Department of Physical Medicine and Rehabilitation, Dongguk University Ilsan Hospital, Goyang-si, Gyeonggi-do, Republic of Korea.
Neurosci Lett. 2010 Mar 3;471(2):104-8. doi: 10.1016/j.neulet.2010.01.020. Epub 2010 Jan 18.
Rehabilitation after a stroke is very important because it has beneficial effects on brain function, including the promotion of plasticity. However, an optimal time window for rehabilitation interventions after hemorrhagic stroke has not been clearly defined. The aim of this study was to determine whether early exercise training initiated 24h after an intracerebral hemorrhage (ICH) might enhance neurologic recovery more than exercise initiated 1 week after ICH without hematoma expansion and edema volume increase. We subjected adult male Sprague-Dawley rats to experimental ICH by the intrastriatal administration of bacterial collagenase. The rats were randomly divided into the following 2 groups: early training group (treadmill exercise started 24h post-ICH; n=18) and late training group (treadmill exercise started 1-week post-ICH; n=18). Two weeks after surgery we performed neurologic tests (rota-rod, modified limb-placing, and adhesive-dot removal tests), and measured hematoma volumes and brain water content. In the late training group, compared with the pre-ICH performance on the rota-rod test (98.3+/-69.4s), the animals had significantly worse performance after the post-ICH rehabilitation (40.5+/-52.6s; p<0.01, paired t-test). In the early training group however, the motor performance after the post-ICH rehabilitation (56.4+/-73.5s) was not significantly different from the baseline pre-ICH performance (79.8+/-33.9s; p=0.24). There were no significant differences between the two groups with respect to the other neurologic tests. Early exercise did not increase hematoma size or brain water content. Early treadmill training could be performed safely, and enhanced motor recovery in a rat model of ICH. Further studies are required to translate the results into clinical significance.
中风后的康复非常重要，因为它对大脑功能有有益的影响，包括促进可塑性。然而，尚未明确界定出血性中风后康复干预的最佳时间窗。本研究旨在确定在脑出血（ICH）后 24 小时开始的早期运动训练是否比在 ICH 后 1 周开始的运动训练更能增强神经功能恢复，而不会导致血肿扩大和水肿体积增加。我们通过向纹状体中注入细菌胶原酶使成年雄性 Sprague-Dawley 大鼠发生实验性 ICH。大鼠被随机分为以下 2 组：早期训练组（ICH 后 24 小时开始进行跑步机训练；n=18）和晚期训练组（ICH 后 1 周开始进行跑步机训练；n=18）。手术后 2 周，我们进行了神经学测试（转棒、改良肢体放置和粘点去除测试），并测量了血肿体积和脑含水量。在晚期训练组中，与转棒测试的 ICH 前表现（98.3+/-69.4s）相比，动物在 ICH 后的康复后表现明显更差（40.5+/-52.6s；p<0.01，配对 t 检验）。然而，在早期训练组中，ICH 后康复后的运动表现（56.4+/-73.5s）与基线 ICH 前表现（79.8+/-33.9s）无显著差异（p=0.24）。两组之间在其他神经学测试方面没有差异。早期运动不会增加血肿大小或脑含水量。早期跑步机训练是安全的，可以增强大鼠 ICH 模型中的运动恢复。需要进一步的研究将结果转化为临床意义。
