Mean Flow Velocity in the Middle Cerebral Artery Is Associated With Rehabilitation Success in Ischemic Stroke Patients

Treger, Iuly; Aidinof, Lena; Lutsky, Lena; Kalichman, Leonid

doi:10.1016/j.apmr.2010.08.008

Cited by 9 publications

(8 citation statements)

References 12 publications

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“…[10][11][12][13] Higher MFV in patients at admission to rehabilitation is associated with a better functional outcome and reduced impairment. 3,4 The current study found sporadic and inconsistent evidence that patients with a smaller extent of neurologic deficit (lower NIHSS score) and better functional status (higher Functional Independence Measure score) responded better to acupuncture. The present results are in line with those of another study that found acupuncture more effective than SA in post-stroke patients with a relatively mild lesion, while both treatments were ineffective for patients with severe stroke.…”

Section: Discussionmentioning

confidence: 92%

“…Transcranial Doppler ultrasonography is used to measure cerebral blood flow in post-stroke patients. 3,4,14,17 Cerebral blood flow velocity was measured by transcranial Doppler ultrasonography (Smart-Lite, Rimed Ltd., Raanana, Israel) at three time points: after 5 minutes of rest before needle insertion (T0, baseline), 15 minutes after needle insertion (T15), and 5 minutes after needle removal (T25). At T0 and T25, blood pressure was measured.…”

Section: Methodsmentioning

confidence: 99%

“…2 Normal blood flow velocity in the damaged hemisphere after stroke is associated with better rehabilitation outcome. 3,4 In 1998, the National Institutes of Health published a consensus statement regarding the efficacy of acupuncture in adult stroke rehabilitation; it mentioned that acupuncture might be useful as an adjunct treatment or an acceptable alternative or be included in a comprehensive management program. 5 Acupuncture is often used as an adjunct to standardized rehabilitation treatments after stroke, but its mode of action in the rehabilitation of these patients is yet to be discovered.…”

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confidence: 99%

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The Effects of Acupuncture on Cerebral Blood Flow in Post-Stroke Patients: A Randomized Controlled Trial

Ratmansky

Levy

Messinger

et al. 2016

The Journal of Alternative and Complementary Medicine

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Background/Objective: Stroke is a major cause of disability and death in the Western world. Studies have shown a direct relationship between specific mental and motor activity and changes in cerebral blood flow. Acupuncture is often used in post-stroke patients, but there is a lack of sham-controlled studies evaluating the effects of acupuncture on cerebral blood flow following a stroke. This pilot concept-assessment study sought to evaluate the effects of true acupuncture on cerebral blood flow velocity compared with sham acupuncture and lay a foundation for future work in this field. Methods: Seventeen inpatients (age range, 44-79 years) 1-3 months post-stroke were allocated to acupuncture at true acupuncture (TA) points or at sham acupuncture (SA) points. The treatment was 20 minutes long. Transcranial Doppler ultrasonography was used to measure mean flow velocity (MFV) and peak flow velocity (PFV) at both healthy and damaged hemispheres before (T0), in the middle of (T15), and 5 minutes after (T25) treatment. Blood pressure was measured at T0 and T25. Results: A statistically significant ( p < 0.04) MFV increase in both hemispheres was found during and after TA; this increase was higher than that seen with SA ( p < 0.035). Acupuncture had no significant effect on PFV. Systolic blood pressure significantly decreased after acupuncture ( p < 0.005) in a similar manner for both TA and SA. National Institutes of Health Stroke Scale score was negatively correlated with MFV at T15 (r = -0.825; p < 0.05). Conclusion: This pilot study showed a significant influence on cerebral blood flow velocity by TA. This study lays a foundation for larger-scale studies that may prove acupuncture to be a useful tool for cerebral blood flow enhancement during post-stroke rehabilitation.

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Section: Discussionmentioning

confidence: 92%

Section: Methodsmentioning

confidence: 99%

mentioning

confidence: 99%

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The Effects of Acupuncture on Cerebral Blood Flow in Post-Stroke Patients: A Randomized Controlled Trial

Ratmansky

Levy

Messinger

et al. 2016

The Journal of Alternative and Complementary Medicine

Self Cite

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“…16 Same group reported contrasting findings in a study in 2010 where blood flow in the contralesional hemisphere was associated with functional improvement. 17 Brint et al in a TCD study observed that the risk of stroke was greater with asymmetry of flow. 15 Han et al described a novel index of asymmetry incorporating flow velocity and pulsatility index to predict stroke outcomes.…”

Section: Discussionmentioning

confidence: 96%

Transcranial Color Coded Duplex Sonography Findings in Stroke Patients Undergoing Rehabilitation: An Observational Study

Venkatakrishnan

Khanna

Gupta

2022

JNRP

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Background Transcranial color-coded duplex sonography (TCCD) provides information on intracranial blood flow status in stroke patients and can predict rehabilitation outcomes. Objective This study aimed to assess middle cerebral artery (MCA) parameters using TCCD in MCA territory stroke patients admitted for rehabilitation and correlate with clinical outcome measures. Material and Methods Patients aged 18 to 65 years with a first MCA territory stroke, within 6 months of onset were recruited. The clinical outcome scales and TCCD parameters were assessed at both admission and discharge. The scales used were the Scandinavian stroke scale (SSS), Barthel Index (BI), modified Rankin Scale (mRS), Fugl–Meyer upper extremity scale (FMA-UE), modified motor assessment scale (mMAS) scores. TCCD parameters measured were MCA peak systolic, end diastolic, mean flow velocities (MFV), and index of symmetry (SI) and were correlated with clinical scores. Results Fourteen patients were recruited with median age of 56.5 years, median duration of stroke was 42.5 days. Mean flow velocities of affected and unaffected MCA were 46.2 and 50.7 cm/s, respectively. Flow velocities and SI did not change between the two assessments. There was significant improvement in clinical outcome scores at discharge. Significant correlation was observed for patient group with SI > 0.9 at admission with FMA-UE, SSS, and BI scores at discharge (p < 0.05). Conclusion Flow velocity parameters did not change during in-patient rehabilitation. Patients with symmetric flow at admission had improved clinical outcomes measure scores at discharge. Thus SI can predict rehabilitation outcomes in stroke survivors.

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“…13,36 After a stroke, 1 study reported that a higher MCAv on admission to inpatient stroke rehabilitation was associated with improved Functional Independence Measure scores at discharge. 37 Studies in healthy adults also report that prolonged inactivity was associated with a decrease in MCAv, 33,38 cardiovascular mortality, 39 and a longer cognitive reaction time. 40 Further research is needed to determine whether performing physical activity and walking farther distances within the acute hospital stay to increase measures of MCAv is associated with improved functional recovery during inpatient rehabilitation.…”

Section: Discussionmentioning

confidence: 98%

Secondary Analysis of Walking Activities During the Acute Stroke Hospital Stay and Cerebrovascular Health

Whitaker¹,

Henry²,

Morton³

et al. 2022

Cardiopulm Phys Ther J

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Purpose:Physical activity within the hospital poststroke is recommended for cardiovascular and musculoskeletal health, but no studies have examined cerebrovascular health. We hypothesized that individuals who walked farther distances (FARhigh) during the acute phase of stroke recovery in a hospital setting would have a higher resting middle cerebral artery blood velocity (MCAv) and a greater cerebrovascular response (CVR) to moderate-intensity exercise at 3 months poststroke, compared with individuals who walked shorter distances (FARlow).Methods:At 3 months poststroke, we recorded 90 seconds of resting baseline (BL) MCAv, followed by 6 minutes of moderate-intensity exercise. We calculated CVR as the change in MCAv from BL to steady-state exercise. We retrospectively collected the farthest distance walked within the hospital poststroke from the electronic medical record. Participants were classified as FARhigh or FARlow based on the average farthest walking distance.Results:Twenty participants completed the study, aged 63 (15) years. Baseline MCAv was not different between groups (P = .07). In comparison with FARlow, we report a higher CVR in FARhigh's ipsilesional ( truex¯ = 7.38 [5.42] vs truex¯ = 2.19 [3.53], P = .02)and contralesional hemispheres ( truex¯ = 8.15 [6.37] vs truex¯ = 2.06 [4.76], P = .04).Conclusions:Physical activity during the hospital stay poststroke may support cerebrovascular health after discharge. Prospective studies are needed to support this finding.

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Mean Flow Velocity in the Middle Cerebral Artery Is Associated With Rehabilitation Success in Ischemic Stroke Patients

Cited by 9 publications

References 12 publications

The Effects of Acupuncture on Cerebral Blood Flow in Post-Stroke Patients: A Randomized Controlled Trial

The Effects of Acupuncture on Cerebral Blood Flow in Post-Stroke Patients: A Randomized Controlled Trial

Transcranial Color Coded Duplex Sonography Findings in Stroke Patients Undergoing Rehabilitation: An Observational Study

Secondary Analysis of Walking Activities During the Acute Stroke Hospital Stay and Cerebrovascular Health

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