Muscle power training to improve depression and walking post-stroke

摘要 抑郁症是中风后最常见的神经精神症状，目前的治疗方法是 大部分无效。抑郁对康复反应有直接和间接的影响，因此受试者 中风后抑郁症（PSD）患者通常被排除在临床试验之外，治疗选择非常有限。 有限公司我们建议确定一种新的高强度抗阻训练计划的影响， 优化步行使用爆炸阻力（POWER）训练，中风后抑郁症状。 此外，我们还将确定抑郁症是否限制了训练引起的肌肉和运动能力的改善。 功能这个项目是基于这样一个前提，即抑郁症会对神经可塑性的潜力产生负面影响。 对治疗作出反应而发生的变化，使得康复可能不会产生相同的适应， 在非抑郁症患者中是如此。我们认为，有效的治疗PSD将导致良性的 循环，减少抑郁增强神经可塑性变化，从而促进功能增益。也就是说， 有效地治疗抑郁症将使个人能够更好地从中风中恢复。更以 除了对抑郁症的有益影响外，POWER训练还可以改善中风后的行走， 为治疗抑郁症提供了一个有吸引力的选择，也为研究 私营部门司对康复的反应。作为该项目一部分提出的实验旨在解决 关键问题涉及：1）POWER训练对抑郁症状的影响; 2） PSD限制训练后的改善; 3）抑郁症改善与 增加行走功能。该项目的顺利完成将为更大规模的建设奠定基础。 试验，以确定剂量参数，以及建立治疗效果的权力训练， 中风后抑郁症，以及确定机制，可能是负责发生的变化， 对治疗的反应。

Abstract Depression is the most common neuropsychiatric manifestation following stroke and current treatments are largely ineffective. Depression has both direct and indirect effects on response to rehabilitation, thus subjects with post-stroke depression (PSD) are routinely excluded from clinical trials and treatment options are extremely limited. We propose to determine the impact of a novel, high-intensity resistance training program, Post-stroke Optimization of Walking using Explosive Resistance (POWER) training, on post-stroke depressive symptoms. Further, we will determine if depression limits training-induced improvements in muscular and locomotor function. This project is based on the premise that depression negatively affects the potential for neuroplastic changes to occur in response to treatment such that rehabilitation may not produce the same adaptations that it does in non-depressed individuals. We propose that effective treatment for PSD would result in a virtuous cycle where reducing depression enhances neuroplastic changes, thereby facilitating functional gains. That is, effectively treating depression will make the individual better able to recover from stroke. Furthermore, in addition to its beneficial effects on depression, POWER training is known to improve post-stroke walking, thus providing an attractive option for treating depression as well as an established vehicle to study the effects of PSD on response to rehabilitation. The experiments proposed as part of this project are designed to address critical questions related to 1) the effects of POWER training on depressive symptoms; 2) the potential for PSD to limit improvements following training; and 3) the interaction between improvements in depression and increases in walking function. Successful completion of this project will provide a foundation for larger scale trials to determine dosing parameters as well as establish therapeutic effectiveness of POWER training on post-stroke depression as well as identify the mechanisms that may be responsible for the changes that occur in response to treatment.