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Ma Y, Luo J, Wang XQ. The effect and mechanism of exercise for post-stroke pain. Front Mol Neurosci 2022; 15:1074205. [PMID: 36533131 PMCID: PMC9755671 DOI: 10.3389/fnmol.2022.1074205] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2022] [Accepted: 11/18/2022] [Indexed: 08/30/2023] Open
Abstract
One of the common negative effects of a stroke that seriously lowers patients' quality of life is post-stroke pain (PSP). Thus, exercise in PSP management has become a hot research topic. The main advantages of exercise therapy are affordability and ease of acceptance by patients compared to other treatment methods. Therefore, this article reviews the effectiveness and possible mechanisms of exercise interventions for PSP. Exercise training for patients with PSP not only improves physical function but also effectively reduces pain intensity and attenuates the behavioral response to pain. In addition, exercise therapy can improve brain function and modulate levels of pro-inflammatory and neurotrophic factors to exert specific analgesic effects. Potential mechanisms for exercise intervention include modulation of synaptic plasticity in the anterior cingulate gyrus, modulation of endogenous opioids in vivo, reversal of brain-derived neurotrophic factor overexpression, inhibition of purinergic receptor (P2X4R, P2X7R) expression, and inhibition of microglia activation. However, current research on exercise for PSP remains limited, and the sustainable benefits of exercise interventions for PSP need to be further investigated.
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Affiliation(s)
- Yue Ma
- Department of Sport Rehabilitation, Xi’an Physical Education University, Xi’an, China
| | - Jing Luo
- Department of Sport Rehabilitation, Xi’an Physical Education University, Xi’an, China
| | - Xue-Qiang Wang
- Department of Sport Rehabilitation, Shanghai University of Sport, Shanghai, China
- Department of Rehabilitation Medicine, Shanghai Shangti Orthopaedic Hospital, Shanghai, China
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2
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Xie J, Geng X, Fan F, Fu X, He S, Li T. The efficacy of therapies for post-stroke depression in aging: An umbrella review. Front Aging Neurosci 2022; 14:993250. [PMID: 36081895 PMCID: PMC9446482 DOI: 10.3389/fnagi.2022.993250] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2022] [Accepted: 08/08/2022] [Indexed: 12/04/2022] Open
Abstract
Post-stroke depression (PSD) is a common complication after stroke. PSD is associated with emotional disorders and psychological dependence, which are potential risk factors for stroke recurrence and suicidality. This study aimed to perform an umbrella review of therapies for PSD through a comprehensive literature search. A systematic search was conducted in the PubMed and Web of Science by two independent authors. We examined the Hamilton Depression Scale (HAMD), Activities of daily living (ADL), Neurologic function as efficacy endpoints, and the incidence of adverse events as safety profiles. Seventeen eligible studies, including 267 clinical trials were included in this study. The results showed that High-Frequency Repetitive Transcranial Magnetic Stimulation (HfrTMS), Acupuncture/EA+conventional treatment, Escitalopram, Modified Sini San, Moxibustion, Xiaoyao Formula, Paroxetine, Chinese herbal medicine, Exercise, Citalopram, and Cognitive behavioral therapy are beneficial for improving the depression symptoms of patients with PSD. HfrTMS and Sertraline may have an impact on slowing the scores of activities of daily living or neurologic function. In addition, Acupuncture/EA+conventional, Escitalopram, Citalopram, Sertraline, and Fluoxetine showed no serious adverse events in PSD patients. Our study demonstrated that 11 treatment methods can effectively improve the condition of PSD patients.
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Affiliation(s)
- Jinlu Xie
- Key Laboratory of Vector Biology and Pathogen Control of Zhejiang, School of Medicine, Huzhou Central Hospital, Huzhou University, Huzhou, China
| | - Xiwen Geng
- Experimental Centre, Shandong University of Traditional Chinese Medicine, Jinan, China
| | - Fangcheng Fan
- School of Pharmacy, Minzu University of China, Beijing, China
| | - Xuyan Fu
- Key Laboratory of Vector Biology and Pathogen Control of Zhejiang, School of Medicine, Huzhou Central Hospital, Huzhou University, Huzhou, China
| | - Shuaibing He
- Key Laboratory of Vector Biology and Pathogen Control of Zhejiang, School of Medicine, Huzhou Central Hospital, Huzhou University, Huzhou, China,*Correspondence: Shuaibing He
| | - Tao Li
- Key Laboratory of Vector Biology and Pathogen Control of Zhejiang, School of Medicine, Huzhou Central Hospital, Huzhou University, Huzhou, China,Tao Li
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Zhao Y, Wang W, Wang M, Gao F, Hu C, Cui B, Yu W, Ren H. Personalized individual-based exercise prescriptions are effective in treating depressive symptoms of college students during the COVID-19: A randomized controlled trial in China. Front Psychiatry 2022; 13:1015725. [PMID: 36699477 PMCID: PMC9869038 DOI: 10.3389/fpsyt.2022.1015725] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/10/2022] [Accepted: 12/19/2022] [Indexed: 01/11/2023] Open
Abstract
BACKGROUND The COVID-19 pandemic has seriously increased depression prevalence among the public, including Chinese college students. However, many exercise cannot be performed as usual under the stay-at-home order. This study was a 12-week three-arm randomized controlled trial using the intention-to-treat principle, aiming to explore and compare the feasibility and effect of individual-based personalized aerobic-exercise and resistance-training prescriptions on depressive symptoms in college students, and conclude with some recommendations for individual-based exercise prescriptions. METHODS Eighty-six college students with depressive symptoms were randomized into aerobic-exercise (AE), resistance-training (RT), and wait-list control (WLC) groups. Participants in two experimental groups received 12-week personalized AE and RT prescriptions on their individual situations, respectively. No intervention was implemented on participants in the WLC group. Depressive symptoms and physical activity (PA) were measured by Zung Self-Rating Depression Scale (SDS) and International Physical Activity Questionnaire-Short Form (IPAQ-SF), respectively. All data were collected at the baseline, 4, 8, and 12 weeks, and 4-week post-intervention. RESULTS At 12 weeks, 72.09% of depressive participants improved to "normal." Participants exhibited a statistical reduction in SDS in all 3 groups (p < 0.05) at 12 weeks compared to baseline. Follow-up assessments showed no significant increase in SDS at 4-week post-intervention compared to 12 weeks (p > 0.05). The independent t-test revealed significantly lower SDS in AE and RT group than in WLC group (p AE < 0.001 and p RT < 0.05) at 4, 8, and 12 weeks, and 4-week post-intervention. Furthermore, the PA of participants (including total PA and intensities) in both experimental groups represented a significant improvement at 4-week post-intervention compared to baseline (p < 0.05), while no differences were observed in the PA of participants in the WLC group (p > 0.05). CONCLUSION Personalized exercise prescriptions have good feasibility as they can increase adherence to intervention and reduce serious adverse events. Besides, individual-based personalized aerobic-exercise and resistance-training prescriptions result in a similar effect in relieving depressive symptoms and improving physical activity in college students. The individual-based exercise programs performed in 45- to 60- min with progressive moderate-to-vigorous intensity, 3 times/week for at least 12 weeks, may reduce depressive symptoms in college students during the COVID-19.
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Affiliation(s)
- Yuanhui Zhao
- School of Sport Science, Beijing Sport University, Beijing, China.,Key Laboratory of the Ministry of Education of Exercise and Physical Fitness, Beijing Sport University, Beijing, China
| | - Wenxing Wang
- School of Sport Science, Beijing Sport University, Beijing, China.,Key Laboratory of the Ministry of Education of Exercise and Physical Fitness, Beijing Sport University, Beijing, China
| | - Mengdie Wang
- China Institute of Sport Science, Beijing, China
| | - Fang Gao
- School of Sport Science, Beijing Sport University, Beijing, China.,Key Laboratory of the Ministry of Education of Exercise and Physical Fitness, Beijing Sport University, Beijing, China
| | - Chun Hu
- School of Sport Science, Beijing Sport University, Beijing, China.,Key Laboratory of the Ministry of Education of Exercise and Physical Fitness, Beijing Sport University, Beijing, China
| | - Bowen Cui
- School of Sport Science, Beijing Sport University, Beijing, China.,Key Laboratory of the Ministry of Education of Exercise and Physical Fitness, Beijing Sport University, Beijing, China
| | - Wenlang Yu
- School of Sport Science, Beijing Sport University, Beijing, China.,Key Laboratory of the Ministry of Education of Exercise and Physical Fitness, Beijing Sport University, Beijing, China
| | - Hong Ren
- School of Sport Science, Beijing Sport University, Beijing, China.,Key Laboratory of the Ministry of Education of Exercise and Physical Fitness, Beijing Sport University, Beijing, China
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Zhang C, He L, Li Z, Qiu H, Wang X, Zhang Y. Effectiveness of non-pharmacological interventions for treating post-stroke depression: Study protocol of an umbrella review of systematic reviews and meta-analyses. Medicine (Baltimore) 2021; 100:e28370. [PMID: 34941157 PMCID: PMC8702277 DOI: 10.1097/md.0000000000028370] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/25/2021] [Accepted: 12/02/2021] [Indexed: 01/05/2023] Open
Abstract
BACKGROUND Many systematic reviews and meta-analyses have evaluated the effectiveness of non-pharmacological therapies to improve symptoms of post-stroke depression (PSD) and reduce disability and mortality in patients with PSD. However, no research has appraised the credibility of the evidence. This study aims to summarize and evaluate the current evidence for non-pharmacological treatment of PSD and to seek effective treatment with reference to reliable evidence. METHODS We searched the electronic databases EMBASE, MEDLINE, Cochrane Central, PubMed, PROSPERO, Web of Science, and CINAHL. We will search articles from the above database for all published meta-analyses to December 2021 to evaluate the effect of non-pharmacological treatment of PSD. Two reviewers will extract the general characteristics of the included articles, as well as participants, interventions, outcome measures, and conclusions. The quality evaluation of each systematic review will be conducted with reference to the AMSTAR 2 tool. The effect size of each review will be recalculated using either a fixed-effects or a random-effects model. Cochrane's Q test and I2 statistics will be used to evaluate the heterogeneity between studies. To determine whether a systematic review had small study effects, we will use the Egger test. We expect to extract valid evidence and classify it from strong to weak. RESULTS The findings of this umbrella review will provide effective evidence for the non-pharmacological treatment of PSD. CONCLUSION Our research conclusion will provide clinical staff and PSD patients with appropriate treatment recommendations. ETHICS AND DISSEMINATION As the data were obtained from published materials, there is no need for ethical approval for this umbrella review. The findings of this umbrella review will be published in a peer-reviewed journal. INPLASY REGISTRATION NUMBER INPLASY2021100083.
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Affiliation(s)
| | - Lianyi He
- The First Affiliated Hospital of Hunan University of Chinese Medicine, Changsha, Hunan, China
| | - Zhendong Li
- Hunan University of Chinese Medicine, Changsha, Hunan, China
| | - Hangjian Qiu
- Hunan University of Chinese Medicine, Changsha, Hunan, China
| | - Xiaoqian Wang
- Hunan University of Chinese Medicine, Changsha, Hunan, China
| | - Yuejuan Zhang
- The First Affiliated Hospital of Hunan University of Chinese Medicine, Changsha, Hunan, China
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