Sakakima Harutoshi
Department of Physical Therapy, School of Health Sciences, Faculty of Medicine, Kagoshima University.
Phys Ther Res. 2019 Sep 6;22(2):45-52. doi: 10.1298/ptr.R0006. eCollection 2019.
Stroke is a leading cause of serious long-term physical disability due to insufficient neurorepair mechanisms. In general, physical activity is an important modifiable risk factor, particularly for stroke and cardiovascular diseases. Physical exercise has shown to be neuroprotective in both animal experiments and clinical settings. Exercise can be considered a mild stressor and follows the prototypical preconditioning stimulus. It has beneficial effects on brain health and cognitive function. Preconditioning exercise, which is prophylactic exercise prior to ischemia, can protect the brain from subsequent serious injury through promotion of angiogenesis, mediation of inflammatory responses, inhibition of glutamate over-activation, protection of the blood-brain barrier, and inhibition of apoptosis. Preconditioning exercise appears to induce brain ischemic tolerance and it has been shown to exert beneficial effects. It is clinically safe and feasible and represents an exciting new paradigm in endogenous neuroprotection for patients with acute stroke. In this review, we describe the neuroprotective potential of preconditioning exercise and clinical applications in patients with acute ischemic stroke.
由于神经修复机制不足，中风是导致严重长期身体残疾的主要原因。一般来说，身体活动是一个重要的可改变风险因素，特别是对于中风和心血管疾病。体育锻炼在动物实验和临床环境中均已显示出具有神经保护作用。运动可被视为一种轻度应激源，并遵循典型的预处理刺激模式。它对大脑健康和认知功能具有有益影响。预处理运动是指在缺血前进行的预防性运动，可通过促进血管生成、调节炎症反应、抑制谷氨酸过度激活、保护血脑屏障以及抑制细胞凋亡，保护大脑免受随后的严重损伤。预处理运动似乎可诱导大脑缺血耐受，并且已显示出具有有益效果。它在临床上安全可行，代表了急性中风患者内源性神经保护的一种令人兴奋的新范例。在本综述中，我们描述了预处理运动的神经保护潜力及其在急性缺血性中风患者中的临床应用。
