Resting blood flow in the paretic and nonparetic lower legs of hemiplegic persons: relation to local skin temperature.

It is commonly observed in patients with established hemiplegia following cerebrovascular accidents (CVA), that the skin temperature (Ts) of the leg and foot is notably cooler on the affected side of the body; the relationship to cutaneous blood flow, however, has not previously been investigated. In the present study, observations of foot and calf blood flow via venous occlusion plethysmography in water were made in six patients with hemiplegia of 5-13 months duration, both at observed Ts and at standard temperature (ST). Similar measurements were obtained on six age-matched control subjects. The patients' mean Ts values for the foot and calf were significantly lower on the affected side, while those for the nonaffected side were not significantly different from control group values. At non-equivalent water temperatures (Tw) blood flows in the patients' affected feet were lower than those on the nonaffected side, but at the ST they were similar. Further, under these conditions, the flows in both feet were lower than in control subjects. Flows in the patients' affected calves were not significantly reduced at non-equivalent TW; at the ST they did not differ significantly from those of the controls. These observations suggest that, in patients who have suffered a stroke, the reduction of TS of the affected limb is associated with reduced limb blood flow, which cannot be attributed to changes in limb tissue composition. Since the reduced limb blood flow on the affected side is more marked in the foot, it is likely to be due to reduction of blood flow in the skin. In addition, the reduction of flow in the foot of the nonaffected leg suggests a more generalized change of skin circulation in these patients.