “gait” factors, in stroke survivors. This study observed significantly good test−retest reliability in the collected data (0.794 ≤ ICC ≤ 0.985), and significant differences existed in both the side and gait factors of the average TA muscle thickness from ultrasound images, and in the gait factors of TA and MG muscle’s MMG and EMG signals (p < 0.05). The muscle morphological characteristics also appeared to be different between the paretic and non-paretic sides on ultrasound images. This study uncovered significantly different internal muscle contraction patterns between paretic and non-paretic sides during walking for TA (7.2% ± 1.6%) and MG (5.3% ± 4.9%) muscles in stroke survivors.

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