Miller Tiev, Ouyang Huixi, Tsang Charlotte S L, Calderón-Juárez Martín, Ying Michael T C, Pang Marco Y C
Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong, SAR, China.
School of Biomedical Engineering, Guangzhou Medical University, Guangzhou 510180, China.
Phys Ther. 2025 Mar 3;105(3). doi: 10.1093/ptj/pzaf002.
Cardiorespiratory fitness is reduced after stroke due to inactivity which may cause structural and functional changes to blood vessels in the extremities. Identifying clinical factors contributing to vascular function may be important for tailoring rehabilitation programs that reduce secondary disease risk and adverse events.
The study objective was to compare measures of arterial and intramuscular blood flow between the paretic and nonparetic upper limbs of individuals with stroke and healthy comparators. Associations between these parameters and stroke-related impairment were also examined.
This was a cross-sectional study.
The setting was a university laboratory.
Participants were individuals with stroke (n = 64; mean age = 60.8 [SD = 7.7] years) and matched controls (n = 64; mean age = 59.4 [SD = 7.8] years).
MAIN OUTCOMES/MEASURES: Brachial artery blood flow volume (Vflow) and arterial diameter (AD) were measured using Doppler ultrasound. Intramuscular blood perfusion of the biceps brachii was estimated using the vascularity index (VI). Motor recovery and perceived use of paretic upper limbs were assessed with the Fugl-Meyer Assessment (FMA) and Motor Activity Log (MAL), respectively.
Side × group interactions were observed for AD (F = 22.6) and VI (F = 4.00). Post hoc analyses showed lower AD and VI for paretic sides (stroke group), greater Vflow for dominant sides (comparators), and greater percent side-to-side differences (%SSDs) in AD and VI for the stroke group than for comparators. %SSDs in Vflow, AD, and VI demonstrated weak correlations with impairment (MAL, FMA; ρ = 0.253 to 0.347). MAL was an independent predictor of %SSD in Vflow (β = -0.286), and FMA was an independent predictor of %SSDs in AD (β = -0.307) and VI (β = 0.371).
CONCLUSIONS/RELEVANCE: Relative to the nonparetic and bilateral limbs of comparators, arterial size and intramuscular blood flow in the paretic upper limbs of individuals with stroke were significantly reduced. Motor impairment and disuse emerged as independent predictors of all vascular outcomes and may be potential intervention targets for reducing cardiovascular disease risk after stroke.
中风后由于缺乏运动，心肺功能会下降，这可能导致四肢血管的结构和功能发生变化。确定影响血管功能的临床因素对于制定能够降低继发性疾病风险和不良事件的康复计划可能很重要。
本研究的目的是比较中风患者和健康对照者患侧与非患侧上肢的动脉血流和肌肉内血流测量值。还研究了这些参数与中风相关损伤之间的关联。
这是一项横断面研究。
研究地点为大学实验室。
参与者为中风患者（n = 64；平均年龄 = 60.8 [标准差 = 7.7] 岁）和匹配的对照组（n = 64；平均年龄 = 59.4 [标准差 = 7.8] 岁）。
主要结局/测量指标：使用多普勒超声测量肱动脉血流量（Vflow）和动脉直径（AD）。使用血管指数（VI）估计肱二头肌的肌肉内血液灌注。分别使用Fugl-Meyer评估（FMA）和运动活动日志（MAL）评估患侧上肢的运动恢复情况和自我感觉使用情况。
在AD（F = 22.6）和VI（F = 4.00）方面观察到侧别×组间交互作用。事后分析显示，患侧（中风组）的AD和VI较低，优势侧（对照组）的Vflow较高，中风组AD和VI的侧别差异百分比（%SSD）高于对照组。Vflow、AD和VI的%SSD与损伤（MAL、FMA；ρ = 0.253至0.347）呈弱相关。MAL是Vflow中%SSD的独立预测因子（β = -0.286），FMA是AD（β = -0.307）和VI（β = 0.371）中%SSD的独立预测因子。
结论/意义：与对照组的非患侧和双侧肢体相比，中风患者患侧上肢的动脉大小和肌肉内血流显著降低。运动损伤和废用是所有血管结局的独立预测因子，可能是中风后降低心血管疾病风险的潜在干预靶点。
