An Exercise Mimetic Approach to Reduce Poststroke Deconditioning and Enhance Stroke Recovery.
Matthew W McDonaldMatthew Strider JeffersLama IssaAnthony CarterAllyson RipleyLydia M KuhlCameron MorseCesar H CominBernard J JasminBaptiste LacosteDale CorbettPublished in: Neurorehabilitation and neural repair (2021)
Evidence supports early rehabilitation after stroke to limit disability. However, stroke survivors are typically sedentary and experience significant cardiovascular and muscular deconditioning. Despite growing consensus that preclinical and clinical stroke recovery research should be aligned, there have been few attempts to incorporate cardiovascular and skeletal muscle deconditioning into animal models of stroke. Here, we demonstrate in rats that a hindlimb sensorimotor cortex stroke results in both cardiovascular and skeletal muscle deconditioning and impairments in gait akin to those observed in humans. To reduce poststroke behavioral, cardiovascular, and skeletal muscle perturbations, we then used a combinatorial intervention consisting of aerobic and resistance exercise in conjunction with administration of resveratrol (RESV), a drug with exercise mimetic properties. A combination of aerobic and resistance exercise mitigated decreases in cardiovascular fitness and attenuated skeletal muscle abnormalities. RESV, beginning 24 hours poststroke, reduced acute hindlimb impairments, improved recovery in hindlimb function, increased vascular density in the perilesional cortex, and attenuated skeletal muscle fiber changes. Early RESV treatment and aerobic and resistance exercise independently provided poststroke benefits, at a time when individuals are rapidly becoming deconditioned as a result of inactivity. Although no additive effects were observed in these experiments, this approach represents a promising strategy to reduce poststroke behavioral impairments and minimize deconditioning. As such, this treatment regime has potential for enabling patients to engage in more intensive rehabilitation at an earlier time following stroke when mechanisms of neuroplasticity are most prevalent.
Keyphrases
- bone marrow
- skeletal muscle
- high intensity
- atrial fibrillation
- physical activity
- mesenchymal stem cells
- insulin resistance
- resistance training
- end stage renal disease
- randomized controlled trial
- upper limb
- cerebral ischemia
- chronic kidney disease
- body composition
- multiple sclerosis
- stem cells
- emergency department
- risk assessment
- brain injury
- newly diagnosed
- adipose tissue
- young adults
- patient reported outcomes
- subarachnoid hemorrhage
- aortic dissection
- adverse drug
- mechanical ventilation