Deans' stroke musings

Changing stroke rehab and research worldwide now.Time is Brain!Just think of all the trillions and trillions of neurons that DIE each day because there are NO effective hyperacute therapies besides tPA(only 12% effective). I have 493 posts on hyperacute therapy, enough for researchers to spend decades proving them out. These are my personal ideas and blog on stroke rehabilitation and stroke research. Do not attempt any of these without checking with your medical provider. Unless you join me in agitating, when you need these therapies they won't be there.

What this blog is for:

Shortly after getting out of the hospital and getting NO information on the process or protocols of stroke rehabilitation and recovery I started searching on the internet and found that no other survivor received useful information. This is an attempt to cover all stroke rehabilitation information that should be readily available to survivors so they can talk with informed knowledge to their medical staff. It's quite disgusting that this information is not available from every stroke association and doctors group.
My back ground story is here:

Tuesday, September 27, 2016

changes in the muscle-tendon complex of triceps surae after 1 year of rehabilitation including a daily self-stretch program in patients with chronic hemiparesis

Totally worthless since they didn't even bother to measure spasticity and the effects of this program on that. Bet your doctor has no clue what a guided Self-rehabilitation contract is?

changes in the muscle-tendon complex of triceps surae after 1 year of rehabilitation including a daily self-stretch program in patients with chronic hemiparesis




To explore changes in muscle architectural parameters of the muscle-tendon unit of soleus and medial gastrocnemius (GM) in patients with chronic hemiparesis, after 1 year of rehabilitation.

Material/Patients and methods

In this prospective study, 20 chronic hemiparetic patients (8W, mean age: 56 [12], time since lesion 9 [8]) were evaluated. Muscle architectural parameters including muscle fascicle length, pennation angle, thickness, tendon and muscle belly lengths were evaluated in vivo using ultrasonography in passive condition (verified by electromyographic recording) in a seated patient with ankle, knee and hip on the paretic side at 90°. Following the biomechanical analysis, each patient benefited from the Five Step Assessment (FSA), involving the measure of XV1, angle of arrest at slow and strong stretch, which estimates soft tissue extensibility around each muscle. Four muscles of interest in the lower limb were selected for this measure: soleus (XV1Sol), medial gastro-soleus complex (XV1GSC), gluteus maximus (XV1GM) and rectus femoris (XV1RF). Biomechanical and clinical analyses were performed at the beginning and after 1 year of treatment. Two treatments were implemented:

– conventional rehabilitation (50%);

– guided Self-rehabilitation contract (GSC, 50%).

Patients in the GSC group were prescribed a daily self-stretch program with static (>10 min/muscle/day) and eccentric stretch. Changes in architectural parameters and clinical muscle extensibility of overall patients before and after 1 year of rehabilitation were analyzed (Student's).


After 1 year, muscle fascicle length and thickness increased respectively by 6.1mm (14.2%, P=0.05), 1.8mm (13.6%, P=0.06) in soleus, and by 2.9mm (9.1%, P=0.04) and 1.7mm (13.2%, P=0.03) in MG. Muscle belly length of MG increased by 2.9cm (17%, P=0.0001) and its tendon length decreased by 0.82cm (5%, P=0.04). XV1GSC increased by 4.8° (3.3%, P=0.07), XV1GM by 4.1° (3.3%, P=0.0004) and XV1RF by 7.2° (6%, P=0.02).

Discussion - Conclusion

Stretch of soleus and medial gastrocnemius practiced over the long term in patients with spastic hemiparesis allowed structural changes, increasing muscle fascicle length and thickness. Muscle belly length of medial gastrocnemius also increased significantly while its tendon length decreased, suggesting that the tendon may adapt its length to the muscle length changes.

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