Charalambous Charalambos C, Helm Erin E, Lau Kristin A, Morton Susanne M, Reisman Darcy S
a Department of Physical Therapy , University of Delaware , Newark , DE , USA.
b Biomechanics and Movement Science Program , University of Delaware , Newark , DE , USA.
Top Stroke Rehabil. 2018 Mar;25(2):83-89. doi: 10.1080/10749357.2017.1399527. Epub 2017 Nov 5.
People post-stroke can learn a novel locomotor task but require more practice to do so. Implementing an approach that can enhance locomotor learning may therefore improve post-stroke locomotor recovery. In healthy adults, an acute high-intensity exercise bout before or after a motor task may improve motor learning and has thus been suggested as a method that could be used to improve motor learning in neurorehabilitation. However, it is unclear whether an acute high-intensity exercise bout, which stroke survivors can feasibly complete in neurorehabilitation session, would generate comparable results.
To determine a feasible, high-intensity exercise protocol that could be incorporated into a post-stroke neurorehabilitation session and would result in significant exercise-induced responses.
Thirty-seven chronic stroke survivors participated. We allocated subjects to either a control (CON) or one of the exercise groups: treadmill walking (TMW), and total body exercise (TBE). The main exercise-induced measures were: average intensity (% max intensity) and time spent (absolute: seconds; normalized: % total time) at target exercise intensity, and magnitudes of change in serum lactate (mmol/l) and brain-derived neurotrophic factor (BDNF; ng/ml).
Compared to CON, both exercise groups reached and exercised longer at their target intensities and had greater responses in lactate. However, the TBE group exercised longer at target intensity and with greater lactate response than the TMW group. There were no significant BDNF responses among groups.
An acute high-intensity exercise bout that could be incorporated into a neurorehabilitation learning-specific session and results in substantial exercise-induced responses is feasible post-stroke.
中风后患者能够学习新的运动任务,但需要更多练习。因此,采用一种能够增强运动学习的方法可能会改善中风后的运动恢复。在健康成年人中,在运动任务之前或之后进行一次急性高强度运动可能会改善运动学习,因此有人建议将其作为一种可用于改善神经康复中运动学习的方法。然而,尚不清楚中风幸存者在神经康复过程中能够实际完成的急性高强度运动是否会产生类似的效果。
确定一种可行的高强度运动方案,该方案可纳入中风后神经康复疗程,并能产生显著的运动诱导反应。
37名慢性中风幸存者参与研究。我们将受试者分为对照组(CON)或运动组之一:跑步机行走(TMW)组和全身运动(TBE)组。主要的运动诱导指标包括:目标运动强度下的平均强度(最大强度的百分比)和花费时间(绝对值:秒;标准化值:总时间的百分比),以及血清乳酸(mmol/L)和脑源性神经营养因子(BDNF;ng/ml)的变化幅度。
与对照组相比,两个运动组均达到并在目标强度下运动更长时间,且乳酸反应更大。然而,TBE组在目标强度下运动时间更长,乳酸反应也比TMW组更大。各组间BDNF反应无显著差异。
在中风后,将一次急性高强度运动纳入神经康复特定学习疗程并产生显著运动诱导反应是可行的。