Billinger Sandra A, Gajewski Byron J, Guo Lisa X, Kluding Patricia M
Department of Physical Therapy and Rehabilitation Sciences, University of Kansas Medical Center, Kansas City, KS 66160, USA.
Stroke. 2009 Sep;40(9):3086-90. doi: 10.1161/STROKEAHA.109.550889. Epub 2009 Jun 11.
After stroke, individuals have decreased mobility of the hemiparetic leg, which demands less muscle oxygen consumption; thus, blood flow decreases. The purpose of this study was to determine the effect of single limb exercise (SLE) on femoral artery blood flow, diameter, and peak flow velocity in the hemiparetic leg after stroke.
Twelve individuals (60.6+/-14.5 years of age; 5 male) with chronic stroke (69.1+/-82.2 months; 5 with right-sided hemiparesis) participated in the study. The intervention consisted of a SLE knee extension/flexion protocol 3 times per week for 4 weeks. Using Doppler ultrasound, bilateral femoral artery blood flow, diameter, and peak flow velocity were assessed at baseline, after 2 weeks, and after 4 weeks of SLE.
Using repeated-measures analysis of variance, femoral artery blood flow, arterial diameter, and blood flow velocity in the hemiparetic limb were significantly improved (P<0.0001) after the SLE. No significant changes occurred in the nontrained limb for any outcome measures.
These data suggest that a 4-week SLE training program that increases muscular activity in the hemiparetic limb improves femoral artery blood flow, diameter, and peak velocity. SLE may be an important training strategy in stroke rehabilitation to minimize the vascular changes that occur poststroke due to decreased activity of the hemiparetic limb.
中风后,偏瘫侧下肢的活动能力下降,肌肉耗氧量减少,进而导致血流量降低。本研究旨在确定单肢运动(SLE)对中风后偏瘫侧下肢股动脉血流量、直径和峰值流速的影响。
12名慢性中风患者(年龄60.6±14.5岁;男性5名)(病程69.1±82.2个月;右侧偏瘫5名)参与了本研究。干预措施为每周进行3次SLE膝关节屈伸训练,共4周。使用多普勒超声在基线、SLE训练2周后和4周后评估双侧股动脉血流量、直径和峰值流速。
采用重复测量方差分析,SLE训练后偏瘫侧肢体的股动脉血流量、动脉直径和血流速度均显著改善(P<0.0001)。未训练肢体的任何结局指标均无显著变化。
这些数据表明,为期4周的SLE训练计划可增加偏瘫侧肢体的肌肉活动,改善股动脉血流量、直径和峰值流速。SLE可能是中风康复中的一项重要训练策略,可将中风后因偏瘫侧肢体活动减少而发生的血管变化降至最低。