{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,14]],"date-time":"2026-04-14T08:06:27Z","timestamp":1776153987037,"version":"3.50.1"},"reference-count":11,"publisher":"MDPI AG","issue":"5","license":[{"start":{"date-parts":[[2022,5,18]],"date-time":"2022-05-18T00:00:00Z","timestamp":1652832000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Hong Kong Research Grants Council (RGC) Direct Allocation Grant\u2014Funding Support to Small Projects","award":["P0036830"],"award-info":[{"award-number":["P0036830"]}]},{"name":"Hong Kong Research Grants Council (RGC) Direct Allocation Grant\u2014Funding Support to Small Projects","award":["P0038945"],"award-info":[{"award-number":["P0038945"]}]},{"name":"Hong Kong Research Grants Council (RGC) Direct Allocation Grant\u2014Funding Support to Small Projects","award":["P0034491"],"award-info":[{"award-number":["P0034491"]}]},{"name":"Research Institute for Smart Ageing, The Hong Kong Polytechnic University","award":["P0036830"],"award-info":[{"award-number":["P0036830"]}]},{"name":"Research Institute for Smart Ageing, The Hong Kong Polytechnic University","award":["P0038945"],"award-info":[{"award-number":["P0038945"]}]},{"name":"Research Institute for Smart Ageing, The Hong Kong Polytechnic University","award":["P0034491"],"award-info":[{"award-number":["P0034491"]}]},{"DOI":"10.13039\/501100004377","name":"The Hong Kong Polytechnic University","doi-asserted-by":"publisher","award":["P0036830"],"award-info":[{"award-number":["P0036830"]}],"id":[{"id":"10.13039\/501100004377","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100004377","name":"The Hong Kong Polytechnic University","doi-asserted-by":"publisher","award":["P0038945"],"award-info":[{"award-number":["P0038945"]}],"id":[{"id":"10.13039\/501100004377","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100004377","name":"The Hong Kong Polytechnic University","doi-asserted-by":"publisher","award":["P0034491"],"award-info":[{"award-number":["P0034491"]}],"id":[{"id":"10.13039\/501100004377","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Biosensors"],"abstract":"<jats:p>Abnormal muscle tone and muscle weakness are related to gait asymmetry in stroke survivors. However, the internal muscle morphological changes that occur during walking remain unclear. To address this issue, this study investigated the muscle activity of the tibialis anterior (TA) and medial gastrocnemius (MG) of both the paretic and non-paretic sides during walking in nine stroke survivors, by simultaneously capturing electromyography (EMG), mechanomyography (MMG), and ultrasound images, and using a validated novel wearable ultrasound imaging and sensing system. Statistical analysis was performed to examine the test\u2013retest reliability of the collected data, and both the main and interaction effects of each \u201cside\u201d (paretic vs. non-paretic) and \u201cgait\u201d factors, in stroke survivors. This study observed significantly good test\u2013retest reliability in the collected data (0.794 \u2264 ICC \u2264 0.985), and significant differences existed in both the side and gait factors of the average TA muscle thickness from ultrasound images, and in the gait factors of TA and MG muscle\u2019s MMG and EMG signals (p &lt; 0.05). The muscle morphological characteristics also appeared to be different between the paretic and non-paretic sides on ultrasound images. This study uncovered significantly different internal muscle contraction patterns between paretic and non-paretic sides during walking for TA (7.2% \u00b1 1.6%) and MG (5.3% \u00b1 4.9%) muscles in stroke survivors.<\/jats:p>","DOI":"10.3390\/bios12050349","type":"journal-article","created":{"date-parts":[[2022,5,18]],"date-time":"2022-05-18T11:59:37Z","timestamp":1652875177000},"page":"349","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":17,"title":["How Paretic and Non-Paretic Ankle Muscles Contract during Walking in Stroke Survivors: New Insight Using Novel Wearable Ultrasound Imaging and Sensing Technology"],"prefix":"10.3390","volume":"12","author":[{"given":"Pei-Zhao","family":"Lyu","sequence":"first","affiliation":[{"name":"Department of Biomedical Engineering, The Hong Kong Polytechnic University, Hong Kong SAR 999077, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7859-2817","authenticated-orcid":false,"given":"Ringo Tang-Long","family":"Zhu","sequence":"additional","affiliation":[{"name":"Department of Biomedical Engineering, The Hong Kong Polytechnic University, Hong Kong SAR 999077, China"},{"name":"Research Institute for Smart Ageing, The Hong Kong Polytechnic University, Hong Kong SAR 999077, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2443-1561","authenticated-orcid":false,"given":"Yan To","family":"Ling","sequence":"additional","affiliation":[{"name":"Department of Biomedical Engineering, The Hong Kong Polytechnic University, Hong Kong SAR 999077, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Li-Ke","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Biomedical Engineering, The Hong Kong Polytechnic University, Hong Kong SAR 999077, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3407-9226","authenticated-orcid":false,"given":"Yong-Ping","family":"Zheng","sequence":"additional","affiliation":[{"name":"Department of Biomedical Engineering, The Hong Kong Polytechnic University, Hong Kong SAR 999077, China"},{"name":"Research Institute for Smart Ageing, The Hong Kong Polytechnic University, Hong Kong SAR 999077, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6507-2329","authenticated-orcid":false,"given":"Christina Zong-Hao","family":"Ma","sequence":"additional","affiliation":[{"name":"Department of Biomedical Engineering, The Hong Kong Polytechnic University, Hong Kong SAR 999077, China"},{"name":"Research Institute for Smart Ageing, The Hong Kong Polytechnic University, Hong Kong SAR 999077, China"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2022,5,18]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"394","DOI":"10.1016\/S1474-4422(18)30500-3","article-title":"Stroke in China: Advances and challenges in epidemiology, prevention, and management","volume":"18","author":"Wu","year":"2019","journal-title":"Lancet Neurol."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"310","DOI":"10.4102\/ajod.v7i0.310","article-title":"An analysis of trunk kinematics and gait parameters in people with stroke","volume":"7","author":"Titus","year":"2018","journal-title":"Afr. J. Disabil."},{"key":"ref_3","doi-asserted-by":"crossref","unstructured":"Ling, Y.T., Ma, C.Z.-H., Shea, Q.T.K., and Zheng, Y.-P. (2020). Sonomechanomyography (SMMG): Mapping of Skeletal Muscle Motion Onset during Contraction Using Ultrafast Ultrasound Imaging and Multiple Motion Sensors. Sensors, 20.","DOI":"10.3390\/s20195513"},{"key":"ref_4","doi-asserted-by":"crossref","unstructured":"Ma, C.Z.-H., Ren, L.-J., Cheng, C.L.-K., and Zheng, Y.-P. (2020). Mapping of Back Muscle Stiffness along Spine during Standing and Lying in Young Adults: A Pilot Study on Spinal Stiffness Quantification with Ultrasound Imaging. Sensors, 20.","DOI":"10.3390\/s20247317"},{"key":"ref_5","first-page":"1","article-title":"Effect of Conventional Physiotherapy on Pain and Muscle Stiffness inPatients with Low Back Pain Assessed by a Wireless Hand-held TissueUltrasound Palpation System (TUPS)","volume":"7","author":"Ren","year":"2019","journal-title":"Int. J. Phys. Med. Rehabil."},{"key":"ref_6","doi-asserted-by":"crossref","unstructured":"Ren, L.-J., Cheng, C.L.-K., Ma, C.Z.-H., and Zheng, Y.-P. (2021). Changes in Muscle Hardness from Resting to Mid-Range Lengthened Positions Detected by Shear Wave Elastography (SWE) with a Novel Protocol of Ultrasound Probe Placement. Appl. Sci., 11.","DOI":"10.3390\/app11010452"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"941","DOI":"10.1519\/JSC.0000000000004230","article-title":"Real-Time Visual Biofeedback via Wearable Ultrasound Imaging Can Enhance the Muscle Contraction Training Outcome of Young Adults","volume":"36","author":"Huang","year":"2022","journal-title":"J. Strength Cond. Res."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"650","DOI":"10.1007\/s00455-020-10179-y","article-title":"Application of ultrasound biofeedback to the learning of the mendelsohn maneuver in non-dysphagic adults: A pilot study","volume":"36","author":"Kwong","year":"2021","journal-title":"Dysphagia"},{"key":"ref_9","doi-asserted-by":"crossref","unstructured":"Ma, C.Z., Ling, Y.T., Shea, Q.T.K., Wang, L.K., Wang, X.Y., and Zheng, Y.P. (2019). Towards Wearable Comprehensive Capture and Analysis of Skeletal Muscle Activity during Human Locomotion. Sensors, 19.","DOI":"10.3390\/s19010195"},{"key":"ref_10","first-page":"S7","article-title":"Measuring balance in the elderly: Validation of an instrument","volume":"83","author":"Berg","year":"1992","journal-title":"Can. J. Public Health Rev. Can. Sante Publique"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"699","DOI":"10.3389\/fneur.2017.00699","article-title":"Electromyography Exposes Heterogeneity in Muscle Co-Contraction following Stroke","volume":"8","author":"Banks","year":"2017","journal-title":"Front. Neurol."}],"container-title":["Biosensors"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2079-6374\/12\/5\/349\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T23:14:01Z","timestamp":1760138041000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2079-6374\/12\/5\/349"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,5,18]]},"references-count":11,"journal-issue":{"issue":"5","published-online":{"date-parts":[[2022,5]]}},"alternative-id":["bios12050349"],"URL":"https:\/\/doi.org\/10.3390\/bios12050349","relation":{},"ISSN":["2079-6374"],"issn-type":[{"value":"2079-6374","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,5,18]]}}}