García-Salazar Luisa Fernanda, Pereira Natalia Duarte, Silva Erika Shirley Moreira, Ribeiro Jean Alex Matos, Nagai Ocamoto Gabriela, Mendes Zambetta Rafaella, de Oliveira Simone Garcia, Catai Aparecida Maria, Borstad Alexandra, Russo Thiago Luiz
Department of Physiotherapy, Federal University of São Carlos (UFSCar), São Carlos, Brazil.
School of Medicine and Health Sciences, Rehabilitation Science Research Group, Universidad del Rosario, Bogotá, Colombia.
Physiother Theory Pract. 2025 Jun;41(6):1191-1202. doi: 10.1080/09593985.2024.2411311. Epub 2024 Oct 6.
Integrating aerobic exercise (AE) into rehabilitation programs for post-stroke individuals could enhance motor recovery and cardiovascular health by increasing brain-derived neurotrophic factor (BDNF) and the myokine irisin. Chronic stroke survivors typically exhibit elevated matrix metalloproteinase-9 (MMP-9) activity, which is negatively correlated with steps and time in medium cadence, although the impact of AE on this biomarker remains unclear.
To evaluate the effect of high-intensity AE training prior to modified constraint-induced movement therapy (mCIMT) on BDNF and irisin concentration, and on MMP-2 and MMP-9 activity in chronic post-stroke individuals and to associate these results with functional improvements.
Nine participants received AE combined with mCIMT for two weeks, while the control group ( = 7) received mCIMT alone. Manual dexterity and functional capacity were assessed before and after the intervention. Serum samples were analyzed for BDNF, irisin, MMP-2 and MMP-9.
There were no significant main effects of assessment, group or interaction on molecular biomarkers. However, the AE group had a significant increase in MMP-9 activity post-intervention ( = .033; = 0.67). For the Box and Block Test, there were significant main effects of assessment ( [1, 14] = 33.27, = .000, = 0.70) and group ( [1, 14] = 5.43, = .035, = .28). No correlations were found between biomarkers and clinical assessments.
AE prior to mCIMT did not influence circulating BDNF and irisin levels but did induce an acute rise in MMP-9 activity, suggesting potential effects on cardiovascular remodeling in this population.
将有氧运动（AE）纳入中风后个体的康复计划中，可通过增加脑源性神经营养因子（BDNF）和肌动蛋白鸢尾素，增强运动恢复能力和心血管健康。慢性中风幸存者通常表现出基质金属蛋白酶-9（MMP-9）活性升高，这与中等节奏下的步数和运动时间呈负相关，尽管AE对该生物标志物的影响尚不清楚。
评估在改良强制性运动疗法（mCIMT）之前进行高强度AE训练对慢性中风后个体BDNF和鸢尾素浓度以及MMP-2和MMP-9活性的影响，并将这些结果与功能改善情况相关联。
9名参与者接受了AE联合mCIMT治疗两周，而对照组（n = 7）仅接受mCIMT治疗。在治疗前后评估手动灵活性和功能能力。分析血清样本中的BDNF、鸢尾素、MMP-2和MMP-9。
评估、组间或交互作用对分子生物标志物均无显著的主效应。然而，AE组干预后MMP-9活性显著增加（p = 0.033；η² = 0.67）。对于箱块测试，评估（F [1, 14] = 33.27，p = 0.000，η² = 0.70）和组间（F [1, 14] = 5.43，p = 0.035，η² = 0.28）均有显著的主效应。未发现生物标志物与临床评估之间存在相关性。
mCIMT之前的AE并未影响循环中的BDNF和鸢尾素水平，但确实导致MMP-9活性急性升高，表明对该人群的心血管重塑可能有潜在影响。
