Skip to main content
Clinical Trials/NCT06320561
NCT06320561
Not yet recruiting
Not Applicable

Stroke-induced Muscular Changes and Their Relation to Clinical Impairments and Gait Recovery in the First 12 Weeks After Stroke.

Vrije Universiteit Brussel0 sites100 target enrollmentMay 2024
ConditionsStroke

Overview

Phase
Not Applicable
Intervention
Not specified
Conditions
Stroke
Sponsor
Vrije Universiteit Brussel
Enrollment
100
Primary Endpoint
Cross-sectional area (CSA)
Status
Not yet recruiting
Last Updated
2 years ago

Overview

Brief Summary

The investigators will use 3D freehand ultrasound to investigate changes in muscle morphology of the paretic m. rectus femoris and m. gastrocnemius medialis during the first 3 months after stroke. Additionally, 2D ultrasound and surface EMG will be synchronized to examine muscle activation and morphological changes resulting from this activation. Clinical tests will be conducted on the same test occasions to objectify lower limb impairment and gait recovery. As such, the investigators will explore the relationship between the muscle specific changes and functional recovery.

Detailed Description

During this longitudinal study, patients who suffer their first-ever stroke will be included within the first week after their stroke (if the inclusion criteria are met). Thereafter, each participant will be assessed at four pre-determined time-points: week 1, 5, 8 and 12 after stroke. On each of the four time-points, the investigators will assess muscle specific parameters of the affected m. rectus femoris (RF) and m. gastrocnemius medialis (GM), together with clinical tests to assess lower limb impairment (Fugl-Meyer Assessment for the lower limb and the Tardieu scale) and gait parameters (10-meter walk test). Specifically, muscle specific parameters will be investigated using 3D freehand ultrasound (3DfUS) and combined dynamic 2D US and surface electromyography (sEMG). Such assessments will help us characterize the electromechanical properties of these muscles, their time-related trajectories and the relationship with the recovery of gait and lower limb function after stroke. At the end of the investigation period, after 3 months, patients who can walk independently will perform a 3D gait analysis. As such, the relationship between changes in muscle specific parameters and the eventual gait quality at the end of the investigation period will be investigated.

Registry
clinicaltrials.gov
Start Date
May 2024
End Date
May 2027
Last Updated
2 years ago
Study Type
Observational
Sex
All

Investigators

Responsible Party
Principal Investigator
Principal Investigator

Eva Swinnen

Assistant professor

Vrije Universiteit Brussel

Eligibility Criteria

Inclusion Criteria

  • Adults (≥ 18 years old)
  • Diagnosed with a first-ever stroke (as defined by WHO)
  • Stroke onset ≤ 1 week (± 3 days)
  • Able to provide written or verbal informed consent at admission
  • Presence of gait problems as a consequence of the stroke (FAC≤4)

Exclusion Criteria

  • Presence of other neurological or orthopedic problems present prior to, or not caused as a direct consequence of, the stroke leading to impaired gait.
  • Modified Ranking scale pre-stroke \> 1/6, meaning presence of slight disability before the stroke.
  • Presence of severe comorbidities (e.g. osteoporosis, cardiovascular instability or chronic obstructive pulmonary disease).
  • Cerebellar or bilateral stroke.
  • Presence of severe deficits in communication, memory or understanding precluding informed consent.

Outcomes

Primary Outcomes

Cross-sectional area (CSA)

Time Frame: Frequency: week 1, 5, 8 and 12 after stroke

Through 3D freehand ultrasound (3DfUS)

Change in cross-sectional area

Time Frame: Frequency: week 1, 5, 8 and 12 after stroke

Through dynamic 2D ultrasound

Change in fascicle length

Time Frame: Frequency: week 1, 5, 8 and 12 after stroke

Through dynamic 2D ultrasound

Peak root mean square (RMS)

Time Frame: Frequency: week 1, 5, 8 and 12 after stroke

Through surface electromyography (sEMG)

Tendon length

Time Frame: Frequency: week 1, 5, 8 and 12 after stroke

Through 3D freehand ultrasound (3DfUS)

Echo Intensity

Time Frame: Frequency: week 1, 5, 8 and 12 after stroke

Through 2D ultrasound

Dynamic muscle morphology

Time Frame: Frequency: week 1, 5, 8 and 12 after stroke

Dynamic 2D ultrasound used to investigate the changes in cross-sectional area (CSA) en fascicle length

Spasticity

Time Frame: Frequency: week 1, 5, 8 and 12 after stroke.

Assessed with the Tardieu Scale. Scores ranging from 0 (no resistance throughout passive movement) to 5 (immobile joint).

Functional Ambulation Categories (FAC)-score

Time Frame: Frequency: week 1, 5, 8 and 12 after stroke

Scores ranging from 0 (not able to walk) to 5 (independent ambulator who can walk freely on any surface)

Muscle tickness

Time Frame: Frequency: week 1, 5, 8 and 12 after stroke

Through 3D freehand ultrasound (3DfUS)

Muscle volume

Time Frame: Frequency: week 1, 5, 8 and 12 after stroke

Through 3D freehand ultrasound (3DfUS)

Fascicle length

Time Frame: Frequency: week 1, 5, 8 and 12 after stroke

Through 3D freehand ultrasound (3DfUS)

Average root mean square (RMS)

Time Frame: Frequency: week 1, 5, 8 and 12 after stroke

Through surface electromyography (sEMG)

Muscle strength

Time Frame: Frequency: week 1, 5, 8 and 12 after stroke

Assessed with a handheld dynamometer (Nm)

Gait quality

Time Frame: Frequency: only at week 12.

Gait profile score (index number in degrees (°)), calculated from the lower limbs' kinematics (3D gait analysis). A higher score means more deviation of the expected (normal) gait pattern.

Physiological cross-sectional area (pCSA)

Time Frame: Frequency: week 1, 5, 8 and 12 after stroke

Through 3D freehand ultrasound (3DfUS)

Muscle length

Time Frame: Frequency: week 1, 5, 8 and 12 after stroke

Through 3D freehand ultrasound (3DfUS)

Pennation angle

Time Frame: Frequency: week 1, 5, 8 and 12 after stroke

Through 2D ultrasound

Lower limb motor impairment

Time Frame: Frequency: week 1, 5, 8 and 12 after stroke.

Fugl-Meyer Assessment of the lower limb (FMA LL). Scores ranging from 0 to 34 (no impairment present).

Spatiotemporal gait parameters

Time Frame: Frequency: week 1, 5, 8 and 12 after stroke.

Patients will perform the 10-meter walk test while wearing the GaitUp sensors.

Secondary Outcomes

  • Knee extension strength(Frequency: only during the first assessment (week 1).)
  • Balance(Frequency: only during the first assessment (week 1))
  • TWIST-score(Within first week after stroke)

Similar Trials