The Role of Muscle Ultrasound in Stroke Rehabilitation: A Review of Calf Muscle Alterations and Clinical Implications

 Useless! You tell us nothing about the efficacy of recovery AND PROVIDE NO PROTOCOLS! Your mentors and senior researchers should be ashamed of allowing  such useless research to be produced

The Role of Muscle Ultrasound in Stroke Rehabilitation: A Review of Calf Muscle Alterations and Clinical Implications

• 

  Ying Shi

• 

  Chuanxiong Li

• The Affiliated Hospital of Yunnan University, Kunming, China

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Abstract

Background: 

Post-stroke morphological alterations in lower-leg muscles contribute to gait impairment. Conventional assessments are subjective and cannot quantify intramuscular changes. Musculoskeletal ultrasound offers a non-invasive, quantitative tool for evaluating these alterations. 

Objective: 

This systematic review synthesizes the past five years of literature on musculoskeletal ultrasound (B-mode, elastography, dynamic, and quantitative ultrasound) for assessing lower-leg muscle changes in stroke patients, exploring correlations with clinical outcomes and utility in guiding rehabilitation. 

Methods: 

PubMed, CNKI, and Wanfang Data were searched (January 2020–December 2025) following PRISMA guidelines. Included were original studies involving stroke patients, using ultrasound to assess lower-leg muscles, and reporting morphological or functional parameters. Results: Eight studies were included. The gastrocnemius and tibialis anterior were most assessed. Paretic muscles showed reduced thickness and cross-sectional area, altered pennation angle, shortened fascicle length, increased echo intensity (fat infiltration/fibrosis), and elevated shear wave velocity/Young's modulus (increased stiffness). These parameters correlated with spasticity, motor function, and muscle strength. Ultrasound effectively monitored treatment responses. 

Conclusion: 

Musculoskeletal ultrasound objectively assesses post-stroke lower-leg muscle changes, correlates with functional outcomes, and aids personalized rehabilitation. Standardized protocols are needed for broader clinical application.