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Hyngstrom AS, Nguyen JN, Gutterman DD, Schmit BD, Klevenow EA, Durand MJ. Noninvasive estimation of skeletal muscle oxygen consumption rate and microvascular reactivity in chronic stroke survivors using near-infrared spectroscopy. J Appl Physiol (1985) 2024; 137:23-31. [PMID: 38601999 DOI: 10.1152/japplphysiol.00093.2024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2024] [Revised: 04/02/2024] [Accepted: 04/03/2024] [Indexed: 04/12/2024] Open
Abstract
Understanding post-stroke changes in skeletal muscle oxidative metabolism and microvascular reactivity could help create therapeutic targets that optimize rehabilitative interventions. Due to disuse atrophy, we hypothesized that basal muscle oxygen consumption rate and microvascular endothelial function would be impaired in the tibialis anterior (TA) muscle of the affected leg of chronic stroke survivors compared with the nonaffected leg and versus matched controls. Fifteen chronic stroke survivors (10 females) and 15 matched controls (9 females) completed this study. A near-infrared spectroscopy oximeter measured tissue oxygen saturation (StO2) of the TA in both legs of stroke survivors and the dominant leg of controls. A cuff was placed around the thigh and inflated to 225 mmHg for 5 min while StO2 was continuously measured. The rate of change in StO2 was calculated during cuff occlusion and immediately post-cuff release. The rate of oxygen desaturation was similar between the legs of the stroke survivors (paretic -0.12 ± 0.04%·s-1 vs. nonparetic -0.16 ± 011%·s-1; P = 0.49), but the paretic leg had a reduced desaturation rate versus controls (-0.25 ± 0.18%·s-1; P = 0.007 vs. paretic leg). After cuff release, there was a greater oxygen resaturation rate in the nonparetic leg compared with the paretic leg (3.13 ± 2.08%·s-1 vs. 1.60 ± 1.11%·s-1, respectively; P = 0.01). The control leg had a similar resaturation rate versus the nonparetic leg (control = 3.41 ± 1.79%·s-1; P = 0.69) but was greater than the paretic leg (P = 0.003). The TA in the paretic leg had an impaired muscle oxygen consumption rate and reduced microvascular endothelial function compared with controls.NEW & NOTEWORTHY Secondary consequences of stroke are not well described. In this study, we show that basal muscle oxidative consumption and microvascular endothelial function are reduced in the paretic tibialis anterior muscle of chronic stroke survivors compared with matched controls using near-infrared spectroscopy and the vascular occlusion technique. There was a moderately strong correlation between microvascular endothelial function and paretic leg strength.
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Affiliation(s)
- Allison S Hyngstrom
- Department of Physical Therapy, Marquette University, Milwaukee, Wisconsin, United States
| | - Jennifer N Nguyen
- Department of Physical Medicine and Rehabilitation, Medical College of Wisconsin, Milwaukee, Wisconsin, United States
| | - David D Gutterman
- Department of Medicine, Medical College of Wisconsin, Milwaukee, Wisconsin, United States
| | - Brian D Schmit
- Department of Biomedical Engineering, Marquette University and the Medical College of Wisconsin, Milwaukee, Wisconsin, United States
| | - Emilie A Klevenow
- Department of Physical Therapy, Marquette University, Milwaukee, Wisconsin, United States
| | - Matthew J Durand
- Department of Physical Medicine and Rehabilitation, Medical College of Wisconsin, Milwaukee, Wisconsin, United States
- Cardiovascular Center, Medical College of Wisconsin, Milwaukee, Wisconsin, United States
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Degens H, Paudyal A, Kwakkel G, Slevin M, Maas H. Stroke-induced excess in capillarization relative to oxidative capacity in rats is muscle specific. Physiol Rep 2024; 12:e16153. [PMID: 39016169 PMCID: PMC11253024 DOI: 10.14814/phy2.16153] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2024] [Revised: 07/08/2024] [Accepted: 07/08/2024] [Indexed: 07/18/2024] Open
Abstract
Stroke is not only associated with muscle weakness, but also associated with reduced muscle fatigue resistance and reduced desaturation during exercise that may be caused by a reduced oxidative capacity and/or microvasculature. Therefore, the objective of the present study was to determine the effects of stroke on muscle mass, fiber size and shape, capillarization and oxidative capacity of the rat m. extensor carpi radialis (ECR) and m. flexor carpi ulnaris (FCU) after a photothrombotic stroke in the forelimb region of the primary sensorimotor cortex. The main observation of the present study was that 4 weeks after induction of stroke there were no significant changes in muscle fiber size and shape. Although there was no significant capillary rarefaction, there was some evidence for remodeling of the capillary bed as reflected by a reduced heterogeneity of capillary spacing (p = 0.006) that may result in improved muscle oxygenation. In the ECR, but not in the FCU, this was accompanied by reduction in muscle fiber oxidative capacity as reflected by reduced optical density of sections stained for succinate dehydrogenase (p = 0.013). The reduced oxidative capacity and absence of significant capillary rarefaction resulted in a capillary to fiber ratio per unit of oxidative capacity that was higher after stroke in the ECR (p = 0.01), but not in the FCU. This suggests that at least during the early stages, stroke is not necessarily accompanied by muscle fiber atrophy, and that stroke-induced reductions in oxidative capacity resulting in relative excess of capillarization are muscle specific.
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Affiliation(s)
- Hans Degens
- Department of Life SciencesManchester Metropolitan UniversityManchesterUK
- Institute of Sport Science and InnovationsLithuanian Sports UniversityKaunasLithuania
| | - Arjun Paudyal
- Department of Life SciencesManchester Metropolitan UniversityManchesterUK
- Department of Human Movement Sciences, Faculty of Behavioural and Movement SciencesAmsterdam Movement Sciences, Vrije Universiteit AmsterdamAmsterdamThe Netherlands
| | - Gert Kwakkel
- Department of Rehabilitation MedicineAmsterdam Movement Sciences, Amsterdam Neuroscience, Amsterdam UMC, Vrije Universiteit AmsterdamAmsterdamThe Netherlands
- Department of Physical Therapy and Human Movement Sciences, Feinberg School of MedicineNorthwestern UniversityChicagoIllinoisUSA
- Department of NeurorehabilitationAmsterdam Rehabilitation Research CentreAmsterdamThe Netherlands
| | - Mark Slevin
- Department of Life SciencesManchester Metropolitan UniversityManchesterUK
- The George Emil Palade University of Medicine, Pharmacy, Science, and Technology of Targu MuresTargu MuresTransylvaniaRomania
| | - Huub Maas
- Department of Human Movement Sciences, Faculty of Behavioural and Movement SciencesAmsterdam Movement Sciences, Vrije Universiteit AmsterdamAmsterdamThe Netherlands
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Hyngstrom AS, Nguyen JN, Murphy SA, Raab SC, Schmit BD, Gutterman DD, Durand MJ. Reduced oxygen desaturation in the vastus lateralis of chronic stroke survivors during graded muscle contractions. Top Stroke Rehabil 2024; 31:513-526. [PMID: 38095272 PMCID: PMC11129930 DOI: 10.1080/10749357.2023.2291902] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2023] [Accepted: 12/02/2023] [Indexed: 01/27/2024]
Abstract
BACKGROUND Few studies have examined changes in skeletal muscle physiology post-stroke. This study examined changes in tissue oxygen saturation (StO2) of the vastus lateralis (VL) muscle of stroke survivors and age-matched control participants during maximal and submaximal isometric contractions of the knee extensor muscles. OBJECTIVES We hypothesized that tissue oxygen desaturation (ΔStO2) during knee extensor muscle contractions would be less in the VL in the paretic vs. the non-paretic and control legs. METHODS Ten chronic stroke survivors (>6 months post-stroke) with lower extremity muscle weakness and 10 age-matched controls completed this prospective cohort study. Maximum voluntary contractions (MVCs) of the knee extensor muscles were assessed with a Biodex dynamometer and StO2 of the VL was measured using near-infrared spectroscopy. RESULTS In the paretic leg of the stroke survivors little change in StO2 of the VL was observed during an MVC (ΔStO2 = -1.7 ± 1.8%) compared to the non-paretic (ΔStO2 = -5.1 ± 6.1%; p < 0.05) and control legs (ΔStO2 = -14.4 ± 8.8%; p < 0.05 vs. paretic and non-paretic leg). These differences remained when normalizing for strength differences between the legs. Compared to controls, both the paretic and non-paretic VL showed pronounced reductions in ΔStO2 during ramp and hold contractions equal to 20%, 40%, or 60% of the MVC (p < 0.05 vs. controls at all load levels). CONCLUSIONS These results indicate that oxygen desaturation in response to isometric muscle contractions is impaired in both the paretic and non-paretic leg muscle of stroke survivors compared to age-matched controls, and these differences are independent of differences in muscle strength.
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Affiliation(s)
| | - Jennifer N. Nguyen
- Department of Physical Medicine and Rehabilitation, Medical College of Wisconsin, Milwaukee, WI, USA, 53226
| | - Spencer A. Murphy
- Department of Physical Therapy, Marquette University, Milwaukee, WI, USA, 53233
| | - Stephanie C. Raab
- Department of Physical Therapy, Marquette University, Milwaukee, WI, USA, 53233
| | - Brian D. Schmit
- Department of Biomedical Engineering, Marquette University and the Medical College of Wisconsin, Milwaukee, WI, USA, 53226
| | - David D. Gutterman
- Department of Medicine, Medical College of Wisconsin, Milwaukee, WI, USA, 53226
- Cardiovascular Center, Medical College of Wisconsin, Milwaukee, WI, USA, 53226
| | - Matthew J. Durand
- Department of Physical Medicine and Rehabilitation, Medical College of Wisconsin, Milwaukee, WI, USA, 53226
- Cardiovascular Center, Medical College of Wisconsin, Milwaukee, WI, USA, 53226
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Esen O, Bailey SJ, Stashuk DW, Howatson G, Goodall S. Influence of nitrate supplementation on motor unit activity during recovery following a sustained ischemic contraction in recreationally active young males. Eur J Nutr 2024:10.1007/s00394-024-03440-9. [PMID: 38809323 DOI: 10.1007/s00394-024-03440-9] [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: 08/15/2023] [Accepted: 05/21/2024] [Indexed: 05/30/2024]
Abstract
PURPOSE Dietary nitrate (NO3-) supplementation enhances muscle blood flow and metabolic efficiency in hypoxia, however, its efficacy on neuromuscular function and specifically, the effect on motor unit (MU) activity is less clear. We investigated whether NO3- supplementation affected MU activity following a 3 min sustained ischemic contraction and whether this is influenced by blood flow restriction (BFR) during the recovery period. METHOD In a randomized, double-blinded, cross-over design, 14 males (mean ± SD, 25 ± 6 years) completed two trials following 5 days of supplementation with NO3--rich (NIT) or NO3--depleted (PLA) beetroot juice to modify plasma nitrite (NO2-) concentration (482 ± 92 vs. 198 ± 48 nmol·L-1, p < 0.001). Intramuscular electromyography was used to assess MU potential (MUP) size (duration and area) and mean firing rates (MUFR) during a 3 min submaximal (25% MVC) isometric contraction with BFR. These variables were also assessed during a 90 s recovery period with the first half completed with, and the second half completed without, BFR. RESULTS The change in MUP area and MUFR, did not differ between conditions (all p > 0.05), but NIT elicited a reduction in MUP recovery time during brief isometric contractions (p < 0.001), and during recoveries with (p = 0.002) and without (p = 0.012) BFR. CONCLUSION These novel observations improve understanding of the effects of NO3- on the recovery of neuromuscular function post-exercise and might have implications for recovery of muscle contractile function. TRIAL REGISTRATION The study was registered on clinicaltrials.gov with ID of NCT05993715 on August 08, 2023.
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Affiliation(s)
- Ozcan Esen
- Department of Sport, Exercise and Rehabilitation, Northumbria University, Newcastle-Upon-Tyne, NE1 8ST, UK.
- Department of Health Professions, Manchester Metropolitan University, Manchester, UK.
| | - Stephen J Bailey
- School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, UK
| | - Daniel W Stashuk
- Department of Systems Design Engineering, University of Waterloo, Waterloo, ON, Canada
| | - Glyn Howatson
- Department of Sport, Exercise and Rehabilitation, Northumbria University, Newcastle-Upon-Tyne, NE1 8ST, UK
- Water Research Group, North West University, Potchefstroom, South Africa
| | - Stuart Goodall
- Department of Sport, Exercise and Rehabilitation, Northumbria University, Newcastle-Upon-Tyne, NE1 8ST, UK
- Physical Activity, Sport and Recreation Research Focus Area, Faculty of Health Sciences, North-West University, Potchefstroom, South Africa
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Lee J, Park D, Lee JY, Park J. Effect of Warm-Up Exercise on Functional Regulation of Motor Unit Activation during Isometric Torque Production. J Hum Kinet 2024; 92:29-41. [PMID: 38736599 PMCID: PMC11079928 DOI: 10.5114/jhk/185157] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2023] [Accepted: 02/21/2024] [Indexed: 05/14/2024] Open
Abstract
In this study, we tested several hypotheses related to changes in motor unit activation patterns after warm-up exercise. Fifteen healthy young men participated in the experiment and the main task was to produce voluntary torque through the elbow joint under the isometric condition. The experimental conditions consisted of two directions of torque, including flexion and extension, at two joint angles, 10° and 90°. Participants were asked to increase the joint torque to the maximal level at a rate of 10% of the maximum voluntary torque. The warm-up protocol followed the ACSM guidelines, which increased body temperature by approximately 1.5°C. Decomposition electromyography electrodes, capable of extracting multiple motor unit action potentials from surface signals, were placed on the biceps and triceps brachii muscles, and joint torque was measured on the dynamometer. The mean firing rate and the recruitment threshold of the decomposed motor units were quantified. In addition, a single motor unit activity from the spike train was quantified for each of five selected motor units. The magnitude of joint torque increased with the warm-up exercise for all the experimental conditions. The results of the motor unit analyses showed a positive and beneficial effect of the warm-up exercise, with an increase in both the mean firing rate and the recruitment threshold by about 56% and 33%, respectively, particularly in the agonist muscle. Power spectral density in the gamma band, which is thought to be the dominant voluntary activity, was also increased by the warm-up exercise only in the high threshold motor units.
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Affiliation(s)
- Jiseop Lee
- Department of Physical Education, Seoul National University, Seoul, South Korea
- Division of Geriatrics, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, South Korea
| | - Dawon Park
- Department of Physical Education, Seoul National University, Seoul, South Korea
| | - Joo-Young Lee
- Advanced Institute of Convergence Science, Seoul National University, Seoul, South Korea
- Department of Fashion and Textiles, Seoul National University, Seoul, South Korea
- Research Institute for Human Ecology, Seoul National University, Seoul, South Korea
| | - Jaebum Park
- Department of Physical Education, Seoul National University, Seoul, South Korea
- Advanced Institute of Convergence Science, Seoul National University, Seoul, South Korea
- Institute for Sports Science, Seoul National University, Seoul, South Korea
- Department of AI-Integrated Education, Seoul National University, Seoul, South Korea
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Moyle DB, Kudiersky MN, Totton MN, Sassani DM, Nichols DS, Jenkins DT, Redgrave DJ, Baig DS, Nair DKPS, Majid PA, Ali DAN. Remote ischaemic conditioning for fatigue after stroke (RICFAST): A pilot randomised controlled trial. J Stroke Cerebrovasc Dis 2023; 32:107420. [PMID: 37832270 DOI: 10.1016/j.jstrokecerebrovasdis.2023.107420] [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: 03/14/2023] [Revised: 10/03/2023] [Accepted: 10/06/2023] [Indexed: 10/15/2023] Open
Abstract
BACKGROUND Post stroke fatigue (PSF) affects 50 % of stroke survivors, and can be disabling. Remote ischaemic conditioning (RIC), can preserve mitochondrial function, improve tissue perfusion and may mitigate PSF. This pilot randomised controlled trial evaluates the safety and feasibility of using RIC for PSF and evaluated measures of cellular bioenergetics. METHODS 24 people with debilitating PSF (7 item Fatigue Severity Score, FSS-7 > 4) were randomised (1:1) in this single-centre phase 2 study to RIC (blood pressure cuff inflation around the upper arm 200 mmHg for 5 min followed by 5 min of deflation), or sham (inflation pressure 20 mmHg), repeated 4 cycles, 3 times per week for 6 weeks. Primary outcomes were safety, acceptability, and compliance. Secondary outcomes included FSS-7, 6 min walking test (6MWT), peak oxygen consumption (V̇O2peak), ventilatory anaerobic threshold (VAT), and muscle adenosine triphosphate (ATP) content measured using 31-phosphorous magnetic resonance spectroscopy of tibialis anterior. RESULTS RIC was safe (no serious adverse events, adverse events mild) and adherence excellent (91 % sessions completed). Exploratory analysis revealed lower FSS-7 scores in the RIC group compared to sham at 6 weeks (between group difference FSS-7 -0.7, 95 %CI -2.0 to 0.6), 3 months (-1.0, 95 %CI -2.2 to 0.2) and 6 months (-0.9, 95 %CI -2.0 to 0.2). There were trends towards increased VAT, increased muscle ATP content and improved 6MWT in the RIC group. DISCUSSION RIC is safe and acceptable for people with PSF and may result in clinically meaningful improvements in fatigue and muscle bioenergetics that require further investigation in larger studies.
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Affiliation(s)
| | | | | | - Dr Matilde Sassani
- Translational Brain Science, Institute of Metabolism and Systems Research, UK
| | | | - Dr Tom Jenkins
- Sheffield Institute for Translational Neurology, UK; Royal Perth Hospital, Western Australia, UK
| | | | | | | | | | - Dr Ali N Ali
- Sheffield Teaching Hospitals NIHR Biomedical Research Centre, University of Sheffield, UK.
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Zhang Y, Chen S, Ruan Y, Lin J, Li C, Li C, Xu S, Yan Z, Liu X, Miao P, Jia J. The Facial Skin Blood Flow Change of Stroke Patients with Facial Paralysis after Peripheral Magnetic Stimulation: A Pilot Study. Brain Sci 2022; 12:brainsci12101271. [PMID: 36291205 PMCID: PMC9599644 DOI: 10.3390/brainsci12101271] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2022] [Revised: 08/31/2022] [Accepted: 09/10/2022] [Indexed: 11/16/2022] Open
Abstract
Background: Facial paralysis (FP) is a common symptom after stroke, which influences the quality of life and prognosis of patients. Recently, peripheral magnetic stimulation (PMS) shows potential effects on peripheral and central nervous system damage. However, the effect of PMS on FP after stroke is still unclear. Methods: In this study, we applied PMS on the facial nerve of nine stroke patients with FP. At the same time, laser speckle contrast imaging (LSCI) was used to explore the facial skin blood flow (SkBF) in 19 healthy subjects and nine stroke patients with FP before and after the PMS intervention. The whole face was divided into 14 regions to compare the SkBF in different sub-areas. Results: In baseline SkBF, we found that there were no significant differences in the SkBF between the left and right faces in the healthy subjects. However, there was a significant difference in the SkBF between the affected and unaffected faces in Region 7 (Chin area, p = 0.046). In the following five minutes after the PMS intervention (Pre_0–5 min), the SkBF increased in Region 5 (p = 0.014) and Region 7 (p = 0.046) and there was an increasing trend in Region 3 (p = 0.088) and Region 6 (p = 0.069). In the five to ten minutes after the intervention (Post_6–10 min), the SkBF increased in Region 5 (p = 0.009), Region 6 (p = 0.021) and Region 7 (p = 0.023) and there was an increasing trend in Region 3 (p = 0.080) and left and right whole face (p = 0.051). Conclusions: These pilot results indicate that PMS intervention could increase facial skin blood flow in stroke patients with FP. A further randomized controlled trial can be performed to explore its possible clinical efficacy.
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Affiliation(s)
- Yongli Zhang
- School of Rehabilitation Medicine, Fujian University of Traditional Chinese Medicine, Fuzhou 350122, China
- Department of Rehabilitation Medicine, Huashan Hospital, Fudan University, Shanghai 200040, China
- School of Kinesiology, Shanghai University of Sport, Shanghai 200438, China
| | - Shugeng Chen
- Department of Rehabilitation Medicine, Huashan Hospital, Fudan University, Shanghai 200040, China
| | - Yinglu Ruan
- Department of Rehabilitation Medicine, Shanghai Jing’an District Central Hospital, Shanghai 200040, China
| | - Jiaying Lin
- School of Rehabilitation Medicine, Fujian University of Traditional Chinese Medicine, Fuzhou 350122, China
- Department of Rehabilitation Medicine, Huashan Hospital, Fudan University, Shanghai 200040, China
| | - Chengdong Li
- School of Biomedical Engineering, Shanghai Jiaotong University, Shanghai 200030, China
| | - Chong Li
- Department of Rehabilitation Medicine, Huashan Hospital, Fudan University, Shanghai 200040, China
- School of Kinesiology, Shanghai University of Sport, Shanghai 200438, China
| | - Shuo Xu
- Department of Rehabilitation Medicine, Huashan Hospital, Fudan University, Shanghai 200040, China
| | - Zhijie Yan
- Department of Rehabilitation Medicine, Huashan Hospital, Fudan University, Shanghai 200040, China
| | - Xiangyun Liu
- School of Kinesiology, Shanghai University of Sport, Shanghai 200438, China
| | - Peng Miao
- School of Biomedical Engineering, Shanghai Jiaotong University, Shanghai 200030, China
| | - Jie Jia
- School of Rehabilitation Medicine, Fujian University of Traditional Chinese Medicine, Fuzhou 350122, China
- Department of Rehabilitation Medicine, Huashan Hospital, Fudan University, Shanghai 200040, China
- Department of Rehabilitation Medicine, Shanghai Jing’an District Central Hospital, Shanghai 200040, China
- National Clinical Research Center for Aging and Medicine, Huashan Hospital, Fudan University, Shanghai 200040, China
- National Center for Neurological Disorders, Shanghai 200040, China
- National Regional Medical Center, Fuzhou 350200, China
- Correspondence:
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Mohamed NE, Hussein AA, Sanad DA. Temporal effects of two interferential current applications on peripheral circulation in children with hemiplegic cerebral palsy. J Taibah Univ Med Sci 2022; 18:140-147. [PMID: 36398021 PMCID: PMC9643556 DOI: 10.1016/j.jtumed.2022.08.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2022] [Revised: 07/21/2022] [Accepted: 08/19/2022] [Indexed: 11/30/2022] Open
Abstract
Objectives To determine the short-term effects of sympathetic and peripheral stimulation of interferential current (IFC) on blood flow (BF) in children with hemiplegic cerebral palsy (CP). Methods Thirty children with hemiplegic CP, ranging from 8 to 12 years old, were randomly divided into three groups (10 children/group). The first group received sympathetic stimulation of IFC, the second group received peripheral stimulation of IFC, and the third group (control) received placebo peripheral stimulation of IFC. A frequency of 80–100 Hz at an intensity of 10–20 mA was applied for 20 min. Blood volume pulse (BVP) amplitude was measured before IFC application using a plethysmography sensor at the big toe immediately after and 15 min poststimulation. The data were statistically analyzed and compared. Results There were statistically significant differences in BVP amplitude among the three time intervals in both the sympathetic and peripheral groups (P < 0.05) with no difference in the control group (P = 0.995). There was a significant increase in BVP amplitude immediately after stimulation compared with before stimulation in both the sympathetic and peripheral groups (P = 0.0001). However, differences between the sympathetic and peripheral groups at the three measured periods were statistically nonsignificant (P > 0.05). Conclusion Both IFC applications had a proper effect on improving BF in children with hemiplegic CP with no difference in efficacy between sympathetic and peripheral stimulation.
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Affiliation(s)
- Nanees E. Mohamed
- Department of Physical Therapy for Pediatrics, Faculty of Physical Therapy, Cairo University, Giza, Egypt
- Corresponding address: Department of Physical Therapy for Pediatrics, Faculty of Physical Therapy, Cairo University, 7 Ahmed Elzayat St. Been Elsarayat, PO 12624, Dokki, Giza, Egypt.
| | - Asmaa A. Hussein
- Department of Physical Therapy, General Organization and Institutes for Teaching Hospitals, National Institute for Neuro-Motor System, Giza, Egypt
| | - Doaa A.M. Sanad
- Department of Physical Therapy for Pediatrics, Faculty of Physical Therapy, Cairo University, Giza, Egypt
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9
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Olson TL, Dames KD, Smith JD, Hayward R. Relationships between Physiological and Self-Reported Assessment of Cancer-Related Fatigue. INTERNATIONAL JOURNAL OF EXERCISE SCIENCE 2022; 15:177-190. [PMID: 36895434 PMCID: PMC9987435] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 03/11/2023]
Abstract
The purpose of this study was to evaluate the relationships between subjective, self-reported cancer related fatigue (CRF) and objective measures of muscular strength and fatigability in cancer survivors. A total of 155 cancer survivors (60 ± 13 years of age) completed a questionnaire for the assessment of CRF, along with assessments of handgrip strength, quadriceps strength and fatigability (reduced force/torque). Fatigability was measured by completing 15 maximal isokinetic contractions of the knee extensors (QFI). Spearman's rho correlation coefficients were calculated as pairwise combinations of the numerical and categorical dependent measures. Categorical variables were analyzed via nonparametric means of association. This included a 4×4 chi-square to test whether cancer stage (0-4) was independent of fatigue status (none, mild, moderate, severe) and whether cancer treatment (surgery, radiation, chemotherapy, or combinations of these) was independent of fatigue status. None of the physiological strength and fatigue measures were significantly correlated to overall perceived fatigue or any of the subscales. Cancer stage and treatment type were also not significantly related to fatigue status (likelihood ratio = .225, Cramer's V = .228; likelihood ratio = .103, Cramer's V = .369, respectively). Our results show that levels of patient reported fatigue severity were not significantly related to muscular fatigability or strength. As a result, cancer patients experiencing fatigue may benefit from following the standard exercise guidelines for cancer survivors, regardless of their levels of self-reported fatigue.
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Affiliation(s)
- Trista L Olson
- School of Sport and Exercise Science, University of Northern Colorado, Greeley, CO, USA.,University of Northern Colorado Cancer Rehabilitation Institute, Greeley, CO, USA
| | - Kevin D Dames
- School of Sport and Exercise Science, University of Northern Colorado, Greeley, CO, USA.,University of Northern Colorado Cancer Rehabilitation Institute, Greeley, CO, USA
| | - Jeremy D Smith
- School of Sport and Exercise Science, University of Northern Colorado, Greeley, CO, USA
| | - Reid Hayward
- School of Sport and Exercise Science, University of Northern Colorado, Greeley, CO, USA.,University of Northern Colorado Cancer Rehabilitation Institute, Greeley, CO, USA
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10
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Fang J, Chopp M, Xin H, Zhang L, Wang F, Golembieski W, Zhang ZG, He L, Liu Z. Plasminogen deficiency causes reduced angiogenesis and behavioral recovery after stroke in mice. J Cereb Blood Flow Metab 2021; 41:2583-2592. [PMID: 33853408 PMCID: PMC8504962 DOI: 10.1177/0271678x211007958] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
Plasminogen is involved in the process of angiogenesis; however, the underlying mechanism is unclear. Here, we investigated the potential contribution of plasmin/plasminogen in mediating angiogenesis and thereby contributing to functional recovery post-stroke. Wild-type plasminogen naive (Plg+/+) mice and plasminogen knockout (Plg-/-) mice were subjected to unilateral permanent middle cerebral artery occlusion (MCAo). Blood vessels were labeled with FITC-dextran. Functional outcomes, and cerebral vessel density were compared between Plg+/+ and Plg-/- mice at different time points after stroke. We found that Plg-/- mice exhibited significantly reduced functional recovery, associated with significantly decreased vessel density in the peri-infarct area in the ipsilesional cortex compared with Plg+/+ mice. In vitro, cerebral endothelial cells harvested from Plg-/- mice exhibited significantly reduced angiogenesis assessed using tube formation assay, and migration, as evaluated using Scratch assays, compared to endothelial cells harvested from Plg+/+ mice. In addition, using Western blots, expression of thrombospondin (TSP)-1 and TSP-2 were increased after MCAo in the Plg-/- group compared to Plg+/+ mice, especially in the ipsilesional side of brain. Taken together, our data suggest that plasmin/plasminogen down-regulates the expression level of TSP-1 and TSP-2, and thereby promotes angiogenesis in the peri-ischemic brain tissue, which contributes to functional recovery after ischemic stroke.
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Affiliation(s)
- Jinghuan Fang
- Department of Neurology, Henry Ford Hospital, Detroit, MI, USA.,Department of Neurology, West China Hospital of Sichuan University, Chengdu, PR China
| | - Michael Chopp
- Department of Neurology, Henry Ford Hospital, Detroit, MI, USA.,Department of Physics, Oakland University, Rochester, MI, USA
| | - Hongqi Xin
- Department of Neurology, Henry Ford Hospital, Detroit, MI, USA
| | - Li Zhang
- Department of Neurology, Henry Ford Hospital, Detroit, MI, USA
| | - Fengjie Wang
- Department of Neurology, Henry Ford Hospital, Detroit, MI, USA
| | | | | | - Li He
- Department of Neurology, West China Hospital of Sichuan University, Chengdu, PR China
| | - Zhongwu Liu
- Department of Neurology, Henry Ford Hospital, Detroit, MI, USA
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Gizzi L, Yavuz UŞ, Hillerkuss D, Geri T, Gneiting E, Domeier F, Schmitt S, Röhrle O. Variations in Muscle Activity and Exerted Torque During Temporary Blood Flow Restriction in Healthy Individuals. Front Bioeng Biotechnol 2021; 9:557761. [PMID: 33816445 PMCID: PMC8017222 DOI: 10.3389/fbioe.2021.557761] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2020] [Accepted: 01/28/2021] [Indexed: 11/29/2022] Open
Abstract
Recent studies suggest that transitory blood flow restriction (BFR) may improve the outcomes of training from anatomical (hypertrophy) and neural control perspectives. Whilst the chronic consequences of BFR on local metabolism and tissue adaptation have been extensively investigated, its acute effects on motor control are not yet fully understood. In this study, we compared the neuromechanical effects of continuous BFR against non-restricted circulation (atmospheric pressure—AP), during isometric elbow flexions. BFR was achieved applying external pressure either between systolic and diastolic (lower pressure—LP) or 1.3 times the systolic pressure (higher pressure—HP). Three levels of torque (15, 30, and 50% of the maximal voluntary contraction—MVC) were combined with the three levels of pressure for a total of 9 (randomized) test cases. Each condition was repeated 3 times. The protocol was administered to 12 healthy young adults. Neuromechanical measurements (torque and high-density electromyography—HDEMG) and reported discomfort were used to investigate the response of the central nervous system to BFR. The investigated variables were: root mean square (RMS), and area under the curve in the frequency domain—for the torque, and average RMS, median frequency and average muscle fibres conduction velocity—for the EMG. The discomfort caused by BFR was exacerbated by the level of torque and accumulated over time. The torque RMS value did not change across conditions and repetitions. Its spectral content, however, revealed a decrease in power at the tremor band (alpha-band, 5–15 Hz) which was enhanced by the level of pressure and the repetition number. The EMG amplitude showed no differences whilst the median frequency and the conduction velocity decreased over time and across trials, but only for the highest levels of torque and pressure. Taken together, our results show strong yet transitory effects of BFR that are compatible with a motor neuron pool inhibition caused by increased activity of type III and IV afferences, and a decreased activity of spindle afferents. We speculate that a compensation of the central drive may be necessary to maintain the mechanical output unchanged, despite disturbances in the afferent volley to the motor neuron pool.
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Affiliation(s)
- Leonardo Gizzi
- Institute for Modelling and Simulation of Biomechanical Systems, Chair for Continuum Biomechanics and Mechanobiology, University of Stuttgart, Stuttgart, Germany
| | - Utku Ş Yavuz
- Department of Biomedical Signals and Systems, Faculty of Electrical Engineering, Mathematics and Computer Sciences, University of Twente, Enschede, Netherlands
| | - Dominic Hillerkuss
- Institute for Modelling and Simulation of Biomechanical Systems, Chair for Continuum Biomechanics and Mechanobiology, University of Stuttgart, Stuttgart, Germany
| | - Tommaso Geri
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), University of Genova, Genova, Italy
| | - Elena Gneiting
- Institute for Modelling and Simulation of Biomechanical Systems, Chair for Continuum Biomechanics and Mechanobiology, University of Stuttgart, Stuttgart, Germany
| | - Franziska Domeier
- Institute for Modelling and Simulation of Biomechanical Systems, Chair for Continuum Biomechanics and Mechanobiology, University of Stuttgart, Stuttgart, Germany
| | - Syn Schmitt
- Institute for Modelling and Simulation of Biomechanical Systems, Chair for Computational Biophysics and Biorobotics, University of Stuttgart, Stuttgart, Germany.,Stuttgart Center for Simulation Technology (SC SimTech), University of Stuttgart, Stuttgart, Germany
| | - Oliver Röhrle
- Institute for Modelling and Simulation of Biomechanical Systems, Chair for Continuum Biomechanics and Mechanobiology, University of Stuttgart, Stuttgart, Germany.,Stuttgart Center for Simulation Technology (SC SimTech), University of Stuttgart, Stuttgart, Germany
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Abstract
Background: Post-stroke fatigue (PSF) is one of the most common and frustrating outcomes of stroke. It has a high prevalence and it can persist for many years after stroke. PSF itself contributes to a wider range of undesirable outcomes that affect all aspects of daily life. The aim of this review was to identify and summarise the most recent research on PSF, in order to update the evidence base. Methods: We updated an existing review (Hinkle et al. 2017) systematically searching CINAHL, MEDLINE, PsycINFO, and PubMed to cover new research studies between 1 st March 2016 and the search date (19 th January 2020). We included interventional and observational research, and clinical practice guidelines that were not covered in the original review. After duplicate removal in EndNote, two reviewers screened the search results in Rayyan, and data from eligible full texts were extracted onto an Excel spreadsheet. Finally, we used RobotReviewer and a human reviewer to assess the risk of bias of randomised trials for this scoping review. Results: We identified 45 records for 30 studies (14 observational, 10 interventional studies, and 6 guidelines). Apart from one, the interventional studies were single-centred, had high risk of bias and small sample size (median 50). They investigated exercise, pharmacotherapy, psychotherapy, education, and light therapy. Observational studies mainly reported the factors related to PSF including co-morbidities, depression and anxiety, quality of life, activities of daily living, stroke severity, medication use and polypharmacy, polymorphism, pain, apathy, limb heaviness, neuroticism, mobility, and thyroid-stimulating hormone. Guidelines either did not report on PSF or, when reported, their recommendations were supported by little or low level of evidence. Conclusion: Although we identified a number of recent studies which have added to our current knowledge on PSF, none are robust enough to change current clinical practice.
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Affiliation(s)
- Ghazaleh Aali
- Division of Psychiatry and Applied Psychology, University of Nottingham, Nottingham, UK
- Institute of Mental Health, Nottinghamshire Healthcare NHS Foundation Trust, Nottingham, UK
| | - Avril Drummond
- Faculty of Medicine and Health Sciences, School of Health Sciences, Queen’s Medical Centre, University of Nottingham, Nottingham, UK
| | - Roshan das Nair
- Division of Psychiatry and Applied Psychology, University of Nottingham, Nottingham, UK
- Institute of Mental Health, Nottinghamshire Healthcare NHS Foundation Trust, Nottingham, UK
| | - Farhad Shokraneh
- Division of Psychiatry and Applied Psychology, University of Nottingham, Nottingham, UK
- Institute of Mental Health, Nottinghamshire Healthcare NHS Foundation Trust, Nottingham, UK
- King's Technology Evaluation Centre (KiTEC), London Institute of Healthcare Engineering, School of Biomedical Engineering and Imaging Sciences, Faculty of Life Sciences and Medicine, King's College London, London, UK
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13
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Abstract
Background: Post-stroke fatigue (PSF) is one of the most common and frustrating outcomes of stroke. It has a high prevalence and it can persist for many years after stroke. PSF itself contributes to a wider range of undesirable outcomes that affect all aspects of daily life. The aim of this review was to identify and summarise the most recent research on PSF, in order to update the evidence base. Methods: We updated an existing review (Hinkle et al. 2017) systematically searching CINAHL, MEDLINE, PsycINFO, and PubMed to cover new research studies between 1 st March 2016 and the search date (19 th January 2020). We included interventional and observational research, and clinical practice guidelines that were not covered in the original review. After duplicate removal in EndNote, two reviewers screened the search results in Rayyan, and data from eligible full texts were extracted onto an Excel spreadsheet. Finally, we used RobotReviewer and a human reviewer to assess the risk of bias of randomised trials for this scoping review. Results: We identified 45 records for 30 studies (14 observational, 10 interventional studies, and 6 guidelines). Apart from one, the interventional studies were single-centred, had high risk of bias and small sample size (median 50). They investigated exercise, pharmacotherapy, psychotherapy, education, and light therapy. Observational studies mainly reported the factors related to PSF including co-morbidities, depression and anxiety, quality of life, activities of daily living, stroke severity, medication use and polypharmacy, polymorphism, pain, apathy, limb heaviness, neuroticism, mobility, and thyroid-stimulating hormone. Guidelines either did not report on PSF or, when reported, their recommendations were supported by little or low level of evidence. Conclusion: Although we identified a number of recent studies which have added to our current knowledge on PSF, none are robust enough to change current clinical practice.
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Affiliation(s)
- Ghazaleh Aali
- Division of Psychiatry and Applied Psychology, University of Nottingham, Nottingham, UK
- Institute of Mental Health, Nottinghamshire Healthcare NHS Foundation Trust, Nottingham, UK
| | - Avril Drummond
- Faculty of Medicine and Health Sciences, School of Health Sciences, Queen’s Medical Centre, University of Nottingham, Nottingham, UK
| | - Roshan das Nair
- Division of Psychiatry and Applied Psychology, University of Nottingham, Nottingham, UK
- Institute of Mental Health, Nottinghamshire Healthcare NHS Foundation Trust, Nottingham, UK
| | - Farhad Shokraneh
- Division of Psychiatry and Applied Psychology, University of Nottingham, Nottingham, UK
- Institute of Mental Health, Nottinghamshire Healthcare NHS Foundation Trust, Nottingham, UK
- King's Technology Evaluation Centre (KiTEC), London Institute of Healthcare Engineering, School of Biomedical Engineering and Imaging Sciences, Faculty of Life Sciences and Medicine, King's College London, London, UK
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Campbell E, Phinyomark A, Scheme E. Current Trends and Confounding Factors in Myoelectric Control: Limb Position and Contraction Intensity. SENSORS (BASEL, SWITZERLAND) 2020; 20:E1613. [PMID: 32183215 PMCID: PMC7146367 DOI: 10.3390/s20061613] [Citation(s) in RCA: 43] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/05/2020] [Revised: 03/08/2020] [Accepted: 03/09/2020] [Indexed: 11/17/2022]
Abstract
This manuscript presents a hybrid study of a comprehensive review and a systematic(research) analysis. Myoelectric control is the cornerstone ofmany assistive technologies used in clinicalpractice, such as prosthetics and orthoses, and human-computer interaction, such as virtual reality control.Although the classification accuracy of such devices exceeds 90% in a controlled laboratory setting,myoelectric devices still face challenges in robustness to variability of daily living conditions.The intrinsic physiological mechanisms limiting practical implementations of myoelectric deviceswere explored: the limb position effect and the contraction intensity effect. The degradationof electromyography (EMG) pattern recognition in the presence of these factors was demonstratedon six datasets, where classification performance was 13% and 20% lower than the controlledsetting for the limb position and contraction intensity effect, respectively. The experimental designsof limb position and contraction intensity literature were surveyed. Current state-of-the-art trainingstrategies and robust algorithms for both effects were compiled and presented. Recommendationsfor future limb position effect studies include: the collection protocol providing exemplars of at least 6positions (four limb positions and three forearm orientations), three-dimensional space experimentaldesigns, transfer learning approaches, and multi-modal sensor configurations. Recommendationsfor future contraction intensity effect studies include: the collection of dynamic contractions, nonlinearcomplexity features, and proportional control.
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Affiliation(s)
- Evan Campbell
- Department of Electrical and Computer Engineering, University of New Brunswick, Canada
- Institute of Biomedical Engineering, University of New Brunswick, Canada
| | - Angkoon Phinyomark
- Institute of Biomedical Engineering, University of New Brunswick, Canada
| | - Erik Scheme
- Department of Electrical and Computer Engineering, University of New Brunswick, Canada
- Institute of Biomedical Engineering, University of New Brunswick, Canada
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