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Altered contractile properties of the gastrocnemius muscle poststroke

¹Rehabilitation Institute of Chicago, Chicago; and Departments of ²Physical Medicine and Rehabilitation, ³Orthopaedic Surgery, and ⁴Biomedical Engineering, Northwestern University, Chicago, Illinois; and ⁵Department of Health and Kinesiology, The University of Texas at Tyler, Tyler, Texas

Submitted 21 July 2008 ; accepted in final form 20 October 2008

Spasticity, contracture and muscle weakness often occur together poststroke and cause considerable motor impairments to stroke survivors. The underlying changes in contractile properties of muscle fascicles are still not clear. The purpose of this study was to investigate the contractile property changes of the medial gastrocnemius muscle fascicles poststroke. Ten stroke survivors and ten healthy subjects participated in the study. The medial gastrocnemius fascicular length was measured at various combinations of ankle and knee positions using ultrasonography, with the muscle activated selectively using electrical stimulation. The stimulation intensity was kept constant across different ankle and knee positions to establish the active force-length relationship of the muscle fascicles. It was found that stroke survivors showed a shift of the force-length curve with a significantly shorter optimal fascicle length (33.2 ± 3.2 mm) compared with that of healthy controls (47.4 ± 2.7 mm) with P < 0.001. Furthermore, the width span of the fascicular force-length curve of stroke survivors was significantly narrower with steeper slopes than that of controls (P 0.001), suggesting reduced number of sarcomeres along the fascicles and/or reduced sarcomere length poststroke. Regression analysis showed that the medial gastrocnemius fascicular length of stroke survivors varied significantly less with ankle and knee flexions (P 0.001) than that of controls, suggesting shorter and stiffer muscle fascicles poststroke, which might be attributed to muscle architectural adaptation. This study showed that there are considerable changes in the contractile properties of muscle fascicles poststroke, which may contribute directly to the joint-level changes of decreased range of motion, increased stiffness, muscle weakness, and impaired motor functions in stroke survivors.

stroke; ultrasound; muscle fascicle; force length; spasticity; gastrocnemius

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