Impaired Microvascular Reactivity to Passive Limb Movement After Stroke Is Improved by a Single Session of Ischemic Conditioning

Authors

• Alicen A. Whitaker-Hilbig, Medical College of Wisconsin
• Jennifer N. Nguyen, Medical College of Wisconsin
• Amanda Wietrzny, Medical College of Wisconsin
• Akash Desai, Medical College of Wisconsin
• Samuel Wietrzny, Medical College of Wisconsin
• Macey Dunn, Medical College of Wisconsin
• Yelyzaveta Merenzon, Medical College of Wisconsin
• Sergey Tarima, University of KentuckyFollow
• Emilie Klevenow, Marquette University
• Allison S. Hyngstrom, Marquette University
• Matthew J. Durand, Medical College of WisconsinFollow

Abstract

BACKGROUND: Microvascular dysfunction post stroke remains insufficiently investigated and may contribute to impairments in physical function. Single passive limb movement (sPLM) provides a clinically relevant assessment of microvascular vasodilation. We hypothesized the response to sPLM would be attenuated in the paretic leg compared with age- and sex-matched controls (CON) and would improve following a single session of ischemic conditioning (IC), an intervention known to enhance vasodilation. METHODS: In this randomized crossover trial, superficial femoral artery leg blood flow was measured during sPLM, using a Biodex dynamometer, which passively moved the leg 90° at 1Hz. A thigh cuff was placed around the paretic leg (dominant leg in CON) and inflated to 225mmHg for IC or 25mmHg for sham-IC for 5minutes, followed by 5minutes deflation, repeated for 45minutes. A blinded assessor remeasured the sPLM response, calculated as the percentage of change in peak leg blood flow relative to baseline. RESULTS: Fifteen individuals post stroke (62±10years old, 60% female, 8±6years post stroke) and fifteen CON completed the study. The microvascular response to sPLM was lower in the paretic leg (x=47%±19%) compared with CON (x=65%±36%, P=0.04) but not the nonparetic leg (x=56%±34%, P=0.10). IC improved the microvascular response to sPLM in the paretic leg (P=0.02) but not the nonparetic leg or CON (P≥0.68). CONCLUSIONS: Individuals post stroke exhibited impaired movement-induced microvascular vasodilation in the paretic leg. A single session of IC acutely improved the paretic leg’s response, potentially supporting local IC as an adjunct therapy to enhance microvascular health before neurorehabilitation.

Document Type

Article

Publication Date

7-25-2026

Notes/Citation Information

Publisher Copyright: © 2026 The Author(s).

Digital Object Identifier (DOI)

10.1161/JAHA.126.050817

Archival?

Archival

Repository Citation

Whitaker-Hilbig, Alicen A.; Nguyen, Jennifer N.; Wietrzny, Amanda; Desai, Akash; Wietrzny, Samuel; Dunn, Macey; Merenzon, Yelyzaveta; Tarima, Sergey; Klevenow, Emilie; Hyngstrom, Allison S.; and Durand, Matthew J., "Impaired Microvascular Reactivity to Passive Limb Movement After Stroke Is Improved by a Single Session of Ischemic Conditioning" (2026). Biostatistics Faculty Publications. 79.
https://uknowledge.uky.edu/biostatistics_facpub/79