Objective:
To identify the asymmetry of fatty infiltration and cross-sectional
areas (CSAs) of individual paravertebral muscles in persons with
hemiplegic presentation post-stroke.
Methods: We
retrospectively reviewed 26 patients with unilateral hemiplegia who
underwent lumbar magnetic resonance imaging post-stroke. CSAs and
functional CSAs (FCSAs) of individual paraspinal muscles (multifidus,
erector spinae, quadratus lumborum, and psoas major) at the mid-disc
level were bilaterally measured from L1-L2 to L5-S1 on T2-weighted
lumbar axial images. The FCSA-to-total CSA ratio of each paraspinal
muscle was also calculated. These parameters were compared between the
more-affected and less-affected sides, and between the less chronic and
chronic phases.
Results: FCSA (p = .049) and FCSA-to-total CSA ratio (p = .044)
were significantly smaller at the L5-S1 multifidus on the more-affected
side than on the less-affected side in the chronic phase. Other muscles
showed no meaningful changes. The erector spinae on the more-affected
side and the multifidus on the less-affected side significantly
increased in size in the chronic phase compared with the less chronic
phase.
Conclusions: Persons with hemiplegic presentation
may have unilateral atrophy and fatty infiltration of the multifidus on
the more-affected side during the chronic phase. The comparison between
the less chronic and chronic phases suggested that the recovery pattern
of the trunk muscles could differ between sides in unilateral
hemiplegia: increased size of the multifidus, a tonic stabilizer, on the
less-affected side and of the erector spinae, a phasic muscle, on the
more-affected side. This finding could be applied to trunk
rehabilitation strategies for persons post-stroke.
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