Key result
Carotid-femoral PWV shows good-to-excellent test-retest reliability in both limbs after chronic stroke.
Why the study?
Arterial stiffness and endothelial dysfunction are non-traditional risk markers after stroke, yet the test-retest reliability and minimal detectable change of pulse wave velocity and flow-mediated dilation had not been established in this population.
What are the test-retest reliability and minimal detectable change values of pulse wave velocity and flow-mediated dilation in the paretic and non-paretic limbs of older adults >12 months post-stroke?
Cross-Sectional (n=17)
No
What are the test-retest reliability and minimal detectable change values of pulse wave velocity and flow-mediated dilation in the paretic and non-paretic limbs of older adults >12 months post-stroke?
Effect estimate: ICC 0.85 (paretic) and ICC 0.94 (non-paretic) (95% CI 0.59-0.95)
Absolute Event Rate: 0.85% vs 0.94%
Establishes that carotid-femoral pulse wave velocity has good-to-excellent test-retest reliability in both paretic and non-paretic limbs of chronic stroke survivors and provides stroke-specific minimal detectable change thresholds to guide future trials.
cfPWV shows good reliability post-stroke with MDC95 1.68-2.23 m/s; supports its use in future trials but leaves clinical adoption open.
Arterial stiffness and endothelial dysfunction are non-traditional risk markers after stroke, yet reliability and minimal detectable change (MDC) of pulse wave velocity (PWV) and flow-mediated dilation (FMD) have not been established. We examined test-retest reliability and MDC of carotid-femoral (cfPWV), carotid-radial (crPWV), and femoral-dorsalis pedis PWV (ffPWV), and absolute and relative brachial artery FMD in people >12 months post-stroke. Seventeen individuals (n=4(24%) females; 63.9±8.6 years; 4.5±2.8 years post-stroke) completed two bilateral assessments of PWV via applanation tonometry and FMD via duplex ultrasound within one week. Intraclass correlation coefficients (ICC 2,1 ) were calculated via two-way random-effects models, and MDC derived at 68%, 90%, and 95% confidence levels. We found good-to-excellent reliability for cfPWV in paretic (ICC 2,1 =0.85; 95%CI:0.59,0.95) and non-paretic (ICC 2,1 =0.94; 95%CI:0.82,0.98) limbs, with MDC 95% values of 2.23 and 1.68 m/s, respectively. crPWV and ffPWV exhibited poor reliability bilaterally (ICC 2,1 =0.12–0.33). Relative FMD showed-moderate reliability for paretic (ICC 2,1 =0.50; 95%CI:-0.20,0.85) and non-paretic (ICC=0.59; 95%CI:0.04,0.84) limbs, with MDC 95% values of 6.88% and 7.65%, respectively. Reliability for absolute FMD was poor (ICC 2,1 =0.11–0.44). These findings support cfPWV as a reliable vascular assessments in individuals >12 months post-stroke, and provide stroke-specific MDC values to guide interpretability in future trials.
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Abreu et al. (2026) conducted a cross-sectional in Chronic stroke (>12 months post-stroke) (n=17). Bilateral pulse wave velocity (cfPWV, crPWV, ffPWV) via applanation tonometry and brachial artery flow-mediated dilation (FMD) via duplex ultrasound vs. Paretic vs. non-paretic limb across two repeated testing sessions within 1 week was evaluated on Test-retest relative reliability (ICC 2,1) and minimal detectable change (MDC95%) of carotid-femoral pulse wave velocity (cfPWV) (ICC 0.85 (paretic) and ICC 0.94 (non-paretic), 95% CI 0.59-0.95). Carotid-femoral PWV demonstrated good-to-excellent test-retest reliability in paretic (ICC 0.85; MDC95% 2.23 m/s) and non-paretic (ICC 0.94; MDC95% 1.68 m/s) limbs of chronic stroke survivors.
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