Could heart rate variability be associated with weight bearing asymmetries in cerebrovascular diseases?

Abstract

Introduction: Cerebrovascular diseases result in sensory-motor deficits disturbing postural control that is observed by weight-bearing asymmetries commonly named as hemiparesis. Besides hemiparetic impairments, first observed after stroke, many studies have pointed cardiac failure and risk of sudden death as the main factors responsible for death of stroke survivars. This case series characterized weight-bearing asymmetries and heart rate variability, and describes relationships between these parameters in hemiparesis. Case Series: Brazilian male subjects with chronic hemiparesis acquired after ischemic stroke in the middle cerebral artery. Five were selected to study heart rate variability obtained by Root Mean Square Successive Difference. Also, weight-bearing asymmetries were measured by Symmetry Ratio calculated by weight-bearing recorded between each foot. The Symmetry Ratio was 1.1±0.43 for all cases presenting a symmetry case (n = 1) and different types of asymmetries cases (n = 4) during upright position. Root Mean Square Successive Difference was 9.9±3.4, presenting strong and significant (p < 0.05) positive correlation with age and a strong but not significant (0.05 < p < 0.10) negative correlation with hemiparesis chronicity. A strong but not significant negative correlation was observed between the Root Mean Square Successive Difference and the Symmetry Rate values. Conclusion: A characteristic pattern of heart rate variability for patients with cerebrovascular disease was observed in these cases, associated significantly with age. Still, this behavior seems to be influenced by chronicity and by different types of asymmetries in the distribution of weight bearing that could be investigated in more appropriate clinical research designs.