Introduction: Stroke is the second leading cause of disability worldwide (Feigin et al., 2022). Although individuals undergo traditional physiotherapy, intermittent pneumatic compression (IPC) therapy may benefit stroke patients as increases in venous return may allow people to engage with more physical activity and more intensive training sessions (Shroeder et al., 2019) that may result in better health, mobility and ultimately quality of life (Park and Kim, 2019).
Aim: The purpose of this study was to assess the effect of using a home-based IPC device on vascular health and functional outcomes in individuals with chronic stroke using a randomized controlled study.
Methods: Research was conducted following institutional human ethics committee approval, while the study was registered with Clinical Trials.gov Protocol Registration and Results System (NCT05276453; https://clinicaltrials.gov/ct2/show/NCT05276453 ). Thirty-one stroke survivors (64.3 ± 14.3y; 4.3 ± 2.7y since stroke) took part in this study and completed pre- and post-intervention assessments which consisted of measures of vascular health (pulse wave analysis, carotid-femoral pulse wave velocity) and functional capacity (six-minute walk test, timed-up-and-go, 10m walk test). On completion of the initial (pre) assessment, individuals were randomly assigned to either a daily, 12-week, home-based IPC condition, or to a usual care control (CON) group. Outcomes were assessed using analysis of covariance, controlling for any baseline differences.
Results: A Time by Condition interaction was observed for peripheral systolic blood pressure (p < 0.05, np2 = 0.140), with significantly greater reductions reported between pre- and post-intervention for IPC (147.4 ± 18.1 to 139.5 ± 15.6 mmHg, respectively) than CON (139.1 ± 17.5 to 137.7 ± 16.4 mmHg, respectively) . Similar findings were observed for central systolic blood pressure and the six-minute walk test (both p < 0.05). For the six-minute walk test, participants significantly increased their walking distance between pre- and post-intervention assessments for IPC (158 ± 73 to 181 ± 109m, respectively) but not CON (170 ± 87 to 174 ± 117m, respectively) (np2 = 0.248). Average weekly physical activity levels significantly increased, and time spent sitting significantly decreased for IPC compared to CON (both p < 0.05).
Conclusions: The observed improvements in blood pressure and six-minute walk test distance, in combination with an increase in physical activity and reduced sedentary behaviours, are important positive findings when considering the use of IPC training for “at home” rehabilitation therapy for chronic stroke survivors.