Application of musculoskeletal ultrasound in quantitative assessment and rehabilitation of lower leg muscles in stroke patients.

OBJECTIVE

To investigate the application of musculoskeletal ultrasound in the quantitative assessment of lower leg muscles and its value in stratifying rehabilitation outcomes in patients with stroke.

METHODS

A single-center retrospective study was conducted, including 152 patients with stroke. Based on predefined composite functional criteria at 6 months after rehabilitation, patients were classified into favorable outcome (n = 105) and poor outcome (n = 47) groups. Baseline clinical characteristics (FMAS, Barthel Index, Brunnstrom stage, MMT, MAS) and MSUS parameters of the tibialis anterior (TA) and medial gastrocnemius (MG), including muscle thickness, fiber length, and pennation angle, were collected. Receiver operating characteristic (ROC) analysis, multivariable logistic regression, and hierarchical regression models were used to evaluate predictive performance.

RESULTS

Favorable outcomes were associated with greater TA and MG muscle architectural parameters (P < 0.05). ROC analysis showed moderate predictive ability for TA fiber length (AUC = 0.755) and MG fiber length (AUC = 0.652). The combined logistic model improved prediction (AUC = 0.801). Hierarchical analysis demonstrated that adding MSUS parameters to baseline functional scores increased predictive performance (AUC from 0.721 to 0.833).

CONCLUSION

MSUS-derived muscle architecture, particularly fiber length, is associated with stroke rehabilitation outcomes and provides incremental predictive value beyond conventional functional assessments.