Effects of Community Exercise Therapy on Metabolic, Brain, Physical, and Cognitive Function Following Stroke: A Randomized Controlled Pilot Trial
Effects of Community Exercise Therapy on Metabolic, Brain, Physical, and Cognitive Function Following Stroke: A Randomized Controlled Pilot Trial
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DOI：
10.1177/1545968314562116
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发表时间：
2015-08-01
影响因子：
4.2
通讯作者：
Trenell, Michael I.
中科院分区：
文献类型：
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作者：
Moore, Sarah A.;Hallsworth, Kate;Trenell, Michael I.
背景运动疗法可以潜在地改变代谢危险因素和脑生理学，同时改善中风后的功能。objective.探讨卒中后运动对代谢、大脑、认知和功能的短期影响。方法.共有40名参与者（> 50岁，卒中后> 6个月，独立移动的）被招募到一项单盲，平行，随机对照试验，以社区为基础的运动（19周，3次/周，运动组）或拉伸（对照组）。主要结果指标为血糖控制和脑血流量。次要结局指标为心肺功能、血压、血脂、身体成分、脑组织萎缩和局部脑代谢以及身体和认知功能。结果运动未改变血糖控制（稳态模型评估15 +/-08至15 +/-07 vs 16 +/-08至17 +/-07，P = 0.97; CI =-05至049）。内侧颞叶组织血流量随运动而增加（38 +/-8至42 +/-10 mL/100 g/min; P <0.05; CI = 9.0至0.1），而灰质组织体积无任何变化。对照组的内侧颞叶组织血流量没有变化（41 +/-8至40 +/-7 mL/100 g/min; P = 0.13; CI =-3.6至6.7），但灰质萎缩明显。呼吸适应性、舒张压、高密度脂蛋白胆固醇、身体功能和认知也随着运动而改善。结论运动疗法可改善短期代谢、大脑、身体和认知功能，而不会改变卒中后的血糖控制。运动对中风复发、心血管健康和残疾的长期影响现在应该被探索。
Background. Exercise therapy could potentially modify metabolic risk factors and brain physiology alongside improving function post stroke. Objective. To explore the short-term metabolic, brain, cognitive, and functional effects of exercise following stroke. Methods. A total of 40 participants (>50 years, >6 months post stroke, independently mobile) were recruited to a single-blind, parallel, randomized controlled trial of community-based exercise (19 weeks, 3 times/wk, exercise group) or stretching (control group). Primary outcome measures were glucose control and cerebral blood flow. Secondary outcome measures were cardiorespiratory fitness, blood pressure, lipid profile, body composition, cerebral tissue atrophy and regional brain metabolism, and physical and cognitive function. Results. Exercise did not change glucose control (homeostasis model assessment 15 +/- 08 to 15 +/- 07 vs 16 +/- 08 to 17 +/- 07, P = .97; CI = -05 to 049). Medial temporal lobe tissue blood flow increased with exercise (38 +/- 8 to 42 +/- 10 mL/100 g/min; P < .05; CI = 9.0 to 0.1) without any change in gray matter tissue volume. There was no change in medial temporal lobe tissue blood flow in the control group (41 +/- 8 to 40 +/- 7 mL/100 g/min; P = .13; CI = -3.6 to 6.7) but significant gray matter atrophy. Cardiorespiratory fitness, diastolic blood pressure, high-density lipoprotein cholesterol, physical function, and cognition also improved with exercise. Conclusion. Exercise therapy improves short-term metabolic, brain, physical, and cognitive function, without changes in glucose control following stroke. The long-term impact of exercise on stroke recurrence, cardiovascular health, and disability should now be explored.