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Peer-reviewedCC BYHealthcare (Basel, Switzerland)

Ultrasonographic and Elastographic Markers of Muscle Changes Associated with Post-Stroke Spasticity: A Systematic Review.

  • Livia-Alexandra Ion1,2
  • Delia Cinteză2,3
  • Daniela Poenaru2,3
  • Claudia Gabriela Potcovaru2,3
  • Andreea Dumitrescu2,4
  • Florina Ligia Popa5,6
6 affiliations
  1. 1Doctoral School, Lucian Blaga University of Sibiu, 550024 Sibiu, Romania.
  2. 2National Institute of Rehabilitation, Physical Medicine and Balneoclimatology, 030079 Bucharest, Romania.
  3. 3Physical Medicine and Rehabilitation, "Carol Davila" University of Medicine and Pharmacy, 050474 Bucharest, Romania.
  4. 4Doctoral School, Carol Davila University of Medicine and Pharmacy, 020021 Bucharest, Romania.
  5. 5Department of Physical Medicine and Rehabilitation, Faculty of Medicine, Lucian Blaga University of Sibiu, 550024 Sibiu, Romania.
  6. 6Sibiu County Emergency Clinical Hospital, 550245 Sibiu, Romania.
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Abstract

Background/Objectives: Clinical assessment of post-stroke spasticity may not fully distinguish neural contributions from structural and mechanical muscle changes. This systematic review examined associations between B-mode ultrasonographic and elastography-derived muscle parameters and the presence or severity of post-stroke spasticity. Methods: PubMed, Scopus, and Web of Science Core Collection were searched from inception to 18 July 2026. Eligible studies investigated ultrasound-derived skeletal muscle parameters in adults after stroke in relation to spasticity status or severity. Methodological quality was assessed using the Joanna Briggs Institute checklist, and certainty of evidence was evaluated using the GRADE approach. Findings were synthesized narratively because of substantial heterogeneity. Results: Eighteen studies were included, six contributing B-mode structural data and twelve elastography-derived mechanical data. B-mode findings were inconsistent across muscles and measurement conditions. Elastography more frequently identified increased stiffness-related parameters in paretic or spastic muscles, although associations with clinical spasticity severity were not consistently observed. The certainty of evidence was very low across the assessed outcome domains, reflecting methodological limitations, small sample sizes, and inconsistency in the reported associations. Conclusions: B-mode ultrasound and elastography provide complementary information on muscle changes after stroke, but neither can currently serve as a stand-alone measure of spasticity severity. Elastography may help characterize the mechanical component of post-stroke hypertonia alongside clinical examination. Larger, standardized longitudinal studies are needed to establish the clinical utility of these techniques.

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Cite

BibTeXRIS
BibTeX
@article{ion2026ultrasonographic,
  title = {{Ultrasonographic and Elastographic Markers of Muscle Changes Associated with Post-Stroke Spasticity: A Systematic Review.}},
  author = {Livia-Alexandra Ion and Delia Cinteză and Daniela Poenaru and Claudia Gabriela Potcovaru and Andreea Dumitrescu and Florina Ligia Popa},
  journal = {Healthcare (Basel, Switzerland)},
  year = {2026},
  month = oct,
  doi = {10.3390/healthcare14203492},
  url = {https://europepmc.org/article/MED/42940537},
  note = {CC BY},
}
RIS
TY  - JOUR
TI  - Ultrasonographic and Elastographic Markers of Muscle Changes Associated with Post-Stroke Spasticity: A Systematic Review.
AU  - Livia-Alexandra Ion
AU  - Delia Cinteză
AU  - Daniela Poenaru
AU  - Claudia Gabriela Potcovaru
AU  - Andreea Dumitrescu
AU  - Florina Ligia Popa
PY  - 2026
DA  - 2026/10/17
JO  - Healthcare (Basel, Switzerland)
DO  - 10.3390/healthcare14203492
UR  - https://europepmc.org/article/MED/42940537
AB  - Background/Objectives: Clinical assessment of post-stroke spasticity may not fully distinguish neural contributions from structural and mechanical muscle changes. This systematic review examined associations between B-mode ultrasonographic and elastography-derived muscle parameters and the presence or severity of post-stroke spasticity. Methods: PubMed, Scopus, and Web of Science Core Collection were searched from inception to 18 July 2026. Eligible studies investigated ultrasound-derived skeletal muscle parameters in adults after stroke in relation to spasticity status or severity. Methodological quality was assessed using the Joanna Briggs Institute checklist, and certainty of evidence was evaluated using the GRADE approach. Findings were synthesized narratively because of substantial heterogeneity. Results: Eighteen studies were included, six contributing B-mode structural data and twelve elastography-derived mechanical data. B-mode findings were inconsistent across muscles and measurement conditions. Elastography more frequently identified increased stiffness-related parameters in paretic or spastic muscles, although associations with clinical spasticity severity were not consistently observed. The certainty of evidence was very low across the assessed outcome domains, reflecting methodological limitations, small sample sizes, and inconsistency in the reported associations. Conclusions: B-mode ultrasound and elastography provide complementary information on muscle changes after stroke, but neither can currently serve as a stand-alone measure of spasticity severity. Elastography may help characterize the mechanical component of post-stroke hypertonia alongside clinical examination. Larger, standardized longitudinal studies are needed to establish the clinical utility of these techniques.
SN  - 2227-9032
ER  -