Objective
To analyze the changes in muscle mass and quality with time on the paretic and non-paretic sides in subacute stroke patients and identify correlations between the variation of muscle mass and quality and lower limb functions.
Methods
Thirty hemiplegia patients diagnosed with stroke participated in this study. To evaluate poststroke muscle changes, longitudinal measurement of muscle mass and quality was conducted with bilateral lower limbs. The elastic shear modulus was measured using shear wave elastography and muscle thickness (MT) of rectus femoris, vastus intermedius, vastus lateralis (VL), vastus medialis, tibialis anterior, and gastrocnemius (GCM) muscles. Functional evaluation was performed using Berg Balance Scale (BBS), Five Times Sit to Stand Test (FTSST). Follow-up was performed at discharge. The muscle mass and quality were compared according to time. We analyzed whether muscle quantity and quality were related to function.
Results
MT demonstrated no significant change with time. The elastic shear modulus increased significantly in the paretic VL and GCM muscles and did not change significantly in the muscles on the non-paretic side. Correlation analysis detected that elastic shear modulus in the VL has a cross-sectional negative relationship between BBS and positive relationship between FTSST. There were significant correlation between variation of FTSST and the variation of the elastic shear modulus in VL.
Conclusion
Only paretic VL and GCM muscle quality changed in subacute stroke patients and muscle’s property related to lower limb functions. Therefore, the lower extremity requires an approach to muscle quality rather than quantity for subacute stroke patients.

Citations

• Effect of end-effector robot training on lower limb motor function and balance in stroke patients: a systematic review and meta-analysis
  Zejian Lou, Fuhai Wang, Difu Guan, Zhichuan Hu, Chen Wei, Xiaoquan Zhang
  Frontiers in Neurology.2026;[Epub]     CrossRef
• Evaluating muscle characteristics and fall events: insights from real-world longitudinal data
  Shaofang Li, Juchuan Dong, Caixia Zhao, Yongmei Li, Wenyuan Wang, Lijuan An, Yongqian Han, Fuhou Zhang, Lihua Jin
  Annals of Medicine.2025;[Epub]     CrossRef
• Association Between Electrophysiological Evaluation and Muscle Quality Changes in the Lower Limb of Subacute Stroke Patients: A Pilot Longitudinal Observational Study
  Se Jin Kim, Jeong Hwan Lee, Young Sook Park, Hyun Jung Chang, Jin Gee Park, Eun Sol Cho, Jae Yeon Kim, Dong Jin Ha
  Diagnostics.2025; 15(22): 2854.     CrossRef
• Efficacy of robot-assisted gait training on lower extremity function in subacute stroke patients: a systematic review and meta-analysis
  Miao-miao Hu, Shan Wang, Cai-qin Wu, Kun-peng Li, Zhao-hui Geng, Guo-hui Xu, Lu Dong
  Journal of NeuroEngineering and Rehabilitation.2024;[Epub]     CrossRef

Objective
To analyze the effects of lymphovenous anastomosis (LVA) surgery after 1 year using the elastic index (EI) and volume.
Methods
This study was a retrospective study of 41 patients, with lymphedema, who underwent LVA surgery between July 2018 and June 2020. Limb circumference, used to determine the volume of the limb with lymphedema, and EI, which reflects tissue stiffness and measured using ultrasonography were measured for each patient before and 1 year after LVA surgery. To examine the effect of LVA, differences in the preoperative and 1-year postoperative volumes and EIs were analyzed using the Wilcoxon signed-rank test.
Results
The mean volume and EI of the dominant site in upper-extremity lymphedema were 2,309.4 cm³ and 1.4, respectively, preoperatively and 2,237.1 cm³ and 0.9, respectively, at 1 year postoperatively. The mean volume and EI difference of the dominant site 1 year after surgery was -16.6 cm³ (p=0.22) and -0.5 (p<0.001). The mean volume and EI of dominant site in lower-extremity lymphedema were 6,137.0 cm³ and 1.2, respectively, preoperatively, and 5,832.6 cm³ and 1.1, respectively, at 1 year postoperatively. The mean volume and EI difference of the dominant site 1 year postoperatively were -320.9 cm³ (p=0.04) and -0.2 (p=0.09), respectively.
Conclusion
LVA surgery is more effective in reducing pressure than in reducing volume, which may be helpful in preventing the progression of lymphedema.

Citations

• Beyond volume reduction: Systematic review and meta-analysis of microsurgical treatment of lymphedema
  C. Zurfluh, H. Ullmann, W.S. Tung, L. Grünherz, Y. Harder, P. Giovanoli, N. Lindenblatt
  Journal of Plastic, Reconstructive & Aesthetic Surgery.2025; 111: 272.     CrossRef
• Microsurgical treatment of breast cancer-related lymphedema under contrast-enhanced ultrasound guidance: a case report and literature review
  Qiuchan Zhao, Xing Huang, Weizhang Chen, Yi Xiao, Jialing Zhang, Yujun Liu, Rongkang Liang, Zhongzeng Liang
  Frontiers in Oncology.2025;[Epub]     CrossRef