Structural Remodeling of Tibialis Anterior Muscle in Stroke

Istanbul Physical Medicine Rehabilitation Training and Research Hospital

Status: Completed

Conditions: Stroke; Tibialis Anterior Architecture

Study type: Observational

Funder types: Other

Identifiers

NCT07314918

IstPRMTRH-EK5

Details and patient eligibility

About

This study aims to investigate the structural architectural changes of the Tibialis Anterior muscle in patients with subacute and chronic stroke using ultrasonography. The study will compare the morphological parameters (pennation angle, fascicle length, and muscle thickness) of the paretic side with the non-paretic side and analyze the relationship between these structural changes and the patients' clinical and demographic data.

Full description

Stroke is a serious neurological disease characterized by high mortality, morbidity, and disability rates. Post-stroke motor and sensory impairments significantly limit patients' independence. A common impairment is hemiparesis, specifically weakness in the paretic leg leading to reduced dorsiflexion range of motion (foot drop). It remains unclear whether this weakness stems solely from neurological impairment or also involves changes in muscle architecture. Muscle fascicle length and pennation angle are critical architectural parameters influencing force production capacity.

Enrollment: 36 patients

Sex: All

Ages: 40 to 80 years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• Male and female patients aged 40-80 years.
• History of ischemic or hemorrhagic Cerebrovascular Accident (CVA).
• Being in the subacute or chronic phase post-stroke.
• Absence of communication deficits; ability to follow verbal commands.
• Voluntary agreement to participate and provision of written informed consent.
• Ability to ambulate without physical assistance from another person (use of assistive devices such as leg orthoses or tripods is permitted).

Exclusion criteria

• Presence of other comorbidities affecting gait (e.g., Parkinson's disease, hip surgery, etc.).
• History of dyspnea (shortness of breath) during activities of daily living within the last 6 months.
• Presence of bone or joint-related pain or pathology in the spine or hips.
• Presence of psychiatric or cognitive disorders (e.g., learning disabilities, mental disorders, autism, etc.).
• Decompensated cardiac, renal, or hepatic failure.
• Presence of malignancy.

Trial design

36 participants in 2 patient groups

Subacute Stroke Patients

Description:

This group consists of patients in the subacute phase post-stroke (1 week to 6 months) who are receiving inpatient treatment at the Istanbul Physical Therapy and Rehabilitation Training and Research Hospital. Ultrasonographic assessment will be performed to determine the structural characteristics of the Tibialis anterior muscle. Measurements will be taken from the mid-belly region where muscle thickness is maximal. The patient will be in a supine position at rest, with the ankle in a neutral position on a stable surface. Pennation angle, muscle fascicle length, and muscle thickness will be measured. Measurements will be repeated three times, and the arithmetic mean of these three measurements will be calculated.

Chronic Stroke Patients

Description:

This group consists of patients in the chronic phase post-stroke ( \> 6 months) who are receiving inpatient treatment at the Istanbul Physical Therapy and Rehabilitation Training and Research Hospital. Ultrasonographic assessment will be performed to determine the structural characteristics of the Tibialis anterior muscle. Measurements will be taken from the mid-belly region where muscle thickness is maximal. The patient will be in a supine position at rest, with the ankle in a neutral position on a stable surface. Pennation angle, muscle fascicle length, and muscle thickness will be measured. Measurements will be repeated three times, and the arithmetic mean of these three measurements will be calculated.