Muscle-tendon Interaction in the Spastic Sural Triceps During Gait

Recruiting

• Conditions: Stroke; Spinal Cord Injuries
• Interventions: Other: Gait analysis coupled with ultrasound; Other: Isokinetic dynamometer with simultaneous ultrasound

• Registration Number: NCT06474117
• Lead Sponsor: Nantes University Hospital

Brief Summary

This project aims to study the mechanical behavior of the muscle-tendon unit (MTU) of the gastrocnemius medialis (GM) and the Achilles tendon (AT) in post-stroke and spinal cord injured (SCI) patients compared to a healthy population, focusing on the variations in muscle and tendon length during the stance phase of the gait cycle. The primary objective is to assess the respective contributions of the GM and AT lengthening in the MTU during walking. Inclusion criteria include adult post-stroke and post-SCI patients with voluntary motor function and some walking capacity. Methods include ultrasound measurements and 3D gait analysis.

Detailed Description

Primary Objective: Evaluate the respective contributions of the gastrocnemius medialis (GM) muscle and the Achilles tendon (AT) within the muscle-tendon unit (MTU) during the single support phase of walking in post-stroke patients compared to healthy subjects.

Study Description: Strokes often lead to spastic paresis, degrading patients' walking performance. Instrumented gait analysis allows for the evaluation of these performances to propose adapted therapeutic strategies. This project will compare muscle and tendon behavior during walking between healthy individuals and post-stroke patients.

Methodology:

* Participants: Adult post-stroke patients or incomplete SCI patients with voluntary motor function on the triceps surae and walking capacity. Control group composed of healthy adults.

* Procedures:

* Measure the force/length profile of the GM on an isokinetic dynamometer with simultaneous ultrasound.

* Conduct gait analysis coupled with ultrasound to measure the lengths of the AT and GM.

* Compare muscle and tendon length data during the stance phase of the gait cycle between the two groups.

Study Timeline

• Status Verified: 2024-06
• Study First Submitted: 2024-06-19
• Study First Submitted QC: 2024-06-19
• Study First Posted: 2024-06-25
• Study Start: 2024-11-15
• Last Update Submitted: 2024-11-18
• Last Update Posted: 2024-11-20
• Primary Completion: 2026-11-15
• Study Completion: 2026-11-15

Recruitment & Eligibility

• Status: RECRUITING
• Sex: All
• Target Recruitment: 80

Inclusion Criteria

Not provided

Exclusion Criteria

Not provided

Study & Design

• Study Type: OBSERVATIONAL
• Study Design: Not specified

Arm && Interventions

Group	Intervention	Description
Post-Stroke Patients	Isokinetic dynamometer with simultaneous ultrasound	Patients will undergo gait analysis coupled with ultrasound to measure the lengths of the Achilles tendon and gastrocnemius medialis muscle. They will also have their force/length profile of the GM measured on an isokinetic dynamometer with simultaneous ultrasound
Post-Stroke Patients	Gait analysis coupled with ultrasound	Patients will undergo gait analysis coupled with ultrasound to measure the lengths of the Achilles tendon and gastrocnemius medialis muscle. They will also have their force/length profile of the GM measured on an isokinetic dynamometer with simultaneous ultrasound
Post-Spinal Cord Injury Patients	Gait analysis coupled with ultrasound	Similar to the post-stroke group, these patients will undergo gait analysis coupled with ultrasound to measure the lengths of the Achilles tendon and gastrocnemius medialis muscle. The force/length profile of the GM will also be measured on an isokinetic dynamometer with simultaneous ultrasound.
Healthy controls	Isokinetic dynamometer with simultaneous ultrasound	The healthy control group will undergo the same gait analysis and ultrasound measurements as the patient groups. Their force/length profile of the GM will also be measured on an isokinetic dynamometer with simultaneous ultrasound for comparison with the post-stroke and post-spinal cord injury groups.
Post-Spinal Cord Injury Patients	Isokinetic dynamometer with simultaneous ultrasound	Similar to the post-stroke group, these patients will undergo gait analysis coupled with ultrasound to measure the lengths of the Achilles tendon and gastrocnemius medialis muscle. The force/length profile of the GM will also be measured on an isokinetic dynamometer with simultaneous ultrasound.
Healthy controls	Gait analysis coupled with ultrasound	The healthy control group will undergo the same gait analysis and ultrasound measurements as the patient groups. Their force/length profile of the GM will also be measured on an isokinetic dynamometer with simultaneous ultrasound for comparison with the post-stroke and post-spinal cord injury groups.

Primary Outcome Measures

Name	Time	Method
Length of the Achilles Tendon (AT), Muscle Fibers of the Gastrocnemius Medialis (GM), and the Muscle GM During the Single Support Phase of Walking	1 Day	This measure involves the use of ultrasound to assess the lengths of the Achilles tendon, muscle fibers of the gastrocnemius medialis, and the entire muscle GM during the single support phase of the gait cycle in post-stroke and SCI patients compared to healthy controls. The primary goal is to determine the contributions of the muscle and tendon to the overall muscle-tendon unit during walking.

Secondary Outcome Measures

Name	Time	Method
Positioning of the Muscle Fibers on the Force-Length Curve During Different Phases of Walking	1 Day	This outcome measure evaluates the positioning of the muscle fibers of the gastrocnemius medialis on the force-length curve during various phases of the gait cycle, including the single support phase and the double support phases (reception and propulsion). The measurements will be compared between post-stroke, SCI patients and healthy controls. The assessment will involve ultrasound measurements and isokinetic dynamometry to determine the force-length relationship.

Trial Locations

Locations (1)

CHU de Nantes; 🇫🇷 Nantes, Loire Atlantique, France