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CLINICAL TRIAL article

Front. Neurol.

Sec. Neurorehabilitation

Volume 16 - 2025 | doi: 10.3389/fneur.2025.1634382

The Correlation Between Lower Limb Spasticity and Proprioceptive Dysfunction in Post-Stroke Patients

Provisionally accepted
  • 1School of Rehabilitation Medicine, Shandong University of Traditional Chinese Medicine, Jinan, China
  • 2Shandong Center for Disease Control and Prevention, Jinan, China
  • 3Affiliated Hospital of Shandong University of Traditional Chinese Medicine, Jinan, China

The final, formatted version of the article will be published soon.

Objective: To investigate the correlation between lower limb spasticity and proprioception in stroke patients, to analyze the influencing factors of spasticity, and to evaluate the predictive value of musculoskeletal ultrasound parameters on spasticity.A cross-sectional study was used to enroll 80 stroke patients admitted to the Rehabilitation Center of the Affiliated Hospital of Shandong University of Traditional Chinese Medicine from October 2024 to April 2025. The degree of lower limb spasticity was evaluated by the modified Ashworth Scale (MAS), and the proprioceptive assessment module of the Pro-kin balance system was used to quantitatively detect the mean trajectory error (ATE) and the average weight-bearing asymmetry (AWA). Musculoskeletal ultrasound was used to detect the spasmodic side and the healthy gastrocnemius muscle, and the longitudinal and transverse ultrasound images were obtained, and the length of muscle fibers, medial head pinnate angle and parameters was (65.83±1.47) %, and the average weight-bearing force difference was (2.41±0.05) kg. Correlation analysis showed that MAS spasticity score was statistically significantly related to proprioceptive parameters and muscle structure parameters (P<0.05), and multiple linear regression analysis showed that muscle feather angle (β=0.362), muscle fiber length (β=-0.157), muscle thickness (β=-0.230), mean trajectory error (β=0.329) and average weight-bearing strength difference (β=0.260) constituted independent influencing factors for MAS score (adjusted R 2 = 0.787, P<0.05). ROC curve analysis showed that the area under the curve of muscle pinnate angle predicting spasticity (MAS≥2 grade) was the largest (AUC=0.850, 95%CI: 0.729-0.972), which was better than muscle fiber length (AUC=0. 840) and muscle thickness (AUC=0.838).There is a significant correlation between lower limb spasticity and proprioceptive and muscle structure parameters in stroke patients, and proprioception and muscle structure parameters are the key factors affecting spasticity, and musculoskeletal ultrasound can be used as a quantitative evaluation tool for lower limb spasticity in stroke.

Keywords: Stroke, spasms of the lower limbs, Proprioception, Musculoskeletal ultrasound, Correlation analysis

Received: 27 May 2025; Accepted: 06 Aug 2025.

Copyright: © 2025 Gao, Yu and Liu. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

* Correspondence: Xihua Liu, Affiliated Hospital of Shandong University of Traditional Chinese Medicine, Jinan, China

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