Constraint-induced movement therapy and rehabilitation exercises lessen motor deficits and volume of brain injury after striatal hemorrhagic stroke in rats
Constraint-induced movement therapy and rehabilitation exercises lessen motor deficits and volume of brain injury after striatal hemorrhagic stroke in rats
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DOI：
10.1161/01.str.0000063374.89732.9f
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发表时间：
2003-04-01
期刊：
影响因子：
8.3
通讯作者：
Colbourne, F
中科院分区：
文献类型：
--
作者：
DeBow, SB;Davies, MLA;Colbourne, F
背景与目的 - 强制性运动疗法（CIMT）可促进人类闭塞性脑卒中后的运动恢复，但其在脑出血（ICH）后的疗效尚未在临床或实验室中进行研究。在本研究中，我们测试了CIMT和康复训练方案是否会减轻大鼠脑出血后的运动功能缺陷。
方法 - 大鼠接受纹状体脑出血（通过注入胶原酶）或假手术。7天后，开始进行治疗，包括CIMT（同侧前肢约束8小时/天）、康复训练（例如，抓取、行走；1小时/天）或两者结合，持续7天。一些大鼠不接受治疗。在长达60天的存活期内评估运动功能缺陷，之后测定组织损失的体积。
结果 - 未经治疗的脑出血大鼠在穿越水平梯子时肢体滑落次数更多，并且在肢体使用不对称的圆筒测试中表现出对使用对侧爪子减少的不对称性（第28天）。这些大鼠在蒙托亚阶梯测试（第55 - 59天）的熟练抓取方面也明显不太成功。单独使用任何一种疗法都没有带来太多益处。然而，日常训练和CIMT相结合显著且持续地改善了恢复情况。出乎意料的是，该组大鼠组织损失的体积在统计学上比未经治疗的脑出血大鼠更小。
结论 - 集中康复训练和CIMT相结合可有效促进脑出血后的功能恢复，而单独使用任何一种疗法效果都较差。这种疗法可能部分通过减少组织损失的体积起作用，可能是通过在促进重塑的同时减少萎缩来实现的。
Background and Purpose-Constraint-induced movement therapy (CIMT) promotes motor recovery after occlusive stroke in humans, but its efficacy after intracerebral hemorrhage (ICH) has not been investigated clinically or in the laboratory. In this study we tested whether CIMT and a rehabilitation exercise program would lessen motor deficits after ICH in rats.Methods-Rats were subjected to striatal ICH (via infusion of collagenase) or sham stroke. Seven days later, treatment began with CIMT (8 h/d of ipsilateral forelimb restraint), rehabilitation exercises (eg, reaching, walking; 1 h/d), or both for 7 days. Some rats were not treated. Motor deficits were assessed up to the 60-day survival time, after which the volume of tissue lost was determined.Results-Untreated ICH rats made more limb slips traversing a horizontal ladder and showed an asymmetry toward less use of the contralateral paw in the cylinder test of limb use asymmetry (day 28). These rats were also significantly less successful in the Montoya staircase test (days 55 to 59) of skilled reaching. Neither therapy alone provided much benefit. However, the combination of daily exercises and CIMT substantially and persistently improved recovery. Unexpectedly, this group had a statistically smaller volume of tissue lost than untreated ICH rats.Conclusions-The combination of focused rehabilitation exercises and CIMT effectively promotes functional recovery after ICH, while either therapy alone is less effective. This therapy may work in part by reducing the volume of tissue lost, likely through reducing atrophy while promoting remodeling.