Cardoso Sara V, Fernandes Sofia R, Tomás Maria T
Hospital Beatriz Ângelo, Loures, Portugal.
ESTeSL - Escola Superior de Tecnologia da Saúde, Instituto Politécnico de Lisboa, Lisboa, Portugal.
Int J Exerc Sci. 2024 Aug 1;17(1):1105-1119. doi: 10.70252/VZWF7949. eCollection 2024.
Neuroplasticity is an essential mechanism by which the nervous system shapes and adapts according to functional requirements. Evidence suggests that physical exercise induces a cascade of cellular processes that favours brain plasticity. The Brain Derived Neurotrophic Factor (BDNF) is a neurotrophin closely linked to neuroplasticity that can be increased due to exercise. To verify the effects of therapeutic exercise on neuroplasticity and/or peripheral BDNF levels in neurological conditions in adults, such as stroke, Parkinson's and Alzheimer's diseases and mild cognitive impairment and address its clinical relevance in the treatment of neurological dysfunctions. A systematic review was carried using PUBMED, Web of Science and Scopus databases. Inclusion criteria were: randomized controlled trials or pilot studies; humans with age > 18 yrs with neurological condition; English language; score ≥ 6 in PEDro Scale (moderate to high quality). Reviews, meta-analyses and other articles that did not meet the criteria were excluded. The PRISMA methodology was applied for studies' selection. A total of 9 studies were selected for a systematic and comprehensive analysis. According to these studies, moderate to high intensity aerobic exercise (AE), increases the level of peripheral BDNF and positively influences functional gains in neurological conditions. Larger outcomes are observed in protocols with minimum session duration of 30 minutes, frequency of 3 times/week and intervention duration of 4 weeks. Current evidence shows that moderate to high intensity AE induces neuroplasticity in neurological patients, thus being a fundamental therapeutic strategy to include in interventions aiming to repair/delay neurological dysfunctions.
神经可塑性是神经系统根据功能需求进行塑造和适应的重要机制。有证据表明，体育锻炼会引发一系列有利于大脑可塑性的细胞过程。脑源性神经营养因子（BDNF）是一种与神经可塑性密切相关的神经营养因子，可因运动而增加。为了验证治疗性运动对成人神经系统疾病（如中风、帕金森病和阿尔茨海默病以及轻度认知障碍）中神经可塑性和/或外周BDNF水平的影响，并探讨其在治疗神经功能障碍中的临床相关性。我们使用PubMed、科学网和Scopus数据库进行了系统综述。纳入标准为：随机对照试验或试点研究；年龄大于18岁的患有神经系统疾病的人类；英文文献；PEDro量表得分≥6分（中等至高质量）。不符合标准的综述、荟萃分析和其他文章被排除。采用PRISMA方法进行研究选择。共选择了9项研究进行系统全面的分析。根据这些研究，中等至高强度有氧运动（AE）可提高外周BDNF水平，并对神经系统疾病的功能改善产生积极影响。在疗程最短持续时间为30分钟、频率为每周3次、干预持续时间为4周的方案中观察到更大的效果。目前的证据表明，中等至高强度的有氧运动可在神经疾病患者中诱导神经可塑性，因此是旨在修复/延缓神经功能障碍的干预措施中应纳入的一项基本治疗策略。
