Arterial Stiffness in Subacute Stroke: Changing Pattern and Relationship with Functional Recovery

• Published in: Journal of stroke and cerebrovascular diseases 2017-05, Vol.26 (5), p.922-929
• Main Authors: Han, Eun Young, MD, PhD, Kim, Bo Ryun, MD, PhD, Joo, Seung-Jae, MD, PhD, Lee, Chang Sub, MD, PhD, Kang, Sa-Yoon, MD, Kim, Song-Yi, MD, Choi, Joon Hyouk, MD, Hyun, Chul Woong, MD
• Format: Article
• Language: English
• Subjects: Aged; Cardiovascular; Female; Gait; Humans; Linear Models; Longitudinal Studies; Male; Middle Aged; Motor Activity; Multivariate Analysis; Neurology; Neuropsychological Tests; Postural Balance; Pulse Wave Analysis; Recovery of Function; Risk Factors; Stroke - diagnosis; Stroke - physiopathology; Stroke - psychology; Stroke - therapy; Stroke Rehabilitation; Time Factors; Treatment Outcome; Vascular Stiffness; Walk Test
• ISSN: 1052-3057; 1532-8511
• DOI: 10.1016/j.jstrokecerebrovasdis.2016.10.040

Background To examine changing patterns in arterial stiffness and functional outcome in patients with subacute stroke, and to determine which parameter shows a strong correlation with the reversal of arterial stiffness, during a 3-month period of comprehensive rehabilitation therapy. Methods This descriptive, observational cohort study enrolled 60 patients (43 male and 17 female; average age, 62.7 years), and all received conventional rehabilitation therapy, during a 3-month period. Brachial-ankle pulse wave velocity (baPWV) was measured as an index of arterial stiffness. Functional assessments included the 6-minute walk test (6MWT), Fugl-Meyer Assessment of hemiparetic upper and lower limbs, the functional ambulatory category, the Berg balance scale, the Korean Mini-Mental Status Examination, and the Korean-Modified Barthel Index. All measurements were conducted at baseline and 1 and 3 months after stroke onset. Results Rehabilitation therapy resulted in a statistically significant improvement in baPWV since 3 months post stroke. Another functional outcome measure showed statistically significant improvements since 1 month after rehabilitation. Multivariable linear regression analysis revealed that a change in baPWV was significantly correlated with changes in the 6MWT. Conclusions Three months of comprehensive rehabilitation therapy led to statistically significant improvements in arterial stiffness and functional outcomes during the subacute phase of stroke. Thus, the comprehensive rehabilitation focused on improving gait endurance would be warranted in subacute stroke patients.