Skeletal muscle changes after hemiparetic stroke and potential beneficial effects of exercise intervention strategies
Skeletal muscle changes after hemiparetic stroke and potential beneficial effects of exercise intervention strategies
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DOI：
10.1682/jrrd.2007.02.0040
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发表时间：
2008-01-01
影响因子：
--
通讯作者：
Macko, Richard F.
中科院分区：
文献类型：
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作者：
Hafer-Macko, Charlene E.;Ryan, Alice S.;Macko, Richard F.
中风是美国残疾的主要原因。新的证据揭示了中风后骨骼肌的显著结构和代谢变化。肌肉改变包括严重萎缩和轻偏瘫（对侧）腿部肌肉向快肌球蛋白重链转移;两者均与步态缺陷严重程度相关。这种萎缩和肌肉表型转变的潜在分子机制尚不清楚。中风后对侧腿部肌肉中也存在炎症标记物。中风患者胰岛素抵抗和糖尿病的患病率很高。骨骼肌是胰岛素-葡萄糖代谢的主要部位。越来越多的证据表明，炎症途径激活和氧化损伤可导致骨骼肌的消耗、功能改变和胰岛素作用受损。运动对残疾人的健康益处现已得到承认。有氧运动可改善慢性卒中患者的体能、力量和步行能力。治疗性运动可以改变或逆转骨骼肌异常。
Stroke is the leading cause of disability in the United States. New evidence reveals significant structural and metabolic changes in skeletal muscle after stroke. Muscle alterations include gross atrophy and shift to fast myosin heavy chain in the hemiparetic (contralateral) leg muscle; both are related to gait deficit severity. The underlying molecular mechanisms of this atrophy and muscle phenotype shift are not known. Inflammatory markers are also present in contralateral leg muscle after stroke. Individuals with stroke have a high prevalence of insulin resistance and diabetes. Skeletal muscle is a major site for insulin-glucose metabolism. Increasing evidence suggests that inflammatory pathway activation and oxidative injury could lead to wasting, altered function, and impaired insulin action in skeletal muscle. The health benefits of exercise in disabled populations have now been recognized. Aerobic exercise improves fitness, strength, and ambulatory performance in subjects with chronic stroke. Therapeutic exercise may modify or reverse skeletal muscle abnormalities.