title: Strain sonoelastographic evaluation of biceps muscle intrinsic stiffness after botulinum toxin-A injection.
abstract: The most commonly used clinical tools for measuring spasticity are modified Ashworth scale (MAS) and Tardieu scale but both yield subjective rather than objective results. Ultrasound elastography (EUS) provides information on tissue stiffness and allows the qualitative or quantitative measurements of the mechanical properties of tissues.
  
  
  
  To assess the stiffness of biceps brachialis muscles in stroke patients by strain EUS and to investigate the sonoelastographic changes and its correlations with clinical evaluation parameters after botulinum toxin-A (BTA) injections.
  
  
  
  This is a prospective study. A total of 48 chronic stroke patients requiring BTA injections to biceps brachialis muscles were included in the study. All patients received injections with BTA to biceps brachialis muscles under ultrasound guidance. MAS, goniometric measurements, and strain EUS assessments were performed at preintervention and at 4-week postintervention.
  
  
  
  Strain index values of biceps muscle on the affected side were significantly increased compared with those on the unaffected side (p < 0.01). At 4 weeks after BTA injection, significant improvements were observed in MAS grades and goniometric measurements (p < 0.05). Statistically significant differences were also found between the MAS grades and strain index values in both pre-/postintervention period (p < 0.01). No significant correlations were observed between clinical parameters and strain EUS findings.
  
  
  
  Strain EUS is a promising diagnostic tool for assessing stiffness in spastic muscles, in establishing the treatment plan and monitoring the effectiveness of the therapeutic modality.
authors.affiliation: a Department of Physical Medicine and Rehabilitation , Katip Celebi University Ataturk Training and Research Hospital , Izmir , Turkey.
authors.forename: Ayhan
authors.initials: A
authors.lastname: Aşkın
authors.affiliation: b Department of Radiology , Katip Celebi University Ataturk Training and Research Hospital , Izmir , Turkey.
authors.forename: Özlem Tuğçe
authors.initials: ÖT
authors.lastname: Kalaycı
authors.affiliation: a Department of Physical Medicine and Rehabilitation , Katip Celebi University Ataturk Training and Research Hospital , Izmir , Turkey.
authors.forename: Korhan Barış
authors.initials: KB
authors.lastname: Bayram
authors.affiliation: a Department of Physical Medicine and Rehabilitation , Katip Celebi University Ataturk Training and Research Hospital , Izmir , Turkey.
authors.forename: Aliye
authors.initials: A
authors.lastname: Tosun
authors.affiliation: a Department of Physical Medicine and Rehabilitation , Katip Celebi University Ataturk Training and Research Hospital , Izmir , Turkey.
authors.forename: Ümit Seçil
authors.initials: ÜS
authors.lastname: Demirdal
authors.affiliation: a Department of Physical Medicine and Rehabilitation , Katip Celebi University Ataturk Training and Research Hospital , Izmir , Turkey.
authors.forename: Emel
authors.initials: E
authors.lastname: Atar
authors.affiliation: b Department of Radiology , Katip Celebi University Ataturk Training and Research Hospital , Izmir , Turkey.
authors.forename: Mehmet Fatih
authors.initials: MF
authors.lastname: İnci
mesh_terms: D000368:Aged; D019274:Botulinum Toxins, Type A / Q000627:therapeutic use*; D002908:Chronic Disease; D054459:Elasticity Imaging Techniques / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D018482:Muscle, Skeletal / Q000000981:diagnostic imaging* / Q000187:drug effects; D009465:Neuromuscular Agents / Q000627:therapeutic use*; D017063:Outcome Assessment, Health Care; D011446:Prospective Studies; D016059:Range of Motion, Articular / Q000187:drug effects; D013223:Statistics as Topic; D018709:Statistics, Nonparametric; D020521:Stroke / Q000188:drug therapy* / Q000473:pathology*
chemical_list: D009465:Neuromuscular Agents; D019274:Botulinum Toxins, Type A
keywords: Biceps brachialis muscle, Botulinum toxin-A; Muscle spasticity; Sonoelastography; Stroke