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Background <p>Alterations in skeletal muscle architecture following stroke-induced neural injury serve as a major contributor to post-stroke motor impairment. Ultrasound has demonstrated promising potential for muscle assessment, however, its reliability in evaluating muscle in post-stroke patients was not systematically investigated. This systematic review aimed to synthesize available data on the reliability of ultrasound-based measurements of muscle architecture in post-stroke patients.</p> Methods <p>Literature searches were conducted across PubMed, Medline, CNKI, Embase, and Wed of Science using keywords of ultrasound (ultrasonic/echotomography) and stroke. Studies were included if they focused on the reliability of ultrasound-based muscle measurements in post-stroke patients. Data on reliability was extracted. Methodological quality was evaluated using a checklist proposed by Pretorius and Keating. The overall level of evidence was also determined.</p> Results <p>Of the 130,484 initial records identified, 13 studies were included. Among these, 12 were rated as high quality and 1 as low quality. Ultrasound demonstrated moderate-to-excellent reliability for measuring both muscle thickness and pennation angle in the gastrocnemius and tibialis anterior (TA) muscles, with intra-class correlation coefficient (ICC) values ranging from 0.69 to 0.99, supported by strong evidence. Furthermore, it exhibited good-to-excellent reliability in assessing both cross-sectional area (ICC = 0.76–0.97 in gastrocnemius, biceps brachii, and flexor digitorum superficialis/profundus) and muscle length (ICC = 0.89–0.98 in TA, gastrocnemius, and biceps brachii), supported by moderate evidence. Similarly, moderate evidence also supported excellent reliability of ultrasound in assessing muscle volume in the TA (ICC &gt; 0.90).</p> Conclusions <p>Ultrasound generally demonstrated moderate-to-excellent reliability for measuring muscle architecture parameters, including muscle thickness, pennation angle, cross-sectional area, muscle volume, and length, across various muscles in post-stroke patients, with supporting evidence rating from moderate to strong.</p>

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Reliability of muscle architecture assessment using clinical ultrasound in post-stroke patients: a systematic review

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年11月14日

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  • Yu-Ying Li,
  • Wei Liu,
  • Chang-Liang Luo,
  • Shi-Fu Feng,
  • Hui-Dong Wu,
  • Lu Li,
  • Shao-Chun Chen,
  • Christina Zong-Hao Ma

摘要

Background

Alterations in skeletal muscle architecture following stroke-induced neural injury serve as a major contributor to post-stroke motor impairment. Ultrasound has demonstrated promising potential for muscle assessment, however, its reliability in evaluating muscle in post-stroke patients was not systematically investigated. This systematic review aimed to synthesize available data on the reliability of ultrasound-based measurements of muscle architecture in post-stroke patients.

Methods

Literature searches were conducted across PubMed, Medline, CNKI, Embase, and Wed of Science using keywords of ultrasound (ultrasonic/echotomography) and stroke. Studies were included if they focused on the reliability of ultrasound-based muscle measurements in post-stroke patients. Data on reliability was extracted. Methodological quality was evaluated using a checklist proposed by Pretorius and Keating. The overall level of evidence was also determined.

Results

Of the 130,484 initial records identified, 13 studies were included. Among these, 12 were rated as high quality and 1 as low quality. Ultrasound demonstrated moderate-to-excellent reliability for measuring both muscle thickness and pennation angle in the gastrocnemius and tibialis anterior (TA) muscles, with intra-class correlation coefficient (ICC) values ranging from 0.69 to 0.99, supported by strong evidence. Furthermore, it exhibited good-to-excellent reliability in assessing both cross-sectional area (ICC = 0.76–0.97 in gastrocnemius, biceps brachii, and flexor digitorum superficialis/profundus) and muscle length (ICC = 0.89–0.98 in TA, gastrocnemius, and biceps brachii), supported by moderate evidence. Similarly, moderate evidence also supported excellent reliability of ultrasound in assessing muscle volume in the TA (ICC > 0.90).

Conclusions

Ultrasound generally demonstrated moderate-to-excellent reliability for measuring muscle architecture parameters, including muscle thickness, pennation angle, cross-sectional area, muscle volume, and length, across various muscles in post-stroke patients, with supporting evidence rating from moderate to strong.