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Ultrasonographic Evaluation of Morphological and Functional Characteristics of Intercostal Muscles in Stroke Patients and Their Relationship With Clinical Parameters

2026年6月22日 更新者：Marmara University
The aim of this study is to evaluate the morphological and functional characteristics of parasternal intercostal muscles in patients with stroke using ultrasonography. Parasternal intercostal muscle thickness and thickening fraction will be assessed on both the hemiplegic and non-hemiplegic sides. The relationship between ultrasonographic findings and respiratory muscle strength, motor function, balance, functional independence, and quality of life will also be investigated. A healthy control group will be included to establish reference values and enable comparative analyses.

研究概览

地位

尚未招聘

条件

详细说明

Stroke frequently leads to respiratory muscle dysfunction due to impaired central motor control. Although diaphragm involvement after stroke has been extensively investigated, there is limited evidence regarding the morphological and functional characteristics of extra-diaphragmatic inspiratory muscles, particularly the parasternal intercostal muscles.

The primary objective of this study is to evaluate parasternal intercostal muscle morphology and contractility in individuals with stroke using ultrasonography. Parasternal intercostal muscle thickness will be measured at end-tidal expiration and maximal inspiration, and intercostal muscle thickening fraction (ICTf) will be calculated as an indicator of muscle contractility. Measurements will be obtained bilaterally, allowing comparison between the hemiplegic and non-hemiplegic sides.

In addition, diaphragm thickness and diaphragm thickening fraction will be assessed using ultrasonography. Respiratory muscle strength will be evaluated by maximal inspiratory pressure (MIP) and maximal expiratory pressure (MEP) measurements according to ATS/ERS recommendations. Pulmonary function tests including forced vital capacity (FVC), forced expiratory volume in one second (FEV1), and FEV1/FVC ratio will also be performed.

Clinical outcomes including motor impairment, balance, functional independence, and stroke-specific quality of life will be assessed using the Fugl-Meyer Assessment, Berg Balance Scale, Functional Independence Measure (FIM), and Stroke-Specific Quality of Life Scale (SS-QoL), respectively.

A healthy control group matched for age, sex, and body mass index will be included to establish reference values for parasternal intercostal muscle ultrasonographic measurements and to allow comparative analyses between stroke patients and healthy individuals.

The study is designed as a single-center, controlled cross-sectional observational study. A minimum of 40 individuals with stroke and 25 healthy volunteers will be enrolled. Associations between ultrasonographic respiratory muscle measurements and clinical parameters will be analyzed to improve understanding of respiratory muscle involvement after stroke and its relationship with functional outcomes.

研究类型

观察性的

注册 (估计的)

65

联系人和位置

本节提供了进行研究的人员的详细联系信息，以及有关进行该研究的地点的信息。

学习联系方式

研究联系人备份

学习地点

  • 土耳其（türkiye）
    • Maltepe
      • Istanbul、Maltepe、土耳其（türkiye）、34854
        • Marmara Üniversitesi Tıp Fakültesi
        • 接触：

参与标准

研究人员寻找符合特定描述的人，称为资格标准。这些标准的一些例子是一个人的一般健康状况或先前的治疗。

资格标准

适合学习的年龄

  • 成人
  • 年长者

接受健康志愿者

是的

取样方法

非概率样本

研究人群

Adults with a history of ischemic or hemorrhagic stroke attending the outpatient Physical Medicine and Rehabilitation clinic of Marmara University, and age-eligible healthy volunteers recruited as controls.

描述

Inclusion Criteria (Stroke Group):

  • Age between 18 and 75 years.
  • History of ischemic or hemorrhagic stroke.
  • Ability to understand and comply with study procedures.
  • Provision of written informed consent.

Exclusion Criteria (Stroke Group):

  • Presence of acute or chronic pulmonary disease.
  • History of thoracic or abdominal surgery.
  • Presence of another neuromuscular disorder.
  • Aphasia or cognitive impairment preventing participation in assessments.
  • Active malignancy.

Inclusion Criteria (Healthy Control Group):

  • Age between 18 and 75 years.
  • Willingness to participate in the study.
  • Provision of written informed consent.

Exclusion Criteria (Healthy Control Group):

  • History of stroke or other neurological disorders.
  • History of chronic respiratory disease (e.g., COPD, asthma).
  • Chest wall deformity.
  • Presence of systemic diseases that may affect muscle function.

学习计划

本节提供研究计划的详细信息，包括研究的设计方式和研究的衡量标准。

研究是如何设计的？

设计细节

队列和干预

团体/队列
Group 1: Stroke Patients
Adults aged 18-75 years with a history of ischemic or hemorrhagic stroke who meet the study eligibility criteria. A minimum of 40 participants will be enrolled in this group.
Group 2: Healthy Controls
Age-eligible healthy volunteers without a history of stroke, neurological disease, chronic respiratory disease, chest wall deformity, or systemic disease affecting muscle function. A minimum of 25 participants will be enrolled in this group.

研究衡量的是什么？

主要结果指标

结果测量
措施说明
大体时间
Parasternal Intercostal Muscle Thickening Fraction (ICTf)
大体时间：Baseline
Ultrasonographic assessment of parasternal intercostal muscle contractility. Thickening fraction will be calculated as: (Inspiratory Thickness - Expiratory Thickness) / Expiratory Thickness × 100. Higher values indicate greater inspiratory muscle contractile activity. Comparison will be performed between the hemiplegic and non-hemiplegic sides.
Baseline

次要结果测量

结果测量
措施说明
大体时间
Parasternal Intercostal Muscle Thickness
大体时间：Baseline
Ultrasonography will be used to examine the structure and function of the muscle and to measure muscle thickness at the end of inspiration and expiration.
Baseline
Intercostal Muscle Asymmetry Index
大体时间：Baseline
Intercostal Muscle Asymmetry Index (AI) is a normalized measure of side-to-side differences in parasternal intercostal muscle contractility. The asymmetry index is calculated using the formula |TF₁ - TF₂| / [(TF₁ + TF₂)/2] × 100, where TF represents the intercostal muscle thickening fraction measured by ultrasonography. Higher values indicate greater asymmetry between the two sides, whereas lower values indicate more symmetrical intercostal muscle function.
Baseline
Relative Hemiplegic Deficit
大体时间：Baseline
Relative Hemiplegic Deficit is a measure of the reduction in parasternal intercostal muscle contractility on the hemiplegic side relative to the non-hemiplegic side in individuals with stroke. It is calculated using the formula [(TFnon-hemiplegic - TFhemiplegic) / TFnon-hemiplegic] × 100, where TF represents the intercostal muscle thickening fraction measured by ultrasonography. Higher values indicate a greater functional deficit of the hemiplegic side, while lower values indicate more preserved intercostal muscle function.
Baseline
Diaphragm Thickening Fraction
大体时间：Baseline
Diaphragm contractility assessed by ultrasonography. Thickening fraction is calculated as [(Thickness at maximal inspiration - Thickness at end-expiration) / Thickness at end-expiration] × 100. Higher values indicate greater diaphragm contractile function.
Baseline
Maximal Inspiratory Pressure (MIP)
大体时间：Baseline
Maximum inspiratory pressure (MIP) is a measurement that evaluates the strength of the inspiratory muscles. This test measures the negative pressure created when a person breathes in at maximum effort. MIP assesses the strength of respiratory muscles, such as the diaphragm and intercostal muscles, and is used to diagnose conditions characterized by respiratory muscle weakness.
Baseline
Maximal Expiratory Pressure (MEP)
大体时间：Baseline
Maximum expiratory pressure (MEP) is a measurement that evaluates the strength of the expiratory muscles. This test measures the positive pressure generated when a person exhales with maximum effort. MEP assesses the strength of expiratory muscles, including the abdominal and internal intercostal muscles, and is commonly used to evaluate respiratory muscle function and identify conditions associated with expiratory muscle weakness. Higher values indicate greater expiratory muscle strength.
Baseline
Fugl-Meyer Assessment Score
大体时间：Baseline
The Fugl-Meyer Assessment (FMA) is a stroke-specific impairment scale used to evaluate motor recovery after stroke. The motor domain score ranges from 0 to 100 points, with higher scores indicating better motor function and less motor impairment.
Baseline
Berg Balance Scale Score
大体时间：Baseline
The Berg Balance Scale (BBS) consists of 14 tasks assessing static and dynamic balance. Scores range from 0 to 56 points. Higher scores indicate better balance performance and lower fall risk, whereas lower scores indicate greater balance impairment.
Baseline
Functional Independence Measure (FIM) Score
大体时间：Baseline
The Functional Independence Measure assesses the level of disability and functional independence in activities of daily living. Total scores range from 18 to 126 points. Higher scores indicate greater independence and lower levels of assistance required.
Baseline
Stroke-Specific Quality of Life (SS-QoL) Score
大体时间：Baseline
Stroke-Specific Quality of Life Scale (SS-QoL) is used to assess the life expectancy of a stroke survivor. It is specifically designed for individuals who have had a stroke. Both personal and psychosocial effects are assessed collectively. Scores range from 49-245. Higher scores indicate better functioning.
Baseline

合作者和调查者

在这里您可以找到参与这项研究的人员和组织。

赞助

Marmara University

研究记录日期

这些日期跟踪向 ClinicalTrials.gov 提交研究记录和摘要结果的进度。研究记录和报告的结果由国家医学图书馆 (NLM) 审查，以确保它们在发布到公共网站之前符合特定的质量控制标准。

研究主要日期

学习开始 (估计的)

2026年7月15日

初级完成 (估计的)

2026年9月15日

研究完成 (估计的)

2026年10月1日

研究注册日期

首次提交

2026年6月22日

首先提交符合 QC 标准的

2026年6月22日

首次发布 (实际的)

2026年6月26日

研究记录更新

最后更新发布 (实际的)

2026年6月26日

上次提交的符合 QC 标准的更新

2026年6月22日

最后验证

2026年6月1日

更多信息

与本研究相关的术语

关键字

其他相关的 MeSH 术语

其他研究编号

  • MarmaraU-FTR-OK-4

计划个人参与者数据 (IPD)

计划共享个人参与者数据 (IPD)？

不

药物和器械信息、研究文件

研究美国 FDA 监管的药品

不

研究美国 FDA 监管的设备产品

不

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