scholarly journals Forced, Not Voluntary, Aerobic Exercise Enhances Motor Recovery in Persons With Chronic Stroke

2019 ◽  
Vol 33 (8) ◽  
pp. 681-690 ◽  
Author(s):  
Susan M. Linder ◽  
Anson B. Rosenfeldt ◽  
Sara Davidson ◽  
Nicole Zimmerman ◽  
Amanda Penko ◽  
...  
Keyword(s):  
Aerobic Exercise ◽  
Motor Function ◽  
Skill Acquisition ◽  
Randomized Clinical Trials ◽  
Motor Recovery ◽  
Voluntary Exercise ◽  
Fine Motor ◽  
Significant Interaction Effect ◽  
Task Practice ◽  
Recovery Of Motor Function

Background. The recovery of motor function following stroke is largely dependent on motor learning–related neuroplasticity. It has been hypothesized that intensive aerobic exercise (AE) training as an antecedent to motor task practice may prime the central nervous system to optimize motor recovery poststroke. Objective. The objective of this study was to determine the differential effects of forced or voluntary AE combined with upper-extremity repetitive task practice (RTP) on the recovery of motor function in adults with stroke. Methods. A combined analysis of 2 preliminary randomized clinical trials was conducted in which participants (n = 40) were randomized into 1 of 3 groups: (1) forced exercise and RTP (FE+RTP), (2) voluntary exercise and RTP (VE+RTP), or (3) time-matched stroke-related education and RTP (Edu+RTP). Participants completed 24 training sessions over 8 weeks. Results. A significant interaction effect was found indicating that improvements in the Fugl-Meyer Assessment (FMA) were greatest for the FE+RTP group ( P = .001). All 3 groups improved significantly on the FMA by a mean of 11, 6, and 9 points for the FE+RTP, VE+RTP, and Edu+RTP groups, respectively. No evidence of a treatment-by-time interaction was observed for Wolf Motor Function Test outcomes; however, those in the FE+RTP group did exhibit significant improvement on the total, gross motor, and fine-motor performance times ( P ≤ .01 for all observations). Conclusions. Results indicate that FE administered prior to RTP enhanced motor skill acquisition greater than VE or stroke-related education. AE, FE in particular, should be considered as an effective antecedent to enhance motor recovery poststroke.

Abstract 144: Forced Aerobic Exercise Enhances Upper Extremity Task Practice in Patients with Stroke

Stroke ◽  
2015 ◽  
Vol 46 (suppl_1) ◽  
Author(s):  
Susan Linder ◽  
Anson Rosenfeldt ◽  
Jay Alberts
Keyword(s):  
Aerobic Exercise ◽  
Upper Extremity ◽  
Motor Function ◽  
Cardiovascular Health ◽  
Statistical Significance ◽  
Voluntary Exercise ◽  
Depressive Symptomology ◽  
Task Practice ◽  
The Central Nervous System ◽  
Minute Session

Introduction: Aerobic exercise (AE) has been shown to improve cardiovascular health in individuals with stroke; however, the potential role of AE in enhancing neuroplasticity after stroke has not been systematically studied. We have implemented a forced exercise (FE) cycling intervention, initially developed for individuals with Parkinson’s disease, with a cohort of individuals with chronic stroke. We hypothesize that intensive AE training, when paired with repetitive task practice (RTP), will “prime” the central nervous system, to exploit the motor learning effects of task practice. Hypothesis: Individuals who perform FE followed by RTP will demonstrate greater improvements in motor and non-motor function compared to the voluntary rate aerobic exercise (VE) + RTP and RTP only groups. Individuals in both AE groups (FE and VE) will demonstrate greater improvements in VO2peak compared to the RTP only group. Methods: Fifteen individuals 6-12 months post-stroke were enrolled into one of the following groups: 1) Forced Exercise + RTP (FE + RTP); 2) Voluntary Exercise + RTP (VE + RTP); and 3) Time-matched RTP. Participants in the AE groups completed one 45-minute session of stationary cycling followed immediately by one 45-minute session of upper extremity RTP; however, the rate of cycling for the FE group was augmented to approximately 35% faster than their voluntary rate. All participants completed a total of 24 exercise sessions over an 8-week period. Results: While all three groups made significant improvements in motor function as measured by the Fugl-Meyer Assessment (p=.03), the FE+RTP group exceeded the VE+RTP and RTP only groups, approaching statistical significance (p=0.06), despite the two AE groups completing 44% less RTP practice time than the RTP group. Improvements in self-reported quality of life and depressive symptomology also improved across all three groups, with trends favoring the FE group. VO2peak improved by 1.1 and 2.68 mL/kg/min for the FE+RTP and VE+RTP groups, respectively; while VO2peak decreased by 0.85mL/kg/min in the RTP group. Conclusion: FE + RTP is a promising intervention to enhance motor and non-motor function, in addition to aerobic capacity in individuals 6-12 months after stroke.

scholarly journals Longitudinal Assessment of Motor Recovery of Contralateral Hand after Basal Ganglia Infarction Using Functional Magnetic Resonance Imaging

2016 ◽  
Vol 2016 ◽  
pp. 1-9 ◽  
Author(s):  
Yue Fu ◽  
Quan Zhang ◽  
Chunshui Yu ◽  
Jing Zhang ◽  
Ning Wang ◽  
...  
Keyword(s):  
Basal Ganglia ◽  
Motor Function ◽  
Acute Phase ◽  
Block Design ◽  
Chronic Phase ◽  
Motor Recovery ◽  
Activation Domain ◽  
Functional Rehabilitation ◽  
Time Points ◽  
Recovery Of Motor Function

We used functional fMRI to study the brain activation during active finger movements at different time points during the recovery phase following basal ganglia infarction. Four hemiplegic patients with basal ganglia infarction were serially evaluated at different time points spanning the acute and chronic phase using fMRI. To evaluate motor recovery, the patients were asked to perform functional tasks arranged in a block design manner with their hand. On follow-up (chronic phase), three patients achieved significant recovery of motor function of affected limbs. Activation of bilateral sensorimotor cortex (SMC) was observed in two of these patients, while activation of cerebellum was observed in all patients. No remarkable recovery of motor function was noted in one patient with left basal ganglia infarction. In this patient, the activation domain was located in SMC of both sides in acute phase and in ipsilateral SMC in chronic phase. Contralateral SMC appears to be involved in the functional rehabilitation following basal ganglia infarction. The cerebellum may act as an intermediary during functional recovery following basal ganglia infarction. The activation domain associated with active finger movement may be bilateral in acute phase; one patient was ipsilateral in the chronic stage.

scholarly journals Effects of Repetitive Transcranial Magnetic Stimulation (rTMS) Combined with Aerobic Exercise on the Recovery of Motor Function in Ischemic Stroke Rat Model

2020 ◽  
Vol 10 (3) ◽  
pp. 186 ◽  
Author(s):  
Juanxiu Cui ◽  
Cuk-Seong Kim ◽  
Yeongwook Kim ◽  
Min Kyun Sohn ◽  
Sungju Jee
Keyword(s):  
Transcranial Magnetic Stimulation ◽  
Combination Therapy ◽  
Aerobic Exercise ◽  
Motor Function ◽  
Rat Model ◽  
Magnetic Stimulation ◽  
Repetitive Transcranial Magnetic Stimulation ◽  
Therapeutic Effects ◽  
Therapeutic Benefits ◽  
Recovery Of Motor Function

The therapeutic benefits of repetitive transcranial magnetic stimulation (rTMS) combined with rehabilitation therapy on recovery after stroke have not been fully elucidated. This study aimed to explore the therapeutic effects of rTMS followed by aerobic exercise on neuroplasticity and recovery of motor function in a rat model of permanent middle cerebral artery occlusion (MCAO). Rats were randomized into sham operation (N = 10, sham op), MCAO (N = 10, control group), rTMS (N = 10, MCAO and rTMS therapy), and combination groups (N = 10, MCAO and combination therapy). High-frequency rTMS (10 Hz) was applied on the ipsilesional forepaw motor cortex, and aerobic exercise training on the rotarod was performed for two weeks. The rotarod and Garcia tests were conducted to evaluate changes in behavioral function. Motor evoked potentials (MEPs) were used to evaluate electrophysiological changes. Stroke severity was assessed using infarction volume measurement. Neuronal recovery was explored with western blot for brain-derived neurotrophic factor (BDNF) pathway proteins. Compared with control therapy, combination therapy was significantly more effective than rTMS therapy for improving function on the rotarod test (p = 0.08), Garcia test (p = 0.001), and MEP amplitude (p = 0.001) In conclusion, combination therapy may be a potential treatment to promote recovery of motor function and neuroplasticity in stroke patients.

Effects of Diabetes on Motor Recovery After Cerebral Infarct: A Diffusion Tensor Imaging Study

2019 ◽  
Vol 104 (9) ◽  
pp. 3851-3858 ◽  
Author(s):  
Jun Sung Moon ◽  
Seung Min Chung ◽  
Sung Ho Jang ◽  
Kyu Chang Won ◽  
Min Cheol Chang
Keyword(s):  
Motor Function ◽  
Corticospinal Tract ◽  
Diffusion Tensor ◽  
Imaging Study ◽  
Motor Recovery ◽  
Cerebral Infarct ◽  
Corona Radiata ◽  
Patients With Diabetes ◽  
Diffusion Tensor Imaging Study ◽  
Recovery Of Motor Function

AbstractObjectiveLittle is known about the effects of diabetes on motor recovery after cerebral infarct. To address this question, we recruited patients with corona radiata infarct and controlled for the integrity of the corticospinal tract (CST) as determined by diffusion tensor tractography (DTT).DesignOne hundred patients were recruited, and DTT was performed within 7 to 30 days of infarct onset. Based on the DTT findings (DTT+, CST was preserved around the infarct; DTT−, CST was interrupted by the infarct) and the presence (DM+) or absence (DM−) of diabetes, patients were divided into DTT+/DM− (36 patients), DTT+/DM+ (19 patients), DTT−/DM− (32 patients), and DTT−/DM+ (13 patients) groups. Six months after cerebral infarct, motor function on the affected side was evaluated for each patient via the upper motricity index (MI), lower MI, modified Brunnstrom classification (MBC), and functional ambulation category (FAC).ResultsIn the patients with a DTT+ finding, no motor function scores were significantly different between the DTT+/DM− and DTT+/DM+ groups at 6-month evaluation. However, in patients with DTT− finding, all motor function scores at the 6-month evaluation were significantly higher in the DTT−/DM− group than in the DTT−/DM+ group.ConclusionWhen the CST is interrupted by a corona radiata infarct, recovery of motor function in patients with diabetes is more impaired than those without diabetes.

scholarly journals Physical activity dimensions after stroke: patterns and relation with lower limb motor function

2021 ◽  
Vol 18 (1) ◽  
Author(s):  
Hanneke E. M. Braakhuis ◽  
Monique A. M. Berger ◽  
Ruben G. R. H. Regterschot ◽  
Erwin E. H. van Wegen ◽  
Ruud W. Selles ◽  
...  
Keyword(s):  
Physical Activity ◽  
Motor Function ◽  
Lower Limb ◽  
Inpatient Rehabilitation ◽  
Individual Variability ◽  
Motor Recovery ◽  
Stroke Survivors ◽  
Activity Levels ◽  
Significant Interaction Effect ◽  
Physical Activity Levels

Abstract Background Stroke survivors show deteriorated physical functioning and physical activity levels. Physical activity levels of stroke survivors are generally low. It is increasingly recognized that physical activity is a multidimensional construct that cannot be captured in a single outcome. In-depth insight into multidimensional physical activity patterns may guide the development and timing of targeted rehabilitation interventions. This longitudinal cohort study explored how multidimensional physical activity outcomes develop during recovery in the subacute phase after stroke and if changes in physical activity were correlated to recovery of lower limb motor function. Methods Patients were recruited during inpatient rehabilitation. At 3, 12, and 26 weeks post-onset, motor function was measured by the Fugl-Meyer Lower Extremity Assessment (FMA-LE). Physical activity was measured with the Activ8 accelerometer in multiple outcomes: counts per minute during walking (CPMwalking; a measure of Intensity), number of active bouts (Frequency), mean length of active bouts (Distribution) and % of waking time in upright positions (Duration). Generalized estimating equations (GEE) were used to study changes in physical activity over time and the relation with the change in lower limb motor recovery. Results Thirty-nine patients (age 56 ± 9, 77% male, 89% ischemic stroke) were included. GEE models showed a significant main effect of time for PA Intensity (+ 13%, p = 0.007) and Duration (+ 64%, p = 0.012) between 3 and 12 weeks. Motor function did not show a significant effect in all PA models across the 3 timepoints (p > 0.020). A significant interaction effect of time × motor function was observed (p < 0.001). Conclusions Patterns of PA recovery depend on the PA dimensions: PA Intensity and Duration increased mostly between 3 and 12 weeks post-stroke, whereas Frequency and Distribution did not show substantial changes. Further, no strong associations with motor recovery and high inter-individual variability were documented, which underlies the need to consider factors specific to the disease, the individual patient and the context.

scholarly journals Forced Aerobic Exercise Preceding Task Practice Improves Motor Recovery Poststroke

2017 ◽  
Vol 71 (2) ◽  
pp. 7102290020p1 ◽  
Author(s):  
Susan M. Linder ◽  
Anson B. Rosenfeldt ◽  
Tanujit Dey ◽  
Jay L. Alberts
Keyword(s):  
Aerobic Exercise ◽  
Motor Recovery ◽  
Task Practice

scholarly journals The effect of GMFCS level, age, sex, and dystonia on multi-dimensional outcomes after selective dorsal rhizotomy: prospective observational study

2021 ◽  
Vol 37 (5) ◽  
pp. 1729-1740
Author(s):  
Conor Scott Gillespie ◽  
◽  
Alan Matthew George ◽  
Benjamin Hall ◽  
Steven Toh ◽  
...  
Keyword(s):  
Motor Function ◽  
Self Care ◽  
Pediatric Neurosurgery ◽  
Care Quality ◽  
Fine Motor ◽  
Selective Dorsal Rhizotomy ◽  
Dorsal Rhizotomy ◽  
Significant Difference ◽  
Age Category ◽  
Gmfcs Level

Abstract Purpose Investigate the effect of age category (1–9 years vs 10–18 years), sex, Gross Motor Function Classification System (GMFCS) level, and presence of dystonia on changes in eight function test parameters 24 months after selective dorsal rhizotomy (SDR). Methods Prospective, single-center study of all children aged 3–18 years with bilateral cerebral palsy with spasticity who underwent SDR at a tertiary pediatric neurosurgery center between 2012 and 2019. A linear mixed effects model was used to assess longitudinal changes. Results From 2012 to 2019, 42 children had follow-up available at 24 months. Mean GMFM-66 scores increased after SDR (mean difference 5.1 units: 95% CI 3.05–7.13, p < 0.001). Statistically significant improvements were observed in CPQoL, PEDI Self-care and Mobility, 6MWT, Gillette, and MAS scores. There was no significant difference in the improvements seen for age category, sex, GMFCS level, and presence of dystonia for most of the parameters tested (5/8, 6/8, 5/8, and 6/8 respectively). Conclusion SDR may improve gross and fine motor function, mobility and self-care, quality of life, and overall outcome based on extensive scoring parameter testing at 24 months. Atypical patient populations may benefit from SDR if appropriately selected. Multi-center, prospective registries investigating the effect of SDR are required.

Sign in / Sign up

Export Citation Format

Share Document