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Zeng WT, Zhou LT, Jia R, Liu Y, Cai Q, Qu Y. Aconitum coreanum and processed products on its base prevent stroke via the PI3K/Akt and KEAP1/NRF2 in the in vivo study. Metab Brain Dis 2024; 39:705-718. [PMID: 38795262 DOI: 10.1007/s11011-024-01357-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/06/2023] [Accepted: 05/06/2024] [Indexed: 05/27/2024]
Abstract
Aconitum coreanum (A. coreanum), a traditional Chinese medicine, has been proved to treat ischemic stroke (IS). However, the mechanisms of A. coreanum's anti-stroke is currently unknown. This study aimed to uncover the effect and mechanisms of A. coreanum. And study raw Aconitum coreanum (RA) and steamed Aconitum coreanum (SA) and Aconitum coreanum processed with ginger and Alumen (GA) on the mechanism of the pharmacological action of treating IS. Determining whether the efficacy is affected after processing. The right unilateral ligation of the carotid artery of gerbils was used to mimic IS. The neurological function score, infarct volume, oxidative stress level and inflammatory factor expression were measured in gerbils after IS. Western blot and immunofluorescence analyses were conducted to evaluate the expression of related proteins. Metabolomic analyzes IS-related metabolic pathways in urinary metabolites. RA, SA and GA significantly improved the infarct volume and behavioral score of IS gerbils, increased the expression of brain tissue superoxide dismutase (SOD), glutathione (GSH), nitric oxide (NO) and decreased the content of malondialdehyde (MDA), interleukin-6 (IL-6), tumor necrosis factor-α (TNF-α). Western blot and immunofluorescence analysis results showed that RA, SA and GA significantly increased the expression of P-Akt, PI3K, HO-1 and KEAP1. Metabolomic studies identified 112 differential metabolites, including L-Proline, Riboflavin, Leukotriene D4, and 7-Methylxanthine, as potential biomarkers of stroke, involving 14 metabolic pathways including riboflavin metabolism, pyrimidine metabolism, and purine metabolism. Our findings indicated that A. coreanum protected against cerebral ischemia injury probably via the PI3K/Akt and KEAP1/NRF2 pathway. A. coreanum before and after processing both had a protective effect against IS brain injury in gerbils. The A. coreanum efficacy was not reduced after processing. Even compared to RA, SA had better efficacy.
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Affiliation(s)
- Wan-Ting Zeng
- College of Pharmacy, Liaoning University of Traditional Chinese Medicine, Dalian, 116600, China
| | - Li-Ting Zhou
- College of Pharmacy, Liaoning University of Traditional Chinese Medicine, Dalian, 116600, China
| | - Ru Jia
- College of Pharmacy, Liaoning University of Traditional Chinese Medicine, Dalian, 116600, China
| | - Yue Liu
- College of Pharmacy, Liaoning University of Traditional Chinese Medicine, Dalian, 116600, China
| | - Qian Cai
- College of Pharmacy, Liaoning University of Traditional Chinese Medicine, Dalian, 116600, China.
| | - Yang Qu
- College of Pharmacy, Liaoning University of Traditional Chinese Medicine, Dalian, 116600, China.
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Aze OD, Ojardias E, Akplogan B, Giraux P, Calmels P. Structural and pathophysiological muscle changes up to one year after post-stroke hemiplegia: a systematic review. Eur J Phys Rehabil Med 2023; 59:474-487. [PMID: 37695037 PMCID: PMC10548887 DOI: 10.23736/s1973-9087.23.07844-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2022] [Revised: 05/31/2023] [Accepted: 07/17/2023] [Indexed: 09/12/2023]
Abstract
INTRODUCTION Muscle changes after stroke cannot be explained solely on the basis of corticospinal bundle damage. Muscle-specific changes contribute to limited functional recovery but have been poorly characterized. EVIDENCE ACQUISITION We conducted a systematic review of muscular changes occurring at the histological, neuromuscular and functional levels during the first year after the onset of post-stroke hemiplegia. A literature search was performed on PubMed, Embase and CINHAL databases up to November 2022 using a keyword combination comprising cerebral stroke, hemiplegic, atrophy, muscle structure, paresis, skeletal muscle fiber type, motor unit, oxidative stress, strength, motor control. EVIDENCE SYNTHESIS Twenty-seven trial reports were included in the review, out of 12,798 articles screened. Structural modifications described on the paretic side include atrophy, transformation of type II fibers into type I fibers, decrease in fiber diameter and apparent myofilament disorganization from the first week post-stroke up to the fourth month. Reported biochemical changes comprise the abnormal presence of lipid droplets and glycogen granules in the subsarcolemmal region during the first month post-stroke. At the neurophysiological level, studies indicate an early decrease in the number and activity of motor units, correlated with the degree of motor impairment. All these modifications were present to a lesser degree on the non-paretic side. Although only sparse data concerning the subacute stage are available, these changes seem to appear during the first two weeks post-stroke and continue up to the third or fourth month. CONCLUSIONS Considering these early pathophysiological changes on both the paretic and non-paretic sides, it seems crucial to promptly stimulate central and also peripheral muscular activation after stroke through specific rehabilitation programs focused on the maintenance of muscle capacities associated with neurological recovery or plasticity.
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Affiliation(s)
- Oscar D Aze
- Interuniversity Lab of Motricity Biology, Savoie Mont-Blanc University, Jean Monnet Saint-Etienne Universities, CHU Saint-Etienne, Lyon1, Saint-Etienne, France
- Impairments, Adapted Physical Activities and Rehabilitation Research Unit (UR-DAPAR), National Institute of Youth, Physical Education, and Sports, Abomey-Calavi University (INJEPS-UAC), Porto-Novo, Benin
- Service of Physical Medicine and Readaptation, CHU Saint-Etienne, Saint-Etienne, France
| | - Etienne Ojardias
- Service of Physical Medicine and Readaptation, CHU Saint-Etienne, Saint-Etienne, France -
- Inserm UMR-S 1028, Lyon Neuroscience Research Center, Lyon1 and Saint-Etienne Universities, Saint-Etienne, France
| | - Barnabé Akplogan
- Impairments, Adapted Physical Activities and Rehabilitation Research Unit (UR-DAPAR), National Institute of Youth, Physical Education, and Sports, Abomey-Calavi University (INJEPS-UAC), Porto-Novo, Benin
| | - Pascal Giraux
- Service of Physical Medicine and Readaptation, CHU Saint-Etienne, Saint-Etienne, France
- Inserm UMR-S 1028, Lyon Neuroscience Research Center, Lyon1 and Saint-Etienne Universities, Saint-Etienne, France
| | - Paul Calmels
- Interuniversity Lab of Motricity Biology, Savoie Mont-Blanc University, Jean Monnet Saint-Etienne Universities, CHU Saint-Etienne, Lyon1, Saint-Etienne, France
- Service of Physical Medicine and Readaptation, CHU Saint-Etienne, Saint-Etienne, France
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García-Bernal MI, González-García P, Madeleine P, Casuso-Holgado MJ, Heredia-Rizo AM. Characterization of the Structural and Mechanical Changes of the Biceps Brachii and Gastrocnemius Muscles in the Subacute and Chronic Stage after Stroke. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:1405. [PMID: 36674159 PMCID: PMC9864550 DOI: 10.3390/ijerph20021405] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/21/2022] [Revised: 01/05/2023] [Accepted: 01/10/2023] [Indexed: 06/17/2023]
Abstract
The objective of this study was to characterize the changes of muscle tone, stiffness, and thickness of upper and lower limb muscles in stroke survivors. Forty patients with subacute or chronic stroke and 31 controls were included and measured using myotonometry (MyotonPRO), with multiple site assessments at muscle belly (MB) and musculotendinous (MT) locations of the biceps brachii and gastrocnemius muscles. Muscle thickness (ultrasonography) was obtained for each muscle. Upper and lower limb motor performance was evaluated with the Fugl−Meyer Assessment for Upper Extremity and the Functional Ambulance Category. Overall, muscle tone and stiffness were significantly higher at MT than at MB sites. Among stroke patients, differences between the paretic and nonparetic limb were found for the biceps brachii, with lower muscle tone, stiffness, and thickness of the paretic side (all, p < 0.05). There were weak to moderate correlations between mechanical (myotonometry) and structural (ultrasound) muscular changes, regardless of the post-stroke stage. This suggests that myotonometry and ultrasonography assess similar, although different, constructs and can be combined in the clinical setting. Their discriminative ability between the paretic and nonparetic sides and between participants with and without stroke differs depending on the muscle, the functional level, and the stroke stage.
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Affiliation(s)
- María Isabel García-Bernal
- Departmento de Fisioterapia, Facultad de Enfermería, Fisioterapia y Podología, Universidad de Sevilla, 41009 Sevilla, Spain
- Instituto de Biomedicina de Sevilla (IBIS), 41013 Sevilla, Spain
| | - Paula González-García
- Departmento de Fisioterapia, Facultad de Enfermería, Fisioterapia y Podología, Universidad de Sevilla, 41009 Sevilla, Spain
- Instituto de Biomedicina de Sevilla (IBIS), 41013 Sevilla, Spain
| | - Pascal Madeleine
- Sport Sciences—Performance and Technology, Department of Health Science and Technology, Aalborg University, 9220 Aalborg, Denmark
| | - María Jesús Casuso-Holgado
- Departmento de Fisioterapia, Facultad de Enfermería, Fisioterapia y Podología, Universidad de Sevilla, 41009 Sevilla, Spain
- Uncertainty, Mindfulness, Self, Spirituality (UMSS) Research Group, Universidad de Sevilla, 41009 Sevilla, Spain
| | - Alberto Marcos Heredia-Rizo
- Departmento de Fisioterapia, Facultad de Enfermería, Fisioterapia y Podología, Universidad de Sevilla, 41009 Sevilla, Spain
- Uncertainty, Mindfulness, Self, Spirituality (UMSS) Research Group, Universidad de Sevilla, 41009 Sevilla, Spain
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Abstract
Spasticity is characterized by an enhanced size and reduced threshold for activation of stretch reflexes and is associated with "positive signs" such as clonus and spasms, as well as "negative features" such as paresis and a loss of automatic postural responses. Spasticity develops over time after a lesion and can be associated with reduced speed of movement, cocontraction, abnormal synergies, and pain. Spasticity is caused by a combination of damage to descending tracts, reductions in inhibitory activity within spinal cord circuits, and adaptive changes within motoneurons. Increased tone, hypertonia, can also be caused by changes in passive stiffness due to, for example, increase in connective tissue and reduction in muscle fascicle length. Understanding the cause of hypertonia is important for determining the management strategy as nonneural, passive causes of stiffness will be more amenable to physical rather than pharmacological interventions. The management of spasticity is determined by the views and goals of the patient, family, and carers, which should be integral to the multidisciplinary assessment. An assessment, and treatment, of trigger factors such as infection and skin breakdown should be made especially in people with a recent change in tone. The choice of management strategies for an individual will vary depending on the severity of spasticity, the distribution of spasticity (i.e., whether it affects multiple muscle groups or is more prominent in one or two groups), the type of lesion, and the potential for recovery. Management options include physical therapy, oral agents; focal therapies such as botulinum injections; and peripheral nerve blocks. Intrathecal baclofen can lead to a reduction in required oral antispasticity medications. When spasticity is severe intrathecal phenol may be an option. Surgical interventions, largely used in the pediatric population, include muscle transfers and lengthening and selective dorsal root rhizotomy.
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Affiliation(s)
- Jonathan Marsden
- School of Health Professions, Faculty of Health, University of Plymouth, Plymouth, United Kingdom.
| | - Valerie Stevenson
- Department of Therapies and Rehabilitation, National Hospital for Neurology and Neurosurgery UCLH, London, United Kingdom
| | - Louise Jarrett
- Department of Neurology, Royal Devon and Exeter Hospital, Exeter, United Kingdom
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García-Bernal MI, González-García P, Casuso-Holgado MJ, Cortés-Vega MD, Heredia-Rizo AM. Measuring Mechanical Properties of Spastic Muscles After Stroke. Does Muscle Position During Assessment Really Matter? Arch Phys Med Rehabil 2022; 103:2368-2374. [PMID: 35724753 DOI: 10.1016/j.apmr.2022.05.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2022] [Revised: 05/04/2022] [Accepted: 05/08/2022] [Indexed: 12/14/2022]
Abstract
OBJECTIVE To investigate the influence of muscle position (relaxed vs stretched) on muscle mechanical properties and the ability of myotonometry to detect differences between sides, groups, and sites of testing in patients with stroke. We also analyzed the association between myotonometry and clinical measures of spasticity. DESIGN Cross-sectional study. SETTING Outpatient rehabilitation units including private and public centers. PARTICIPANTS Seventy-one participants (20 subacute stroke, 20 chronic stroke, 31 controls) were recruited (N=71). INTERVENTION Muscle mechanical properties were measured bilaterally with a MyotonPRO at muscle belly and musculotendinous sites during 2 protocols (muscle relaxed or in maximal bearable stretched position). MAIN OUTCOME MEASURES Muscle tone and stiffness of the biceps brachii and gastrocnemius. Poststroke spasticity was evaluated with the Modified Tardieu Scale (MTS). A mixed-model analysis of variance was used to detect differences in the outcome measures. RESULTS The analysis of variance showed a significant effect of muscle position on muscle mechanical properties (higher tone and stiffness with the muscle assessed in stretched position). Measurements with the stretched muscle could help discriminate between spastic and nonspastic sides, but only at the biceps brachii. Overall, there was a significant increase in tone and stiffness in the chronic stroke group and in myotendinous sites compared with muscle belly sites (all, P<.05). No correlations were found between myotonometry and the MTS. CONCLUSIONS Myotonometry assessment of mechanical properties with the muscle stretched improves the ability of myotonometry to discriminate between sides in patients after stroke and between people with and without stroke.
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Affiliation(s)
- María-Isabel García-Bernal
- Departmento de Fisioterapia, Facultad de Enfermería, Fisioterapia y Podología, Universidad de Sevilla, Sevilla, Spain
| | - Paula González-García
- Departmento de Fisioterapia, Facultad de Enfermería, Fisioterapia y Podología, Universidad de Sevilla, Sevilla, Spain.
| | - María Jesús Casuso-Holgado
- Departmento de Fisioterapia, Facultad de Enfermería, Fisioterapia y Podología, Universidad de Sevilla, Sevilla, Spain; UMSS Research Group, Universidad de Sevilla, Sevilla, Spain
| | - María Dolores Cortés-Vega
- Departmento de Fisioterapia, Facultad de Enfermería, Fisioterapia y Podología, Universidad de Sevilla, Sevilla, Spain
| | - Alberto Marcos Heredia-Rizo
- Departmento de Fisioterapia, Facultad de Enfermería, Fisioterapia y Podología, Universidad de Sevilla, Sevilla, Spain; UMSS Research Group, Universidad de Sevilla, Sevilla, Spain
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Takahashi Y, Kawakami M, Mikami R, Nakajima T, Nagumo T, Yamaguchi T, Honaga K, Kondo K, Ishii R, Fujiwara T, Liu M. Relationship between spinal reflexes and leg motor function in sub-acute and chronic stroke patients. Clin Neurophysiol 2022; 138:74-83. [DOI: 10.1016/j.clinph.2022.02.025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2021] [Revised: 01/27/2022] [Accepted: 02/27/2022] [Indexed: 11/03/2022]
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García-Salazar LF, Ribeiro JAM, Saade-Pacheco CR, Mattiello SM, Catai AM, Garcia-Araújo AS, Russo TL. Adiponectin Concentration and Chronic Stroke Individuals, Associations with Body Composition, Physical Activity Levels and Lipid Profile: A Cross-Sectional Explorative Study. J Stroke Cerebrovasc Dis 2021; 30:105993. [PMID: 34325270 DOI: 10.1016/j.jstrokecerebrovasdis.2021.105993] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2021] [Revised: 06/25/2021] [Accepted: 07/01/2021] [Indexed: 12/18/2022] Open
Abstract
OBJECTIVE Higher adiponectin concentration has been associated with the presence of sarcopenia in individuals with cardiovascular diseases. Post-stroke individuals presented higher adiponectin concentrations than non-stroke ones. However, no previous study has investigated the association between the adiponectin concentration and skeletal muscle mass in post-stroke individuals. On the other hand, higher adiponectin concentration has been associated with a more favorable lipid profile and the physical activity level might regulate adiponectin concentration. These associations have not been studied in this population. Thus, the main objective of this study was to determine whether the adiponectin concentration is associated with: (1) body composition; (2) lipid profile; and (3) physical activity level in chronic post-stroke individuals. MATERIALS AND METHODS This study was a correlational, cross-sectional exploratory study. Data on body composition and lipid profile were collected using a bioelectrical impedance analyzer (InBody® 720) and an automated method analyzer (CELL-DYN Ruby), respectively. The physical activity level was measured by the StepWatch® Activity Monitor and the serum adiponectin concentration was analyzed using an enzyme-linked immunosorbent assay kit. Correlation analyses were made using Spearman's rank correlation coefficient (rs). RESULTS Twenty-one post-stroke participants took part in the study. The adiponectin concentration was associated with the following: skeletal muscle mass (rs = -0.78), skeletal muscle mass index (rs = -0.75) and high-density lipoprotein (rs = 0.43). CONCLUSIONS A greater adiponectin concentration is associated with a lower skeletal muscle mass and a higher high-density lipoprotein level in chronic post-stroke individuals, but not with physical activity levels.
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Affiliation(s)
- Luisa Fernanda García-Salazar
- Department of Physical Therapy, Federal University of São Carlos, São Carlos, Brazil; Physical Therapy Program, Rehabilitation Science Research Group, School of Medicine and Health Sciences, Universidad del Rosario, Bogotá, Colombia
| | | | - Cássia Regina Saade-Pacheco
- Department of Physical Therapy, Federal University of São Carlos, São Carlos, Brazil; Educational Foundation of the Municipality of Assis, Municipal Institute of Higher Education of Assis, Assis, Brazil
| | | | - Aparecida Maria Catai
- Department of Physical Therapy, Federal University of São Carlos, São Carlos, Brazil
| | | | - Thiago Luiz Russo
- Department of Physical Therapy, Federal University of São Carlos, São Carlos, Brazil.
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Garcia-Bernal MI, Heredia-Rizo AM, Gonzalez-Garcia P, Cortés-Vega MD, Casuso-Holgado MJ. Validity and reliability of myotonometry for assessing muscle viscoelastic properties in patients with stroke: a systematic review and meta-analysis. Sci Rep 2021; 11:5062. [PMID: 33658623 PMCID: PMC7930253 DOI: 10.1038/s41598-021-84656-1] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2020] [Accepted: 02/16/2021] [Indexed: 01/31/2023] Open
Abstract
There is a lack of consensus about the measurement of the muscle viscoelastic features in stroke patients. Additionally, the psychometric properties of the most-commonly used clinical tools remain controversial. Our objective is to investigate the validity and reliability of myotonometry to assess viscoelastic muscle features in stroke survivors. Pubmed, PEDro, Scopus and Cinahl were systematically searched to include studies reporting the psychometric properties of myotonometric devices used in people after stroke. The QUADAS-2 and the COSMIN checklists were used to assess the methodological quality of the studies and the psychometric properties of myotonometry. Nine studies were included in the qualitative synthesis and data from five of these were pooled in a meta-analysis. Overall, low to moderate risk of bias and applicability concerns were observed. Pooled data from intra-rater reliability for muscle tone showed a mean coefficient of correlation of 0.915 (95% CI: 0.880-0.940, I 2 = 69.2%) for upper limbs, and a mean coefficient of 0.785 (95%CI: 0.708-0.844, I 2 = 4.02%) for lower limbs. Myotonometry seems to be a valid and reliable complementary tool to assess muscle viscoelastic properties in stroke survivors, although definite conclusions about concurrent validity need further research.
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Affiliation(s)
- Maria-Isabel Garcia-Bernal
- grid.9224.d0000 0001 2168 1229Department of Physical Therapy, Faculty of Nursing, Physiotherapy and Podiatry, University of Sevilla, Sevilla, Spain
| | - Alberto Marcos Heredia-Rizo
- grid.9224.d0000 0001 2168 1229Department of Physical Therapy, Faculty of Nursing, Physiotherapy and Podiatry, University of Sevilla, Sevilla, Spain
| | - Paula Gonzalez-Garcia
- grid.9224.d0000 0001 2168 1229Department of Physical Therapy, Faculty of Nursing, Physiotherapy and Podiatry, University of Sevilla, Sevilla, Spain
| | - María-Dolores Cortés-Vega
- grid.9224.d0000 0001 2168 1229Department of Physical Therapy, Faculty of Nursing, Physiotherapy and Podiatry, University of Sevilla, Sevilla, Spain
| | - María Jesús Casuso-Holgado
- grid.9224.d0000 0001 2168 1229Department of Physical Therapy, Faculty of Nursing, Physiotherapy and Podiatry, University of Sevilla, Sevilla, Spain
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Kahn MB, Williams G, Mentiplay BF, Bower KJ, Olver J, Clark RA. Upper Limb Associated Reactions: The Relationship Between Movement Kinematics and Muscle Activity in Seated Versus Walking Testing. Am J Phys Med Rehabil 2021; 100:235-242. [PMID: 33595935 DOI: 10.1097/phm.0000000000001551] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE The aims of this study were to (1) evaluate the relationships between stationary and dynamic associated reaction (AR) tests in people with acquired brain injury using surface electromyography (sEMG) muscle activity and three-dimensional motion analysis kinematic measures and (2) assess the test-retest reliability of sEMG and seated tests of ARs. DESIGN Forty-two adults with acquired brain injury underwent AR testing with seated contralateral maximal voluntary isometric contraction tests and walking (self-selected and fast speeds). Associated reaction measurements included biceps brachii sEMG, elbow goniometry, and three-dimensional motion analysis kinematics during walking. Pearson correlations evaluated the relationships between seated and dynamic walking AR tests and between muscle activity and kinematic measures. Chronic participants were reassessed 1 wk later for reliability. RESULTS A strong (r = 0.65) and moderate (r = 0.53) relationship existed for biceps brachii sEMG during seated and walking tests at self-selected and fast walk, respectively. A weak to moderate relationship existed between biceps brachii sEMG and kinematics during walking and between seated and walking measures of ARs (r = 0.23-0.53). All tests had strong to very strong test-retest reliability (intraclass correlation coefficients, >0.78). CONCLUSION Seated contralateral maximal voluntary isometric contraction tests correlate only weakly to moderately with AR walking kinematics and moderately to strongly with biceps brachii activation during walking. Moderate relationships exist between sEMG and kinematics, indicating that they may provide different information for ARs.
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Affiliation(s)
- Michelle B Kahn
- From the Department of Physiotherapy, Epworth Rehabilitation, Epworth Healthcare, Melbourne (MBK, GW); School of Health and Sport Sciences, University of Sunshine Coast, Sunshine Coast (MBK, RAC); School of Physiotherapy, The University of Melbourne, Melbourne (GW, KJB); La Trobe Sport and Exercise Medicine Research Centre, La Trobe University, Melbourne (BFM); and Epworth Monash Rehabilitation Unit (EMReM), Melbourne, Australia (JO)
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Ribeiro JAM, Oliveira AGDS, Thommazo-Luporini LD, Monteiro CI, Ocamoto GN, Catai AM, Borghi-Silva A, Phillips SA, Russo TL. Underlying mechanisms of oxygen uptake kinetics in chronic post-stroke individuals: A correlational, cross-sectional pilot study. PLoS One 2020; 15:e0241872. [PMID: 33166347 PMCID: PMC7652273 DOI: 10.1371/journal.pone.0241872] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2020] [Accepted: 10/21/2020] [Indexed: 11/30/2022] Open
Abstract
Post-stroke individuals presented deleterious changes in skeletal muscle and in the cardiovascular system, which are related to reduced oxygen uptake ([Formula: see text]) and take longer to produce energy from oxygen-dependent sources at the onset of exercise (mean response time, MTRON) and during post-exercise recovery (MRTOFF). However, to the best of our knowledge, no previous study has investigated the potential mechanisms related to [Formula: see text] kinetics response (MRTON and MRTOFF) in post-stroke populations. The main objective of this study was to determine whether the MTRON and MRTOFF are related to: 1) body composition; 2) arterial compliance; 3) endothelial function; and 4) hematological and inflammatory profiles in chronic post-stroke individuals. Data on oxygen uptake ([Formula: see text]) were collected using a portable metabolic system (Oxycon Mobile®) during the six-minute walk test (6MWT). The time to achieve 63% of [Formula: see text] during a steady state (MTRON) and recovery (MRTOFF) were analyzed by the monoexponential model and corrected by a work rate (wMRTON and wMRTOFF) during 6MWT. Correlation analyses were made using Spearman's rank correlation coefficient (rs) and the bias-corrected and accelerated bootstrap method was used to estimate the 95% confidence intervals. Twenty-four post-stroke participants who were physically inactive took part in the study. The wMRTOFF was correlated with the following: skeletal muscle mass (rs = -0.46), skeletal muscle mass index (rs = -0.45), augmentation index (rs = 0.44), augmentation index normalized to a heart rate of 75 bpm (rs = 0.64), reflection magnitude (rs = 0.43), erythrocyte (rs = -0.61), hemoglobin (rs = -0.54), hematocrit (rs = -0.52) and high-sensitivity C-reactive protein (rs = 0.58), all p < 0.05. A greater amount of oxygen uptake during post-walking recovery is partially related to lower skeletal muscle mass, greater arterial stiffness, reduced number of erythrocytes and higher systemic inflammation in post-stroke individuals.
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Affiliation(s)
| | | | | | | | | | - Aparecida Maria Catai
- Department of Physical Therapy, Federal University of São Carlos, São Carlos, Brazil
| | - Audrey Borghi-Silva
- Department of Physical Therapy, Federal University of São Carlos, São Carlos, Brazil
| | - Shane A. Phillips
- Department of Physical Therapy, College of Applied Health Sciences, University of Illinois at Chicago, Chicago, Illinois, United States of America
| | - Thiago Luiz Russo
- Department of Physical Therapy, Federal University of São Carlos, São Carlos, Brazil
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