Institute of Chronic Disease Risks Assessment, School of Nursing and Health Sciences, Henan University, Kaifeng 475004, China.
The School of Life Sciences, Henan University, Kaifeng 475000, China.
Int J Mol Sci. 2022 Sep 10;23(18):10508. doi: 10.3390/ijms231810508.
Among cerebrovascular diseases, ischemic stroke is a leading cause of mortality and disability. Thrombolytic therapy with tissue plasminogen activator is the first choice for clinical treatment, but its use is limited due to the high requirements of patient characteristics. Therefore, the choice of neurological rehabilitation strategies after stroke is an important prevention and treatment strategy to promote the recovery of neurological function in patients. This study shows that rehabilitation exercise 24 h after stroke can significantly improve the neurological function (6.47 ± 1.589 vs. 3.21 ± 1.069 and 0.76 ± 0.852), exercise ability (15.68 ± 5.95 vs. 162.32 ± 9.286 and 91.18 ± 7.377), daily living ability (23.37 ± 5.196 vs. 66.95 ± 4.707 and 6.55 ± 2.873), and quality of life (114.39 ± 7.772 vs. 168.61 ± 6.323 and 215.95 ± 10.977) of patients after 1 month and 3 months, and its ability to promote rehabilitation is better than that of rehabilitation exercise administered to patients 72 h after stroke (p < 0.001). Animal experiments show that treadmill exercise 24 h after middle cerebral artery occlusion and reperfusion can inhibit neuronal apoptosis, reduce the volume of cerebral infarction on the third (15.04 ± 1.07% vs. 30.67 ± 3.06%) and fifth (8.33 ± 1.53% vs. 30.67 ± 3.06%) days, and promote the recovery of neurological function on the third (7.22 ± 1.478 vs. 8.28 ± 1.018) and fifth (4.44 ± 0.784 vs. 6.00 ± 0.767) days. Mechanistic studies have shown that treadmill exercise increases the density of microvessels, regulates angiogenesis, and promotes the recovery of nerve function by upregulating the expression of vascular endothelial growth factor and laminin. This study shows that rehabilitation exercise 24 h after stroke is conducive to promoting the recovery of patients’ neurological function, and provides a scientific reference for the clinical rehabilitation of stroke patients.
在脑血管疾病中，缺血性脑卒中是导致死亡和残疾的主要原因。组织型纤溶酶原激活物溶栓治疗是临床治疗的首选，但由于对患者特征的高要求，其应用受到限制。因此，选择脑卒中后的神经康复策略是促进患者神经功能恢复的重要预防和治疗策略。本研究表明，脑卒中后 24 小时进行康复运动可显著改善患者的神经功能（6.47±1.589 分比 3.21±1.069 分和 0.76±0.852 分）、运动能力（15.68±5.95 分比 162.32±9.286 分和 91.18±7.377 分）、日常生活能力（23.37±5.196 分比 66.95±4.707 分和 6.55±2.873 分）和生活质量（114.39±7.772 分比 168.61±6.323 分和 215.95±10.977 分），其康复促进能力优于脑卒中后 72 小时开始康复运动的患者（p<0.001）。动物实验表明，大脑中动脉闭塞再灌注后 24 小时进行跑步机运动可抑制神经元凋亡，降低第三天（15.04±1.07%比 30.67±3.06%）和第五天（8.33±1.53%比 30.67±3.06%）脑梗死体积，促进第三天（7.22±1.478 分比 8.28±1.018 分）和第五天（4.44±0.784 分比 6.00±0.767 分）神经功能恢复。机制研究表明，跑步机运动通过上调血管内皮生长因子和层粘连蛋白的表达，增加微血管密度，调节血管生成，促进神经功能恢复。本研究表明，脑卒中后 24 小时进行康复运动有利于促进患者神经功能的恢复，为脑卒中患者的临床康复提供了科学参考。
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