Transcranial Doppler ultrasonography can predict inpatient rehabilitation functional outcome in patients with stroke.
Nina Navalkar, Kristen Sandefer, Hely Nanavati and 1 others
PMID 38545750WHAT IT FOUND
Stroke patients with abnormally low blood flow velocity in the affected brain artery gained significantly less motor function during inpatient rehabilitation compared to those with normal flow.
This single-center study suggests transcranial Doppler may help predict motor recovery potential.
Key findings
01Patients with abnormally low mean flow velocity had significantly lower total Functional Independence Measure (FIM) change and total motor FIM change compared to those with normal velocities.
02There was no statistically significant difference in cognitive FIM scores between patients with abnormally low mean flow velocity and those with normal velocity.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTs
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What it does not show
The study had a small sample size (57 patients), which limits statistical power and generalizability. It was conducted at a single academic center in the southeastern United States with a specific demographic profile (59.6% Black), which may not represent all populations. The study only included patients who could tolerate inpatient rehabilitation and had funding for it, excluding more severely impaired or uninsured patients. It was restricted to MCA strokes, so findings do not apply to other stroke types. The timing of TCD (median 2 days post-onset) may not be the optimal window for prediction, and the biological mechanism linking flow velocity to recovery was not explored.
Declared interests
The authors declare no conflicts of interest. The study was conducted as part of an Institutional Stroke Registry with IRB approval and waived consent.
The easy way to misread this
Do not use TCD to predict cognitive recovery or to exclude patients from rehabilitation. The study found no significant link between low flow velocity and cognitive FIM scores, and it only included patients already deemed suitable for inpatient rehab, so it cannot predict who will benefit from rehabilitation in the first place.