London, United Kingdom 2013 Poster Session Blue Cerebrovasc Dis 2013; 35 (suppl 3)1-854 763 789 Rehabilitation and reorganisation after stroke Cardiovascular Fitness as a Predictor of Functional Recovery in Subacute Stroke Patients B.R. Kim1, E.Y. Han2, S.J. Joo3, S.Y. Kim4, H.M. Yoon5 Jeju National University Hospital, Jeju, SOUTH KOREA1, Jeju National University Hospital, Jeju, SOUTH KOREA2, Jeju National University Hospital, Jeju, SOUTH KOREA3, Jeju National University Hospital, Jeju, SOUTH KOREA4, Jeju National University Hospital, Jeju, SOUTH KO-REA5 Background: In stroke patients, reduced cardiovascular fitness is a well-studied physical impair-ment. However, there is relatively limited evidence for a correlation between baseline cardiovascu-lar fitness and functional status in subacute stroke patients. We investigated the correlation between baseline cardiovascular fitness and ADL function, and whether baseline cardiovascular fitness is of predictive value in terms of functional recovery after rehabilitation in subacute stroke patients. Methods: This study was a descriptive, observational cohort study. Fifty-five subacute stroke pa-tients (37 males and 18 females; average age, 62.2 years) were enrolled for this study, and all sub-jects underwent symptom-limited low-velocity graded treadmill testing. Baseline assessments included cardiovascular fitness, 6 minute walk test (6MWT), Korean-Modified Barthel Index (K-MBI), Motricity Index (MI). Four weeks after rehabilitation, K-MBI was measured repeatedly. Results: Mean peak oxygen consumption (Vo2 peak) was 19.7 ± 6.7 mL/kg/min. Baseline K-MBI correlated significantly with Vo2 peak, peak heart rate (HR), 6MWT, and MI, and in regression analysis, Vo2 peak and MI were significant independent predictors of baseline K-MBI. Follow-up K-MBI correlated significantly with Vo2 peak, peak HR, peak rate pressure product, 6MWT, base-line K-MBI and MI, and in linear regression analysis, Vo2 peak and baseline K-MBI were signifi-cant independent predictors of follow-up K-MBI. Conclusion: These results indicate that baseline cardiovascular fitness correlates significantly with the baseline functional status, in addition to being an important prognostic factor regarding the func-tional recovery of subacute stroke patients. 790 Rehabilitation and reorganisation after stroke Visual cortex plasticity without visual recovery: report of a case of homonymous hemianopia studied with functional MRI retinotopic mapping P.L. Clatworthy1, K.V. Haak2, P.S. Jones3, E.A. Warburton4, N.J. Sarkies5, H. Johansen-Berg6, A.B. Morland7, J-C. Baron8 University of Cambridge, Cambridge, UNITED KINGDOM1, University of York, York, UNIT-ED KINGDOM2, University of Cambridge, Cambridge, UNITED KINGDOM3, University of Cam-bridge, Cambridge, UNITED KINGDOM4, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UNITED KINGDOM5, University of Oxford, Oxford, UNITED KINGDOM6, Univer-sity of York, York, UNITED KINGDOM7, University of Cambridge, Cambridge, UNITED KING-DOM8 Background Lateral homonymous hemianopia (HH) is a common consequence of stroke, impairing daily living and quality of life. Visual perception in HH often shows recovery, and some types of rehabilitation aim to improve this. Visual stimulation of the hemianopic field in chronic stroke can evoke bilater-al extrastriate cortex responses, and visual training may increase the representation of the affected hemifield in the unaffected hemisphere, suggesting plasticity. This in turn may represent a target for rehabilitation. Methods We report an illustrative patient with right posterior MCA territory stroke resulting in left HH. Visu-al fields were assessed by serial static (Humphrey 24-2) perimetry performed 4 days and 9 months after stroke. MR imaging was also performed at 9 months, including automated tractography to assess optic radiation damage (Clatworthy, NeuroImage 2010) and fMRI retinotopic mapping to measure visual field representations in occipital cortex. The latter included population receptive field (PRF) mapping. Results Early perimetry showed complete HH, which partially recovered over the 9 months. Optic radiation damage was demonstrated using tractography. Marked topographical changes were found in oc-cipital visual cortex, with areas of the affected hemifield being represented in the unaffected hemi-sphere. However, the areas with altered cortical maps were only those which had not recovered on perimetry. The recovered field was still represented in the stroke affected hemisphere. PRF estimates were not increased in these areas, arguing against eye movements confounding the results. Conclusions Inter-hemispheric changes of visual field representations appear to be possible without recovery of visual perimetry in the “re-mapped” areas. While this does not rule out some visual recovery as a consequence of plasticity, it shows that caution must be used when interpreting changes in visual representations as the mechanism of adaptive change underlying visual recovery.
Karger_ESC London_2013
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