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Peer-reviewedCC BYJournal of functional morphology and kinesiology

Ultrasound Use in Clinical Decision-Making for Spasticity and Contracture Management in Neurological Rehabilitation.

  • Nicola Theis1
  • Cherry Kilbride2,3
  • Stephen A Ashford4,5
5 affiliations
  1. 1School of Education, Health and Science, University of Gloucestershire, Gloucester GL2 9HW, UK.
  2. 2Department of Health Sciences, Brunel University of London, Middlesex UB8 3PN, UK.
  3. 3Royal Free London NHS Trust, London NW3 2QG, UK.
  4. 4Department of Palliative Care, Policy and Rehabilitation, Cicely Saunders Institute, Florence Nightingale Faculty of Nursing, Midwifery and Palliative Care, King's College London, London SE5 9PJ, UK.
  5. 5Regional Hyper-Acute Rehabilitation Unit, Northwick Park Hospital, London North West University Hospitals, London HA1 3UJ, UK.
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Abstract

Ultrasound is increasingly used in neurological rehabilitation, most visibly to improve the accuracy and safety of botulinum toxin (BoNT) and phenol administration for spasticity. However, its potential to contribute to wider clinical decision-making remains underdeveloped, particularly through characterisation of structural muscle-tendon unit (MTU) changes that may help clinicians interpret the relative neural and structural contributors to stiffness and contracture. This position paper argues that ultrasound should be conceptualised not only as a procedural adjunct but also as a clinical decision-support tool. We synthesise current evidence supporting muscle ultrasound for tissue characterisation and intervention guidance, outline barriers to implementation, and distinguish established procedural applications from the emerging use of ultrasound for tissue-informed clinical decision support. The modified Heckmatt scale is presented as one feasible method for tissue characterisation within this broader ultrasound toolkit, while recognising that validated thresholds linking ultrasound findings to specific treatment decisions have not yet been established. Further methodological standardisation, competency development and prospective evaluation are required before these emerging applications can be incorporated consistently into routine clinical pathways.

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Cite

BibTeXRIS
BibTeX
@article{theis2026ultrasound,
  title = {{Ultrasound Use in Clinical Decision-Making for Spasticity and Contracture Management in Neurological Rehabilitation.}},
  author = {Nicola Theis and Cherry Kilbride and Stephen A Ashford},
  journal = {Journal of functional morphology and kinesiology},
  year = {2026},
  month = oct,
  doi = {10.3390/jfmk11040405},
  url = {https://europepmc.org/article/MED/42924684},
  note = {CC BY},
}
RIS
TY  - JOUR
TI  - Ultrasound Use in Clinical Decision-Making for Spasticity and Contracture Management in Neurological Rehabilitation.
AU  - Nicola Theis
AU  - Cherry Kilbride
AU  - Stephen A Ashford
PY  - 2026
DA  - 2026/10/03
JO  - Journal of functional morphology and kinesiology
DO  - 10.3390/jfmk11040405
UR  - https://europepmc.org/article/MED/42924684
AB  - Ultrasound is increasingly used in neurological rehabilitation, most visibly to improve the accuracy and safety of botulinum toxin (BoNT) and phenol administration for spasticity. However, its potential to contribute to wider clinical decision-making remains underdeveloped, particularly through characterisation of structural muscle-tendon unit (MTU) changes that may help clinicians interpret the relative neural and structural contributors to stiffness and contracture. This position paper argues that ultrasound should be conceptualised not only as a procedural adjunct but also as a clinical decision-support tool. We synthesise current evidence supporting muscle ultrasound for tissue characterisation and intervention guidance, outline barriers to implementation, and distinguish established procedural applications from the emerging use of ultrasound for tissue-informed clinical decision support. The modified Heckmatt scale is presented as one feasible method for tissue characterisation within this broader ultrasound toolkit, while recognising that validated thresholds linking ultrasound findings to specific treatment decisions have not yet been established. Further methodological standardisation, competency development and prospective evaluation are required before these emerging applications can be incorporated consistently into routine clinical pathways.
SN  - 2411-5142
ER  -