Structural muscular adaptations in upper limb after stroke: a systematic review

Author(s)

Faturi, Fernanda Maria ^[1] ; Santos, Gabriela Lopes ^[1] ; Ocamoto, Gabriela Nagai ^[1] ; Russo, Thiago Luiz ^[1]

Affiliation

^[1] Fed Univ Sao Carlos UFSCar, Dept Phys Therapy, Lab Neurol Phys Therapy Res, Rodovia Washington Luis, Km 235, Sao Carlos, SP - Brazil

• Document type: Review article
• Source: Topics in Stroke Rehabilitation; v. 26, n. 1, p. 73-79, JAN 2 2019.
• Web of Science Citations: 1

Abstract

Background: Stroke is a leading cause of disability in the adult population, impairing upper limb (UL) movements affecting activities of daily living. Muscle weakness has been associated to disabilities in this population, but much attention is given to central nervous system alterations and less to skeletal muscles. Objective: The objective of this review is to carry out a systematic literature review to identify structural muscle alterations in the UL of poststroke individuals. Method: The search was performed in December, 2017. MEDLINE, PubMed, SCOPUS, CINAHL, and Science Direct were used as electronic databases. There was no restriction regarding language and publication dates. Studies conducted on poststroke subjects and results on UL skeletal muscle alterations identified by imaging tests were included. Results: Seven studies were included. The sample size and the variables varied among the studies. All the studies compared the paretic UL with the nonparetic UL and one of the studies also compared healthy subjects. Ultrasonography was the most used measurement tool to assess muscle adaptation. Conclusions: This review demonstrated little evidence with poor to fair quality on the structural muscle adaptations in the poststroke subjects, showing muscle atrophy, a higher stiffness, and amount of fibrous and fat tissue without alterations in lean tissue of distal muscles of the paretic UL compared to the nonparetic limb. However, the nonparetic side also presented alterations, which makes it an inappropriate comparison. Thus, well-designed studies addressing this issue are required. (AU)

• FAPESP's process: 14/25845-6 - Effects of elastic tape on shoulder proprioception and sensory-motor performance during reaching in chronic hemiparetic subjects
• Grantee: Gabriela Lopes dos Santos
• Support Opportunities: Scholarships in Brazil - Doctorate
• FAPESP's process: 17/22173-5 - Characterization of intracranial pressure by non-invasive method in post-stroke subjects: relationship with sedentarism and cardiovascular system
• Grantee: Gabriela Nagai Ocamoto
• Support Opportunities: Scholarships in Brazil - Doctorate (Direct)
• FAPESP's process: 13/21621-3 - Effect of task specific training on muscle adaptation in gerbils post-ischemic stroke
• Grantee: Thiago Luiz de Russo
• Support Opportunities: Regular Research Grants