Grip Exercise of Non-Paretic Hand Can Improve Venous Return in the Paretic Arm in Stroke Patients: An Experimental Study in the Supine and Sitting Positions

Objective: This study aims to determine the effect of grip exercise by the non-paretic hand on venous return in the paretic arm in stroke in sitting and supine positions. Methods: The study population included 21 stroke patients (mean age, 59.5 years). The diameter (mm) and time-averaged mean velocity (TAMV) (cm/s) of the axillary vein on the paretic side were measured by ultrasound during three distinct conditions: resting, rhythmic non-resistive grip exercise, and resistive exercise (30% of maximum grip strength) in supine and sitting positions. The venous flow volume (ml/min) was calculated using the obtained data. Results: In the supine and sitting positions, the venous flow volume during rhythmic non-resistive and resistive exercises was increased in comparison to resting, which resulted in more increased venous flow volume by rhythmic resistive grip exercise than by non-resistive grip exercise (both, p=0.01). Conclusion: Grip exercise by the non-paretic hand was found to be effective for increasing the venous flow volume in the paretic hand, and resistive grip exercise caused the greatest increase. Our results suggest that rhythmic handgrip exercise may be clinically useful for reducing the incidence of hand edema in stroke patients.