Recovery from hemiplegia is a complex phenomenon that depends on various adaptive
processes involving both the affected and the unaffected hemisphere. Our aim in
this study was to investigate changes in cerebral perfusion in hemiplegic stroke
patients during passive movements and their correlation with the subsequent motor
recovery. The study included 30 patients with single, subcortical ischemic
cerebral lesions. Within 14 days (range 8 to 14 days) from stroke onset, all
patients were examined for the effects of passive elbow movements on cerebral
blood flow in the middle cerebral arteries (MCAs) by means of bilateral
transcranial Doppler (TCD) ultrasonography. On the same day as TCD assessment,
they were also evaluated clinically with the Canadian Neurological Scale (CNS)
and with Medical Research Council (MRC) scale for motor deficit of the affected
arm. A clinical evaluation using the same scales was repeated after two months of
motor rehabilitation therapy. We investigated the relationship between changes of
Mean Flow Velocity (MFV) during passive movements and degree of recovery after
stroke. The logistic regression procedure indicated that out of all factors
considered as possibly related to a good clinical motor deficit recovery of the
affected arm, evaluated by means of MRC, only the MFV percentage increase played
a predictive role. In particular, for each additional point of contralateral MFV
percentage increase during passive movement of the affected arm, the relative
probability of good clinical recovery increased 5.68 times (95% CI=1.76-18.40;
p=0.004). Similar results were found when the clinical recovery was measured by
means of the CNS (slope=0.40, p<0.001). Passive movements in hemiplegic stroke
patients before clinical recovery elicit activation patterns that may be critical
for the restoration of motor function.I n particular, early and consistent
activation of the affected hemisphere, as detected with TCD, seems to predict the
positive evolution of a motor deficit