Dissertation
Dissertation > Medicine, health > Neurology and psychiatry > Neurology > Cerebrovascular disease > Acute cerebrovascular disease ( stroke)

The Study on the Effect of Exercise Training Intensity and ES on Recovery Mechanism and Function in Cerebral Stroke

Author ZhangAnJing
Tutor BaiYuLong
School Fudan University
Course Rehabilitation Medicine and Physical Therapy
Keywords MCAO model Cerebral ischemia NR2B receptor phosphorylation Low-intensity exercise training Medium-intensity exercise training Stroke Functional electrical stimulation signal type Motor function Functional Independence Cognitive dysfunction
CLC R743.3
Type Master's thesis
Year 2011
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The first part of different intensity treadmill training on cerebral ischemia in rats NR2B receptor expression Objective: cerebral ischemia model different intensity treadmill training on stroke NR2B receptor expression in rat implications for clinical stroke rehabilitation Select the appropriate exercise intensity provides a theoretical basis. Methods: 144 male adult SD rats were randomly divided to four groups, namely, sham, static group, low-intensity training group, the strength training group, each 36. 108 rats were subjected to permanent MCAO model, modeling after 24 hours, to give different intensity treadmill training intervention. In the first three days after surgery, 7 days, 14 days for neurological science score, weight measurement, drawn after decapitation, respectively, the amount of phosphorylated NR2B receptor expression detection, brain water content and infarct volume was measured. Results: Compared with the rest, exercise training group ischemic hippocampus phosphorylated NR2B receptor expression was significantly decreased with time. 3 after cerebral ischemia and 7 days, low-intensity training group in the rat hippocampal receptor expression was significantly lower than in the strength training group (P <0.05), the two groups on the 14th day of the receptor No significant expression differences. TTC staining showed that the first 7 days, 14 days exercise training group infarct volume was significantly reduced compared with the rest (P lt; 0.01), and low-intensity training group of infarct volume was significantly smaller than the moderate-intensity training group (P <0.05). Exercise training group compared with the rest can significantly reduce the degree of neurological deficit (p <0.05), but not until the first 14 days only statistically significant difference was observed, and the low-intensity training group to reduce the degree of neurological deficit than moderate intensity training group. Brain edema results showed: low-intensity training group can significantly reduce the extent of brain edema (p lt; 0.05), but the strength training group did not reduce cerebral edema. From the experimental animals died during the situation, low-intensity training can significantly reduce mortality after cerebral infarction, while the intensity of the training is not significantly reduce mortality. Changes in body weight in rats showed that: compared with the static, low-intensity weight training can significantly promote the recovery, while the moderate intensity training is ineffective. CONCLUSION: Cerebral ischemia after exercise training is effective and necessary. While low-intensity exercise training in reducing phosphorylation of NR2B receptor expression, reduced infarct volume, promote brain edema absorption, reducing mortality after cerebral ischemia, etc., is more effective interventions. This suggests that in clinical practice, given early after cerebral ischemia in patients treated with low-intensity exercise training may be safer and more effective. The second part of the signal-type functional electrical stimulation on hemiplegic upper limb motor function, cognitive function and mood Objective: To investigate the signal type of functional electrical stimulation on patients with early stroke upper limb motor function, cognitive function and emotional effects . Methods: 48 patients with stroke were randomly divided into four groups, namely, the signal-type functional electrical stimulation therapy group (referred to signal group), the traditional low-frequency electrical stimulation therapy group (referred to as low-group), EMG feedback electric stimulation therapy group (referred to muscle Electric group) as well as non-electrical stimulation therapy group. After enrollment, all patients received conventional rehabilitation treatment, including routine medical therapy, and the same basic rehabilitation. In addition, the electrical stimulation group of patients to be appropriate electrical stimulation therapy. Respectively before treatment and after 20 days using a simplified Fugl-Meyer motor function assessment (upper part), functional comprehensive assessment (FCA), the Mini Mental Scale (MMSE) and Hamilton Depression Scale (HAMD) for patients with upper extremity motor function, cognitive function and mood assessment and statistical analysis. Results: Before treatment, the scale scores in each group showed no statistically significant difference (P gt; 0.05). 20 days after treatment, each group has a different degree of upper limb motor function recovery, but the EMG group, low-frequency group, signal group compared with before treatment differences were statistically significant (P lt; 0.05); without electrical stimulation therapy group and treatment no significant differences before (P gt; 0.05). Treatment of 20 days, the EMG group, signal group to simplify Fugl-Meyer motor function assessment (upper part) and functional comprehensive assessment scale score with no electrical stimulation group and low group were significantly different (P lt; 0.05), but Compared with the EMG signal group, the difference was not statistically significant (P gt; 0.05). After 20 days of treatment, each group there are different levels of cognitive function recovery. Wherein the signal type functional electrical stimulation, EMG feedback and electrical stimulation group MMSE score FCA cognitive portion compared with before treatment were significantly different (P lt; 0.05); domestic low-frequency electrical stimulation group and without electrical stimulation FCA treatment group MMSE and cognitive portion of the score before and after treatment difference was not significant (P gt; 0.05). 20 days after treatment, the signal functional electrical stimulation group and EMG feedback electric stimulation group, the cognitive part of the functional assessment showed no significant difference (P gt; 0.05); but both with and without electrical stimulation group and the low-frequency electrical stimulation of domestic group is statistically significant (P lt; 0.05); domestic low-frequency electrical stimulation group and no electrical stimulation group, MMSE and the cognitive part of the rating scale FCA found no significant difference (P gt; 0.05). After treatment, the signal group and the EMG group of patients, depression is well improved, domestic low-frequency electrical stimulation group and the group of patients without depression obvious improvement. Conclusion: Signal type functional electrical stimulation therapy can promote impaired motor function in stroke patients recover, improve mood disorders, improve cognitive function, and its degree of recovery is similar to EMG biofeedback group, but higher than domestic low-frequency electrical stimulation group and without electrical stimulation group.

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