高强度间歇训练增加脑卒中患者血清脑源性神经营养因子：一项随机对照试验。
Increased serum brain-derived neurotrophic factor with high-intensity interval training in stroke patients: A randomized controlled trial.
机构信息
Department of Physical Medicine and Rehabilitation, Keelung Chang Gung Memorial Hospital, 204 Keelung, Taiwan; School of Medicine, College of Medicine, Chang Gung University, 333 Taoyuan, Taiwan; Community Research Center, Keelung Chang Gung Memorial Hospital, 204 Keelung, Taiwan.
Department of Physical Medicine and Rehabilitation, Keelung Chang Gung Memorial Hospital, 204 Keelung, Taiwan; Heart Failure Research Center, Keelung Chang Gung Memorial Hospital, 204 Keelung, Taiwan.
出版信息
Ann Phys Rehabil Med. 2021 Jul;64(4):101385. doi: 10.1016/j.rehab.2020.03.010. Epub 2020 May 11.
BACKGROUND
Physiological adaptations of stroke patients after high-intensity interval training (HIIT) and moderate-intensity continuous training (MICT) remain unclear.
OBJECTIVE
This study determined the HIIT and MICT effects on aerobic capacity, cerebral oxygenation, peak cardiac output (CO), and serum brain-derived neurotrophic factor (BDNF) in stroke patients.
METHODS
We included 23 stroke patients with age about 55 years and stroke duration>24 months; participants completed 36 sessions of exercise training for 30min; 13 were randomly assigned to perform MICT at 60% of peak oxygen consumption (VO) and 10 to perform HIIT at alternating 80% (3min) and 40% (3min) VO. Before and after interventions, we evaluated VO, peak CO, arteriovenous oxygen difference (AV O), bilateral frontal cortex oxygenation (relative changes of oxyhemoglobin Δ[OHb], deoxyhemoglobin Δ[HHb], and total hemoglobin Δ[THb] levels), serum brain-derived neurotrophic factor (BDNF) level, and fluorescent cell staining for neuron morphology and percentage of cell-bearing neurites (% neurites).
RESULTS
HIIT induced significant increases in VO (P=0.008), CO (P=0.038), Δ[HHb] (P=0.046), Δ[THb] (P=0.046), and serum BDNF level (P=0.012). The improvement in VO was significantly greater with HIIT than MICT (20.7% vs. 9.8%, P=0.031), as was AV O (P=0.041), Δ[HHb] (P=0.027), and serum BDNF level (P<0.001). HIIT facilitated neuron dendritic protrusions (greater % neurites, P=0.012) with prominent redistribution of mitochondria.
CONCLUSION
As compared with MICT, HIIT-improved aerobic capacity by increasing systemic tissue O extraction in stroke patients. Increased cerebral O utilization in the involved hemisphere was also identified after HIIT. These physiological adaptations may be associated with increased serum BDNF level. In vitro dendritic growth in neurons treated with serum from HIIT participants may imply significant effects on neuron activities as compared with MICT. CLINICALTRIALS.
GOV IDENTIFIER
NCT04135391.
背景
高强度间歇训练（HIIT）和中等强度持续训练（MICT）对脑卒中患者的生理适应性仍不清楚。
目的
本研究旨在确定 HIIT 和 MICT 对脑卒中患者有氧能力、脑氧合、峰值心输出量（CO）和血清脑源性神经营养因子（BDNF）的影响。
方法
我们纳入了年龄约 55 岁且卒中病程>24 个月的 23 例脑卒中患者；参与者完成了 36 次 30 分钟的运动训练；其中 13 例随机分配至 60%最大摄氧量（VO）的 MICT 组，10 例分配至 HIIT 组，交替进行 80%（3 分钟）和 40%（3 分钟）VO。干预前后，我们评估了 VO、峰值 CO、动静脉血氧差（AV O）、双侧额皮质氧合（氧合血红蛋白相对变化[Δ[OHb]、脱氧血红蛋白相对变化[Δ[HHb]和总血红蛋白相对变化[Δ[THb]水平）、血清 BDNF 水平、神经元形态的荧光细胞染色和携带神经突的细胞百分比（%神经突）。
结果
HIIT 显著增加了 VO（P=0.008）、CO（P=0.038）、Δ[HHb]（P=0.046）、Δ[THb]（P=0.046）和血清 BDNF 水平（P=0.012）。与 MICT 相比，HIIT 对 VO 的改善更显著（20.7%比 9.8%，P=0.031），AV O（P=0.041）、Δ[HHb]（P=0.027）和血清 BDNF 水平（P<0.001）也显著增加。HIIT 促进神经元树突状突起（更多的%神经突，P=0.012），并伴有线粒体的明显再分布。
结论
与 MICT 相比，HIIT 通过增加卒中患者全身组织 O 摄取来改善有氧能力。HIIT 后还发现受累半球的脑氧利用率增加。这些生理适应性可能与血清 BDNF 水平的增加有关。与 MICT 相比，用 HIIT 参与者的血清处理的神经元中的树突生长可能暗示对神经元活动有显著影响。临床试验。
GOV IDENTIFIER
NCT04135391。
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