Moore Sarah A, Hallsworth Kate, Jakovljevic Djordje G, Blamire Andrew M, He Jiabao, Ford Gary A, Rochester Lynn, Trenell Michael I
Institute for Cellular Medicine, Newcastle University, Newcastle upon Tyne, UK Institute for Ageing and Health, Newcastle University, Newcastle upon Tyne, UK.
Institute for Cellular Medicine, Newcastle University, Newcastle upon Tyne, UK.
Neurorehabil Neural Repair. 2015 Aug;29(7):623-35. doi: 10.1177/1545968314562116. Epub 2014 Dec 23.
Exercise therapy could potentially modify metabolic risk factors and brain physiology alongside improving function post stroke.
To explore the short-term metabolic, brain, cognitive, and functional effects of exercise following stroke.
A total of 40 participants (>50 years, >6 months post stroke, independently mobile) were recruited to a single-blind, parallel, randomized controlled trial of community-based exercise (19 weeks, 3 times/wk, "exercise" group) or stretching ("control" group). Primary outcome measures were glucose control and cerebral blood flow. Secondary outcome measures were cardiorespiratory fitness, blood pressure, lipid profile, body composition, cerebral tissue atrophy and regional brain metabolism, and physical and cognitive function.
Exercise did not change glucose control (homeostasis model assessment 1·5 ± 0·8 to 1·5 ± 0·7 vs 1·6 ± 0·8 to 1·7 ± 0·7, P = .97; CI = -0·5 to 0·49). Medial temporal lobe tissue blood flow increased with exercise (38 ± 8 to 42 ± 10 mL/100 g/min; P < .05; CI = 9.0 to 0.1) without any change in gray matter tissue volume. There was no change in medial temporal lobe tissue blood flow in the control group (41 ± 8 to 40 ± 7 mL/100 g/min; P = .13; CI = -3.6 to 6.7) but significant gray matter atrophy. Cardiorespiratory fitness, diastolic blood pressure, high-density lipoprotein cholesterol, physical function, and cognition also improved with exercise.
Exercise therapy improves short-term metabolic, brain, physical, and cognitive function, without changes in glucose control following stroke. The long-term impact of exercise on stroke recurrence, cardiovascular health, and disability should now be explored.
运动疗法在改善中风后功能的同时，可能会改变代谢危险因素和脑生理。
探讨中风后运动的短期代谢、脑、认知和功能影响。
共招募40名参与者（年龄>50岁，中风后>6个月，可独立活动），进行一项单盲、平行、随机对照试验，分为社区运动组（19周，每周3次，“运动”组）或拉伸组（“对照组”）。主要结局指标为血糖控制和脑血流量。次要结局指标为心肺适能、血压、血脂谱、身体成分、脑组织萎缩和局部脑代谢，以及身体和认知功能。
运动未改变血糖控制（稳态模型评估：1.5±0.8至1.5±0.7，对照组为1.6±0.8至1.7±0.7，P = 0.97；可信区间=-0.5至0.49）。运动使内侧颞叶组织血流量增加（38±8至42±10 mL/100 g/min；P<0.05；可信区间=9.0至0.1），灰质组织体积无变化。对照组内侧颞叶组织血流量无变化（41±8至40±7 mL/100 g/min；P = 0.13；可信区间=-3.6至6.7），但灰质有显著萎缩。运动还改善了心肺适能、舒张压、高密度脂蛋白胆固醇、身体功能和认知。
运动疗法可改善中风后的短期代谢、脑、身体和认知功能，而不改变血糖控制。现在应探讨运动对中风复发、心血管健康和残疾的长期影响。
