Capacidade Funcional e Rigidez Arterial em Indivíduos Pós Acidente Vascular Encefálico Crônico

Abstract

Introduction: Stroke is a cardiovascular health condition with neurological impairment, characterized by motor impairment, resulting from vascular changes. Individuals after chronic stroke often present motor disabilities resulting from brain injury, which can lead to changes in the functional capacity of these individuals. Concomitantly, vascular changes lead to increase in arterial stiffness in individuals after chronic stroke when compared to healthy individuals. Structural and functional changes in arteries related to arterial stiffness, establish pathophysiological mechanisms that hinder the propagation of pulse waves, in which they contribute to brain damage. Objective: To investigate the association between the functional capacity and arterial stiffness between individuals after chronic stroke, in addition to comparing arterial stiffness stratified in worse and better functional capacity. Methods: This is a cross- sectional study, composed of individuals diagnosed with chronic stroke, both sexes, over 18 years age. Functional capacity was assessed using the Duke Activity Status Index (DASI) questionnaire. The individuals were stratified into worse functional capacity (˂31,95 points) and better functional capacity (≥ 31,95 points). Arterial stiffness was assessed by means of arterial stiffness indices, using the Augmentation Index corrected by the heart rate 75 beats per minute (Alx@75). Arterial stiffness was assessed in the paretic arm, non-invasively, using the Mobil-O-Graph® equipment. Pearson’s correlation was used to verify the association between functional capacity and arterial stiffness and the T test (CI95%) was used to compared Alx@75 between individuals with worse and better functional capacity. All variables were analyzed using the SPSS version 17.0 statistical package, with a significance level of 5%. Results: The sample consisted of twenty-eight individuals with chronic stroke, mean age of 57.7 ±17.0 years, 61% of the sample consisting of men. Individuals had a mean of 51.1 ±54.1 months since stroke and 84% of the sample had ischemic stroke. The average of the DASI score was 29±19 METS and the mean Alx@75 was 23.8 ±11.4%. There was a significant, negative and reasonably magnitude correlation (r: -0.53; p: 0.01) between functional capacity and arterial stiffness. Eighteen individuals were categorized with worse functional capacity. There was a statistically significant difference between groups (mean difference 10.04 [CI95% 2.44 to 17.64]). Conclusion: The present study demonstrated association between functional capacity and arterial stiffness in individuals with chronic stroke. Individuals with better functional capacity have lower arterial stiffness indices.