Use of Doppler Ultrasound to Assess Femoral Artery Adaptations in the Hemiparetic Limb in People with Stroke

BACKGROUND: A reduction in physical activity combined with decreased demand for leg oxygen consumption may affect blood flow to the hemiparetic lower extremity after stroke. The purpose of this study was to characterize femoral artery adaptations that occur in the hemiparetic leg in chronic stroke. A secondary goal was to examine intrarater reliability using Doppler ultrasound in people with hemiparesis after stroke. METHODS: This descriptive study used a sample of convenience at 2 locations (urban medical center and rural university). Eighteen individuals (68.4 +/- 3.7 years of age; 15 males) with chronic stroke (time since stroke: 5.7 +/- 1.1 years; 12 with right-side hemiparesis) participated in the study. Femoral artery blood flow, diameter, velocity and vessel wall thickness in the bilateral lower extremities were assessed using Doppler ultrasound. Intrarater reliability was determined for femoral artery diameter and blood flow velocity. RESULTS: Femoral artery blood flow, arterial diameter and blood flow velocity were significantly lower (p < 0.0001) in the hemiparetic limb when compared to the less affected limb. Femoral artery vessel wall thickness was significantly greater (p = 0.002) in the hemiparetic limb. Doppler ultrasound intrarater reliability was strong and significant (intraclass correlation coefficient(3,1) >0.94, p < 0.0001) for femoral artery diameter and blood flow velocity measurements. CONCLUSION: These data suggest that individuals with chronic stroke demonstrate vascular changes in the femoral artery of the hemiparetic limb.