From the Guidelines
Diagnostic ultrasound can be used to measure spasticity, although its clinical application for this purpose is still evolving. Ultrasound provides real-time visualization of muscle architecture and behavior during passive stretching, allowing clinicians to quantify changes in muscle length, thickness, pennation angle, and echo intensity that correlate with spasticity 1. The technique involves placing an ultrasound probe over the affected muscle while performing standardized passive stretching maneuvers, then measuring parameters such as muscle displacement, strain, or stiffness using elastography techniques.
Key Points to Consider
- Ultrasound offers advantages over traditional clinical scales like the Modified Ashworth Scale by providing objective, quantitative measurements rather than subjective assessments.
- Ultrasound is non-invasive, radiation-free, portable, and relatively affordable compared to other imaging modalities.
- However, its clinical application for spasticity measurement is still evolving, with ongoing research to standardize protocols and establish normative values.
- For practical implementation, clinicians would need training in neuromuscular ultrasound techniques and access to ultrasound equipment with appropriate software for quantitative analysis.
Relevant Evidence
- A study published in the International Journal of Stroke in 2016 discussed the use of ultrasound in the treatment of focal spasticity in chronic stroke patients, although it did not directly address the use of ultrasound for measuring spasticity 1.
- The guidelines for adult stroke rehabilitation and recovery published in Stroke in 2016 mentioned the use of ultrasound findings in the hemiplegic shoulder, including effusion in biceps tendon or subacromial bursa, tendinopathy of biceps, supraspinatus, or subscapularis, and rotator cuff tear, but did not discuss the use of ultrasound for measuring spasticity 1.
Clinical Application
- The use of diagnostic ultrasound to measure spasticity is a promising approach, but it requires further research to standardize protocols and establish normative values.
- Clinicians should consider the potential benefits and limitations of using ultrasound for spasticity measurement, including the need for training and access to appropriate equipment.
- The clinical application of ultrasound for spasticity measurement should be based on the latest available evidence and guidelines, taking into account the individual patient's needs and circumstances.
From the Research
Diagnostic Ultrasound for Measuring Spasticity
- There is no direct evidence in the provided studies to support the use of diagnostic ultrasound for measuring spasticity 2, 3, 4, 5, 6.
- The studies primarily focus on the treatment and management of spasticity using botulinum toxin, baclofen, and other therapies, but do not discuss the use of diagnostic ultrasound as a measurement tool.
- Spasticity is typically assessed using clinical scales such as the Modified Ashworth Scale (mAS) and the Disability Assessment Scale (DAS) 4.
- The use of diagnostic ultrasound in the context of spasticity is not mentioned in the provided studies, suggesting that it may not be a commonly used method for measuring spasticity in clinical practice.