Transcutaneous oxygen measurement in stroke: Circulatory disorder of the affected leg?

Abstract

Objective: To identify variances in the microcirculation of the affected leg of stroke patients and to correlate them with a number of variables that are clinically associated with a possible circulatory disorder (“cold leg”). Design: Survey. Setting: Large regional (tertiary care) rehabilitation center. Patients: From 93 acute, first-ever stroke patients admitted for stroke rehabilitation, 10 individuals were selected. Patients with vascular or cardiopulmonary pathology and severe cognitive or speech impairments were excluded. Main Outcome Measures: A clinical assessment of the following variables was performed: subjective complaints of the affected leg, medication, walking performance, degree of lower-leg edema, trophic pathology, voluntary muscle activity of the dorsal flexors of the affected foot, and the degree of spasticity of the calf muscles. The microcirculation of the affected leg was registered via transcutaneous oxygen measurement (TcPo 2). Results: The clinical picture associated with a circulatory disorder (“cold leg”) was partially and modestly present in seven patients. The TcPo 2 values showed no differences between the paretic and nonparetic lower legs, nor did values change in the course of time after stroke: mean 77.9mmHg (range 42–124) versus 86.1 (41–124) after 8 weeks ( n = 10, p = .17); 76.9 (45–96) versus 73.1 (50–96) after 14 weeks ( n = 9, p = .38); and 65.8 (44–88) versus 65.8 (37–78) after 20 weeks ( n = 8, p = .48). The clinical symptoms could not be objectified in relation to the microcirculation. Conclusions: In selected stroke patients, no differences were established between microcirculation in both lower legs. TcPo 2 measurement does not seem to be a suitable method for clinical research on this topic.