Cerebral blood volume and oxygenation among poststroke hemiplegic patients: Effects of 13 rehabilitation tasks measured by near-infrared spectroscopy

Objective: To measure with near-infrared spectroscopy (NIRS) the changes in cerebral hemodynamics and oxygenation in the prefrontal cortex of poststro ke patients with hemiplegia performing several rehabilitation tasks and to analyze the different effects of the tasks. Design: Case series pilot study. Setting: Hospitals and facilities near Tsukuba, Japan. Participants: Twenty-four healthy volunteers and 44 patients with hemiplegi a. Interventions: For healthy volunteers, conventional rehabilitation tasks of head-up tilt (HUT), calculation, and ergometer. For patients with hemipleg ia, these 3 tasks plus reading aloud, listening to music, reciprocal extens ion, nonparalyzed extension, passive range of motion, pulley, bridge, facil itation, stand-up, and gait. Main Outcome Measures: Changes in cerebral blood volume (CBV) and cerebral oxygen volume (COV) in the prefrontal region sensed by a noninvasive NIRS d evice placed midforehrad in healthy volunteers or on the impaired side in p atients with hemiplegia. Computer analysis of the quality and quantity of t he CBV and COV change patterns. Results: In healthy subjects, the change patterns of the 3 tasks were clear ly different: decrease in COV with HUT, limited increase in CBV and COV wit h calculation tasks, and gradual increase in CBV and COV with ergometer tas ks. In patients with hemiplegia, significant (positive) CBV changes were ob served in ergometer, facilitation, stand-up, and gait and significant (nega tive) changes with Remover. Significant (positive) COV changes were observe d in ergometer and facilitation and (negative) in HUT. Conclusions: NIRS is useful for monitoring the change in regional hemodynam ics and oxygenation in rehabilitation; some tasks commonly used in rehabili tation, such as ergometer and facilitation, increase both CBV and COV in th e affected prefrontal cortex of patients with hemiplegia.