%0 Journal Article
%T Ultrasound Structural Changes in Triceps Surae After a 1
%A Christina Marciniak
%A Dawn Hicklin
%A Emilie Hutin
%A Ingrid Masson
%A Jean-Michel Gracies
%A Maud Pradines
%A Mouna Ghedira
%A Nicolas Bayle
%A Pierre Portero
%A Rapha£¿l Portero
%J Neurorehabilitation and Neural Repair
%@ 1552-6844
%D 2019
%R 10.1177/1545968319829455
%X Introduction. The effects of long-term stretching (>6 months) in hemiparesis are unknown. This prospective, randomized, single-blind controlled trial compared changes in architectural and clinical parameters in plantar flexors of individuals with chronic hemiparesis following a 1-year guided self-stretch program, compared with conventional rehabilitation alone. Methods. Adults with chronic stroke-induced hemiparesis (time since lesion >1 year) were randomized into 1 of 2, 1-year rehabilitation programs: conventional therapy (CONV) supplemented with the Guided Self-rehabilitation Contract (GSC) program, or CONV alone. In the GSC group, specific lower limb muscles, including plantar flexors, were identified for a diary-based treatment utilizing daily, high-load, home self-stretching. Blinded assessments included (1) ultrasonographic measurements of soleus and medial gastrocnemius (MG) fascicle length and thickness, with change in soleus fascicle length as primary outcome; (2) maximum passive muscle extensibility (XV1, Tardieu Scale); (3) 10-m maximal barefoot ambulation speed. Results. In all, 23 individuals (10 women; mean age [SD], 56 [¡À12] years; time since lesion, 9 [¡À8] years) were randomized into either the CONV (n = 11) or GSC (n = 12) group. After 1 year, all significant between-group differences favored the GSC group: soleus fascicle length, +18.1mm [9.3; 29.9]; MG fascicle length, +6.3mm [3.5; 9.1]; soleus thickness, +4.8mm [3.0; 7.7]; XV1 soleus, +4.1¡ã [3.1; 7.2]; XV1 gastrocnemius, +7.0¡ã [2.1; 11.9]; and ambulation speed, +0.07m/s [+0.02; +0.16]. Conclusions. In chronic hemiparesis, daily self-stretch of the soleus and gastrocnemius over 1 year using GSC combined with conventional rehabilitation increased muscle fascicle length, extensibility, and ambulation speed more than conventional rehabilitation alone
%K hemiparesis
%K self-stretch program
%K muscle fascicle lengthening
%K muscle extensibility
%K ultrasound fascicle length
%U https://journals.sagepub.com/doi/full/10.1177/1545968319829455