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Could heart rate variability be associated with weight-bearing asymmetries in cerebrovascular diseases?
Rogério Batista Balthazar1, Pedro Henrique Côrtes de Sousa2, Paulo Henrique Ferreira de Araujo Barbosa2, Lidiane Teles de Menezes2, Abraão Souza Costa2, Danilo Veloso Alves Carneiro2, Vera Regina Fernandes da Silva Marães3, Emerson Fachin Martins4
1Physical Educator and Physical Therapy student, Faculty of Ceilandia, University of Brasilia, Brasilia, Federal District, Brazil.
2Physical Therapy student, Faculty of Ceilandia, University of Brasilia, Brasilia, Federal District, Brazil.
3Ph.D. in Physical Therapy, Faculty of Ceilandia, University of Brasilia, Federal District, Brazil.
4Ph.D. in Neuroscience and Behaviour, Faculty of Ceilandia, University of Brasilia, Brasilia, Federal District, Brazil.

doi:10.5348/ijcri-2012-02-87-CS-1

Address correspondence to:
Emerson Fachin Martins
Universidade de Brasilia
Faculdade de Ceilandia, Campus UnB Ceilandia
QNN 14 Area Especial, Ceilandia Sul, Brasilia, Distrito Federal
Brasil, 72220-140
Phone: 55 61 31078401
Fax: 55 61 31078416
Email: efmartins@unb.br

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How to cite this article:
Balthazar RB, de Sousa PHC, de Araujo Barbosa PHF, de Menezes LT, Costa AS, Carneiro DVA, da Silva Marães VRF, Martins EF. Could heart rate variability be associated with weight-bearing asymmetries in cerebrovascular diseases? International Journal of Case Reports and Images 2012;3(2):1-5.


Abstract
Introduction: Cerebrovascular diseases result in sensory-motor deficits disturbing postural control that is observed by weight-bearing asymmetries commonly named as hemiparesis. Besides hemiparetic impairments, first observed after stroke, many studies have pointed cardiac failure and risk of sudden death as the main factors responsible for death of stroke survivars. This case series characterized weight-bearing asymmetries and heart rate variability, and describes relationships between these parameters in hemiparesis.
Case Series: Brazilian male subjects with chronic hemiparesis acquired after ischemic stroke in the middle cerebral artery. Five were selected to study heart rate variability obtained by Root Mean Square Successive Difference. Also, weight-bearing asymmetries were measured by Symmetry Ratio calculated by weight-bearing recorded between each foot. The Symmetry Ratio was 1.1±0.43 for all cases presenting a symmetry case (n = 1) and different types of asymmetries cases (n = 4) during upright position. Root Mean Square Successive Difference was 9.9±3.4, presenting strong and significant (p < 0.05) positive correlation with age and a strong but not significant (0.05 < p < 0.10) negative correlation with hemiparesis chronicity. A strong but not significant negative correlation was observed between the Root Mean Square Successive Difference and the Symmetry Rate values.
Conclusion: A characteristic pattern of heart rate variability for patients with cerebrovascular disease was observed in these cases, associated significantly with age. Still, this behavior seems to be influenced by chronicity and by different types of asymmetries in the distribution of weight bearing that could be investigated in more appropriate clinical research designs.

Key Words: Cardiovascular, Neurological, Stroke, Posture, Physical therapy

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Author Contributions:
Rogério Batista Balthazar - Acquisition of data, Analysis and interpretation of all data, Drafting the article, Final approval of the version to be published
Pedro Henrique Côrtes de Sousa - Acquisition of data and Analysis of weight-bearing data, Final approval of the version to be published
Paulo Henrique Ferreira de Araujo Barbosa - Acquisition of data and Analysis of weight-bearing data, Final approval of the version to be published
Lidiane Teles de Menezes - Acquisition of data and Analysis of weight-bearing data, Final approval of the version to be published
Abraão Souza Costa - Acquisition of data and Analysis of weight-bearing data, Final approval of the version to be published
Danilo Veloso Alves Carneiro - Acquisition of data and Analysis of heart rate variability data, Final approval of the version to be published
Vera Regina Fernandes da Silva Marães - Acquisition, Analysis and interpretation of heart rate variability data, Critical revision of the article, Final approval of the version to be published
Emerson Fachin Martins - Conception and design, Acquisition of data, Analysis and interpretation of data, Drafting the article, Critical revision of the article, Final approval of the version to be published
Guarantor of submission:
The corresponding author is the guarantor of Submission.
Source of support:
None
Conflict of interest:
The authors declare no conflict of interest.
Copyright:
© Rogério Batista Balthazar et al. 2012; This article is distributed under the terms of Creative Commons Attribution License which permits unrestricted use, distribution and reproduction in any means provided the original authors and original publisher are properly credited. (Please see http://www.ijcasereportsandimages.com/copyright-policy.php for more information.)