Observational studyFrontiers in neurology2026
Tibialis anterior surface electromyography during ankle dorsiflexion as a complementary assessment measure after stroke.
Observational study in Frontiers in neurology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: The Fugl-Meyer Assessment of Lower Extremity (FMA-LE), Berg Balance Scale (BBS), and Brunnstrom lower-limb stage summarize lower-limb motor and balance function after stroke but do not directly reflect the electrical activity of distal muscles during a specific task. The tibialis anterior (TA) is a primary superficial agonist during active ankle dorsiflexion, and its surface electromyography (sEMG) may provide muscle-specific and task-specific complementary information relevant to foot drop and voluntary distal ankle-foot control. Objective: To examine the relationships of TA sEMG measures obtained during active ankle dorsiflexion with lower-limb motor function, balance, and stage of motor recovery in inpatients with ischemic or hemorrhagic stroke within 1 year of onset, and to explore whether short-term improvements in clinical scales were accompanied by corresponding changes in sEMG measures. Methods: This single-center observational study included 118 participants with supratentorial or infratentorial index stroke lesions. Bilateral TA and gastrocnemius sEMG was recorded during a standardized seated active ankle dorsiflexion task. The primary measures were paretic-side TA average rectified value (ARV) and the TA paretic/non-paretic ratio. Baseline sEMG analyses included 110 participants, clinical longitudinal analyses included 88, and sEMG longitudinal analyses included 81. Spearman correlation, multivariable linear regression, and paired Wilcoxon signed-rank tests were used, with adjustment for multiple comparisons. Results: At baseline, paretic-side TA ARV was lower than non-paretic-side TA ARV. Paretic-side TA ARV showed moderate positive correlations with the FMA-LE, BBS, and Brunnstrom lower-limb stage ( Conclusion: TA sEMG during active ankle dorsiflexion was associated with concurrent lower-limb motor and balance function and may provide muscle-specific and task-specific information complementary to routine clinical scales. Its longitudinal responsiveness and value in clinical practice require further investigation. Clinical trial registration: https://itmctr.ccebtcm.org.cn/mgt/search, identifier ITMCTR2026000773.
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