Relationships between Heart Rate Variability, Motor Impairments and Level of Disability in Chronic Ischemic Stroke Patients

Authors

  • Natchaya Chondaen Exercise and rehabilitation sciences research unit, Department of Physical Therapy, Faculty of Allied health sciences, Naresuan University
  • Phannarai Plusiri Exercise and rehabilitation sciences research unit, Department of Physical Therapy, Faculty of Allied health sciences, Naresuan University
  • Sukunya Srisawad Exercise and rehabilitation sciences research unit, Department of Physical Therapy, Faculty of Allied health sciences, Naresuan University
  • Sujitra Meesribau Exercise and rehabilitation sciences research unit, Department of Physical Therapy, Faculty of Allied health sciences, Naresuan University
  • Olan Isariyapan Exercise and rehabilitation sciences research unit, Department of Physical Therapy, Faculty of Allied health sciences, Naresuan University
  • Phatiwat Chotimol Department of Cardio-Thoracic Technology, Allied health sciences, Naresuan University
  • Duangnapa Roongpiboonsopit Division of Neurology, Department of Medicine, Faculty of Medical, Naresuan University
  • Benjarat Sangthong Faculty of Physical Therapy and Sport Medicine, Rangsit University
  • Waroonnapa Srisoparb Exercise and rehabilitation sciences research unit, Department of Physical Therapy, Faculty of Allied health sciences, Naresuan University

Keywords:

Heart Rate Variability; Ischemic Stroke; Motor Impairment; Disability Level

Abstract

Background and objective: Cardiac autonomic dysfunction that is measured by heart rate variability (HRV) is associated with motor impairments of acute chronic stroke patients. The purposes of this study were to investigate the association between HRV, motor impairments and disability level in chronic ischemic stroke patients.

Methods: Thirteen individuals with chronic stroke (6-72 months) were included. They were required to have the ability to stand independently for at least 5 minutes and could follow 2 step commands. Participants were evaluated their HRV for 20 minutes in supine position. Upper and lower extremities motor impairments and level of disability were assessed by Fugl-Meyer assessment (FMA) and modified Rankin Scale (mRS), respectively. Spearman’s correlation coefficients were used to investigate the association between outcome measures. Differences were considered statistically significant at p<0.05.

Result: The results showed moderate positive correlations between upper extremity motor impairments (FMA-UEs) and low-frequency power in normal units (LF (nu)) (r=0.622; p=0.02), and low-frequency to high- frequency power (LF/HF) ratio (r=0.561; p=0.04). Furthermore, there were strong negative correlations between level of disability and LF nu (r =-0.855; p<0.001), and LF/HF ratio (r=-0.711; p=0.006).

Conclusion: HRV of chronic ischemic stroke is associated with upper extremity motor impairments and level of disability.

References

1. Venketasubramanian N, Yoon BW, Pandian J, Navarro JC. Stroke epidemiology in south, east, and south-east asia: A Review. J Stroke. 2017; 19: 286-294.
2. Feigin VL, Krishnamurthi RV, Parmar P, Norrving B, Mensah GA, Bennett DA, et al. Update on the global burden of ischemic and hemorrhagic stroke in 1990-2013: The GBD 2013 Study. Neuroepidemiology 2015; 45: 161-176.
3. Al-Qudah ZA, Yacoub HA, Souayah N. Disorders of the autonomic nervous system after hemispheric cerebrovascular disorders: An Update. J Vasc Interv Neurol 2015; 8: 43-52.
4. Chen Z, Venkat P, Seyfried D, Chopp M, Yan T, Chen J. brain-heart interaction: cardiac complications after stroke. Circ Res 2017; 121: 451-468.
5. Katz-Leurer M, Shochina M. Heart rate variability (HRV) parameters correlate with motor impairment and aerobic capacity in stroke patients. NeuroRehabilitation 2005; 20: 91-95.
6. Fyfe L, Muller J, Alonso A, Folsom R, Gottesman F, Rosamond D, et al. heart rate variability and incident Stroke. Stroke 2016; 47: 1452-1458.
7. Xhyheri B, Manfrini O, Mazzolini M, Pizzi C, Bugiardini R. Heart rate variability today. Prog Cardiovasc Dis 2012; 55: 321-331.
8. Heaney LM. Cardiac and respiratory monitoring of acute stroke patients. Heart & lung: J Crit Care 1977; 6: 469-474.
9. Yperzeele L, van Hooff R-J, Nagels G, De Smedt A, De Keyser J, Brouns R. Heart rate variability and baroreceptor sensitivity in acute stroke: A Systematic Review. Int J Stroke 2015; 10: 796-800.
10. Fatisson J, Oswald V, Lalonde F. Influence diagram of physiological and environmental factors affecting heart rate variability. Heart Int 2016; 11(1): e32-e40. doi: 10.5301/heartint.5000232.
11. Graff B, Gasecki D, Rojek A, Boutouyrie P, Nyka W, Laurent S, et al. Heart rate variability and functional outcome in ischemic stroke: a multiparameter approach. J. hypertens 2013; 31: 1629-1636.
12. Francica JV, Bigongiari A, Mochizuki L, Scapini KB, Moraes OA, Mostarda C, et al. Cardiac autonomic dysfunction in chronic stroke women is attenuated after submaximal exercise test, as evaluated by linear and nonlinear analysis. BMC Cardiovasc Disord 2015; 15:105.
13. Zhao M, Guan L, Wang Y. The association of autonomic nervous system function with ischemic stroke and treatment strategies. Front Neurol 2020; 10: 1411. doi: 10.3389/fneur.2019.01411.
14. Sethi A, Callaway CW, Sejdic E, Terhorst L, Skidmore ER. Heart rate variability is associated with motor outcome 3-months after Stroke. J Stroke Cerebrovasc Dis 2016; 25: 129-135.
15. Cohen J. Statistical power analysis for the behavioral Sciences ed 2. Hillsdale. NJ: Lawrence Erlbaum Associates, 1988.
16. Gladstone DJ, Danells CJ, Black SE. The fugl-meyer assessment of motor recovery after stroke: a critical review of its measurement properties. Neurorehabil Neural Repair 2002; 16: 232-240.
17. Fugl-Meyer AR, Jaasko L, Leyman I, Olsson S, Steglind S. The post-stroke hemiplegic patient. a method for evaluation of physical performance. Scand J Rehabil Med 1975; 7: 13-31.
18. G Sulter , C Steen, J De Keyser. Use of the barthel index and modified rankin scale in acute stroke trials. Stroke 1999; 30(8): 1538-1541. doi: 10.1161/01.str.30.8.1538.
19. อภิชาต สุคนธสรรพ์.Cardiovascular medicine: The new balance. พิมพ์ครั้งที่ 1. เชียงใหม่: โรงพิมพ์ทริคธิงค์. 2555.
20. Duncan PW, Goldstein LB, Horner RD, Landsman PB, Samsa GP, Matchar DB. Similar motor recovery of upper and lower extremities after stroke. Stroke 1994; 25: 1181-1188.
21. Banks JL, Marotta CA. Outcomes Validity and Reliability of the Modified Rankin Scale: Implications for Stroke Clinical Trials. Stroke 2007; 38: 1091-1096.
22. Gujjar AR, Sathyaprabha TN, Nagaraja D, Thennarasu K, Pradhan N. Heart rate variability and outcome in acute severe stroke: role of power spectral analysis. Neurocrit Care 2004; 1: 347-353.
23. Kerman IA. Organization of brain somatomotor-sympathetic circuits. Exp Brain Res 2008; 187: 1-16.
24. Sequeira H, Viltart O, Ba-M’Hamed S, Poulain P. Cortical control of somato-cardiovascular integration: neuroanatomical studies. Brain Res. Bull 2000; 53: 87-93.
25. Song H-S. The effects of specific respiratory rates on heart rate and heart rate variability. Appl Psychophysiol Biofeedbac 2003; 28: 13-23.
26. Steffen PR, Austin T, DeBarros A, Brown T. The impact of resonance frequency breathing on measures of heart rate variability, blood pressure, and mood. Public Health Front 2017; 5: 222.
27. Levin CJ, Swoap SJ. The impact of deep breathing and alternate nostril breathing on heart rate variability: a human physiology laboratory. Adv Physiol Educ 2019; 43: 270-6.
28. Arad M, Abboud S, Radai MM, Adunsky A. Heart rate variability parameters correlate with functional independence measures in ischemic stroke patients. J Electrocardiol 2002; 35: 243-6.
29. Monge-Argilés J, Palacios Ortega F, Vila X, Prados J, Vicente J, Ortiz A, et al. Brainstem lesions decrease heart rate variability. Neurología 2000; 15: 158-63.
30. Adams Jr HP, Bendixen BH, Kappelle LJ, Biller J, Love BB, Gordon DL, et al. Classification of subtype of acute ischemic stroke. Definitions for use in a multicenter clinical trial. TOAST. Trial of Org 10172 in Acute Stroke Treatment. Stroke 1993; 24(1): 35-41.

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Published

2020-10-16

How to Cite

1.
Chondaen N, Plusiri P, Srisawad S, Meesribau S, Isariyapan O, Chotimol P, Roongpiboonsopit D, Sangthong B, Srisoparb W. Relationships between Heart Rate Variability, Motor Impairments and Level of Disability in Chronic Ischemic Stroke Patients. SRIMEDJ [Internet]. 2020 Oct. 16 [cited 2024 Apr. 20];35(6):746-52. Available from: https://li01.tci-thaijo.org/index.php/SRIMEDJ/article/view/247347

Issue

Vol. 35 No. 6 (2020): November - December

Section

Original Articles