Quantitative assessment of spasticity-related and treatment-induced changes in muscle properties of hemiparetic patients
(2026)
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- Summary Stroke is a leading cause of long-term disability worldwide. Many stroke survivors develop spasticity syndrome, a complex condition resulting from the interaction between neural abnormalities and changes in the muscles and soft tissues. While spastic muscle overactivity is well recognized and routinely targeted in clinical practice, the non-neural component of spasticity syndrome remains insufficiently understood. Structural and mechanical changes of muscles may contribute substantially to movement limitations, reduced mobility, and impaired independence and quality of life after stroke. The overall objective of this thesis was to improve the understanding of post-stroke muscle changes and to investigate the effects of Botulinum toxin type A (BoNT-A), one of the most commonly used treatments for spastic muscle overactivity, on muscle properties. Particular attention was given to the triceps surae muscle group, which plays a key role in gait and is frequently affected after stroke. To address these objectives, a series of complementary studies was conducted. First, a systematic review and meta-analysis synthesized the available evidence regarding structural and mechanical muscle changes following BoNT-A injections in neurological populations. Second, a quantitative MRI study investigated the effects of repeated BoNT-A injections on calf muscle structure in individuals with chronic stroke. Third, an ultrasound elastography study aimed to optimize the assessment of muscle stiffness by evaluating the influence of ankle position and muscle activation on measurement reliability. Finally, a longitudinal study was designed to characterize the evolution of muscle structure and stiffness from the acute phase after stroke using MRI and shear wave elastography. By combining advanced imaging techniques, including magnetic resonance imaging and ultrasound, this work provides new insights into the mechanisms underlying post-stroke muscle remodeling and their evolution over time. Ultimately, a better understanding and quantification of these changes may contribute to more individualized rehabilitation strategies and improved management of spasticity syndrome after stroke.
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Devis, M. (2026). Quantitative assessment of spasticity-related and treatment-induced changes in muscle properties of hemiparetic patients. https://hdl.handle.net/2078.5/280712