Objectives： The purpose of this study is to evaluate the changes in baPWV after four
weeks of intensive rehabilitation therapy, and the correlation between these changes and
functional recovery.
Background： Arterial stiffness, increasing with age, is a significant risk factor for
atherosclerotic diseases and a predictor of mortality from various causes, including
symptomatic strokes. The brachial-ankle pulse wave velocity (baPWV), a reliable measure
of arterial stiffness, correlates with cardiovascular events and mortality risk. Clinical
improvements post-ischemic stroke align with a decrease in PWV, emphasizing arterial
stiffness's role in recovery. Previous studies indicate significant differences in
pressure waveforms and baPWV between stroke patients and control groups. Despite evidence
of baPWV's prognostic value in predicting functional outcomes after acute cerebral
infarction, the literature on its relation to functional recovery, especially upper limb
function, in subacute stroke patients remains limited.
Study Design： Twenty-five patients admitted to the Department of Physical Medicine and
Rehabilitation Medicine at Shin-Kong Wu Ho Su Memorial Hospital will be enrolled
prospectively. Demographic and baseline clinical data, including age, gender, stroke
duration (day), lesion side, stroke type, underlying disease, severity of neurological
deficit (NIHSS) at admission were recorded. Once their neurological symptoms have
stabilized, all patients will have their baPWV and functional outcome measurements before
and four weeks after undergoing intensive rehabilitation therapy.
Methods： Inclusion criteria are as follows: first-onset cerebral ischemic stroke within
the previous 3 months, which is confirmed clinically by computed tomography scans or
magnetic resonance imaging; sufficient cognition to understand procedures and provide
informed consent. Exclusion criteria are as follows: hemorrhagic stroke, cerebellar or
brainstem lesions which may affect autonomic or balance; concurrent neurological or
neurodegenerative diseases (e.g. Parkinson's disease, multiple sclerosis, etc.), brain
tumor, malignancy, limb deficiency or amputation.
The intervention includes daily physical and occupational therapy sessions tailored to
each patient's functional status. In this study, stroke patients will undergo a four-week
rehabilitation therapy program comprising 60-minute daily sessions of physical and
occupational therapy. The physical therapy includes balance training, mobility and
strengthening exercises, while occupational therapy covers sensorimotor and fine motor
training, and ADL activities. The primary outcome is baPWV, measured noninvasively using
an oscillometric method. Patients maintain their prescribed medication regime throughout.
Secondary outcomes assessed include activities of daily living, balance, gait function,
ambulation, and upper limb function.
Effect： Arterial stiffness in subacute stroke patients can be improved after four weeks
of intensive rehabilitation therapy. After four weeks of intensive rehabilitation
training, the brachial-ankle pulse wave velocity (baPWV) will decrease and will be
negatively correlated with functional recovery.