Transcranial Doppler ultrasonography can predict inpatient rehabilitation functional outcome in patients with stroke

Author:

Navalkar Nina1ORCID,Sandefer Kristen1,Nanavati Hely2,Lin Chen1ORCID

Affiliation:

1. Department of Neurology University of Alabama at Birmingham Birmingham Alabama USA

2. Department of Epidemiology University of Alabama at Birmingham Birmingham Alabama USA

Abstract

AbstractBackgroundDespite advances in imaging techniques and treatment modalities, tools to predict recovery after stroke remain limited. The objective of the study was to determine if transcranial Doppler (TCD) mean flow velocities were predictive of functional recovery following ischemic stroke.MethodsData were collected from patients with stroke admitted to an academic tertiary care facility in the southeastern region of the United States between 2012 and 2019 who had a middle cerebral artery distribution ischemic stroke, TCD, and were discharged to our inpatient rehabilitation facility. Mean flow velocities were categorized as low (<40 cm/s), normal (40–80 cm/s), or high (>80 cm/s). Functional Independence Measure (FIM) scores were collected on admission to and discharge from IPR. Multiple linear regression models were used to assess the differences in mean FIM score changes by categories of mean flow velocities.ResultsWe enrolled 57 patients, mean age 60 years, 73.7% male. Compared to the normal velocity group, those with abnormally low velocities had a significantly smaller change in their FIM score (adjusted β = −8.42; p = .01). Compared to the normal velocity group, those with abnormally high velocities experienced a greater change in FIM score, but this association was not statistically significant (beta = 1.12; p = .77).ConclusionsIn this limited population, we found that low mean flow velocity as measured by TCD ultrasonography after a middle cerebral artery stroke is associated with poorer functional recovery following inpatient rehabilitation. Our results suggest that the value of TCD ultrasonography as a tool to predict motor recovery after stroke warrants further investigation.

Publisher

Wiley

Reference28 articles.

1. Stroke Facts.202211/2/2022 Available fromhttps://www.cdc.gov/stroke/facts.htm.

2. Heart Disease and Stroke Statistics—2022 Update: A Report From the American Heart Association

3. Post‐Stroke Rehabilitation.2020; Available fromhttps://www.stroke.nih.gov/materials/rehabilitation.htm#:~:text=In%20the%20United%20States%2C%20about best%20possible%20quality%20of%20life

4. Guidelines for the Early Management of Patients With Acute Ischemic Stroke: 2019 Update to the 2018 Guidelines for the Early Management of Acute Ischemic Stroke: A Guideline for Healthcare Professionals From the American Heart Association/American Stroke Association

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