{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,9]],"date-time":"2026-09-09T16:44:24Z","timestamp":1788972264810,"version":"build-2803163510"},"reference-count":23,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2025,9,12]],"date-time":"2025-09-12T00:00:00Z","timestamp":1757635200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100002594","name":"American Osteopathic Association","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100002594","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J of Ultrasound Medicine"],"published-print":{"date-parts":[[2026,2]]},"abstract":"<jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>To assess the feasibility of ultrasound strain zero\u2010crossing (ZC) to assess adult hypertonic muscles.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      After receiving Institutional Review Board (IRB) approval and informed consent, we prospectively performed free\u2010hand compression ultrasound strain imaging (USI) on normal and hypertonic upper trapezius muscles (UTM) and subcutaneous tissues using a linear array transducer (10L4, bandwidth 4\u201310\u2009MHz). Ultrasound data containing tissue deformation and relaxation produced by axial compression and decompression were processed using 2D speckle tracking software. Using the ZC point on the reference strain curve as the reference, we determined a negative ZC if the muscle strain curve returned to zero strain after or at the same time as that of the reference curve. We determined a positive ZC when the muscle strain curve returned to zero strain ahead of the reference curve. Modified Ashworth Scale (MAS) was used to assess muscle tonicity performed by clinicians. The difference in ZC between normal and hypertonic muscles and the diagnostic performance of ZC in determining \u2265mild hypertonic muscles were analyzed using a paired\n                      <jats:italic>t<\/jats:italic>\n                      \u2010test and the receiver operating characteristic curve (ROC), respectively.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      From October 2023 to August 2024, we performed USI on 28 subjects with normal muscles and 56 with hypertonic muscles (38 men and 46 women, mean age: 52\u2009years). The difference in ZC between normal and hypertonic muscles was statistically significant (\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&lt;\u2009.001). The area under the ROC of ZC for determining \u2265mild hypertonic muscles was 0.92.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The study results suggest that ultrasound strain ZC is feasible for determining \u2265mild hypertonic muscles with good diagnostic performance.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/jum.70059","type":"journal-article","created":{"date-parts":[[2025,9,12]],"date-time":"2025-09-12T14:21:20Z","timestamp":1757686880000},"page":"357-364","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Ultrasound Strain Zero\u2010Crossing for Assessing Adult Hypertonic Muscles"],"prefix":"10.1002","volume":"45","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5993-042X","authenticated-orcid":false,"given":"Jing","family":"Gao","sequence":"first","affiliation":[{"name":"Rocky Vista University, Montana College of Osteopathic Medicine  Billings MT USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6643-486X","authenticated-orcid":false,"given":"Jonathan M.","family":"Rubin","sequence":"additional","affiliation":[{"name":"University of Michigan  Ann Arbor MI USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,9,12]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12891-021-04957-4"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1002\/jum.14558"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ultrasmedbio.2023.02.005"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ultrasmedbio.2018.10.034"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.3390\/s23104763"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.1109\/58.285465"},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0301-5629(02)00697-X"},{"key":"e_1_2_7_9_1","first-page":"923","volume-title":"Proceeding, IEEE Ultrasonic Symposium","author":"Sridhar M","year":"2003"},{"key":"e_1_2_7_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ultrasmedbio.2011.12.009"},{"key":"e_1_2_7_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ultrasmedbio.2014.04.002"},{"key":"e_1_2_7_12_1","doi-asserted-by":"publisher","DOI":"10.1002\/jum.14997"},{"key":"e_1_2_7_13_1","volume-title":"Biomechanics Mechanical Properties of Living Tissues","author":"Fung YC","year":"1993"},{"key":"e_1_2_7_14_1","doi-asserted-by":"publisher","DOI":"10.6084\/m9.figshare.13547138"},{"key":"e_1_2_7_15_1","volume-title":"StatPearls","author":"Harb A","year":"2024"},{"key":"e_1_2_7_16_1","doi-asserted-by":"publisher","DOI":"10.3138\/ptc-2018-0086"},{"key":"e_1_2_7_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijosm.2015.05.003"},{"key":"e_1_2_7_18_1","doi-asserted-by":"publisher","DOI":"10.2217\/pmt-2020-0046"},{"key":"e_1_2_7_19_1","doi-asserted-by":"publisher","DOI":"10.1109\/58.764839"},{"key":"e_1_2_7_20_1","doi-asserted-by":"publisher","DOI":"10.3389\/fspor.2023.1172414"},{"key":"e_1_2_7_21_1","doi-asserted-by":"publisher","DOI":"10.3390\/medicines9050033"},{"key":"e_1_2_7_22_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0090132"},{"key":"e_1_2_7_23_1","doi-asserted-by":"publisher","DOI":"10.1111\/cpf.12315"},{"key":"e_1_2_7_24_1","doi-asserted-by":"publisher","DOI":"10.3390\/s20247200"}],"container-title":["Journal of Ultrasound in Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/jum.70059","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,1,2]],"date-time":"2026-01-02T09:08:00Z","timestamp":1767344880000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/jum.70059"}},"subtitle":["A Feasibility Study"],"short-title":[],"issued":{"date-parts":[[2025,9,12]]},"references-count":23,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2026,2]]}},"alternative-id":["10.1002\/jum.70059"],"URL":"https:\/\/doi.org\/10.1002\/jum.70059","archive":["Portico"],"relation":{},"ISSN":["0278-4297","1550-9613"],"issn-type":[{"value":"0278-4297","type":"print"},{"value":"1550-9613","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,9,12]]},"assertion":[{"value":"2025-08-22","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-08-30","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-09-12","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}