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The comparative effects of unilateral and bilateral transcranial direct current stimulation on motor learning and motor performance: A systematic review of literature and meta-analysis.
Halakoo, S, Ehsani, F, Hosnian, M, Zoghi, M, Jaberzadeh, S
Journal of clinical neuroscience : official journal of the Neurosurgical Society of Australasia. 2020;:8-14
Abstract
Application of unilateral tDCS (Uni-tDCS) vs. bilateral tDCS (Bi-tDCS) is another important factor that can affect the physiological results of tDCS intervention on motor learning and motor performance. According to the evidence, some studies indicated that motor performance or motor learning are facilitated in healthy individuals by application of the Bi-tDCS more than the Uni-tDCS. On the other hand, some studies showed that there was no significant differences between Uni-tDCS and Bi-tDCS; and both techniques were more effective than sham stimulation. In contrast, the other studies have shown more significant effectiveness of Uni-tDCS than Bi-tDCS on motor performance and motor learning. The aim of this study was to systematically review the studies which investigated the effectiveness of Uni-tDCS and Bi-tDCS intervention on the motor learning and motor performance. The search was performed from databases in the Google Scholar, PubMed, Elsevier, Medline, Ovid and Science Direct with the keywords of motor behavior, motor performance, motor learning, Bi-tDCS or bilateral tDCS, dual tDCS, Uni-tDCS or unilateral tDCS, anodal tDCS and cathodal tDCS from 2000 to 2019. The results indicated that the study population was a key factor in determining study's findings. Data meta-analysis showed that Uni-tDCS was more effective than Bi-tDCS in patients with stroke, while, Bi-tDCS was more effective than Uni-tDCS to improve motor learning and motor performance in healthy individuals.
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Metabolomics of Aerobic Exercise in Chronic Stroke Survivors: A Pilot Study.
Serra, MC, Accardi, CJ, Ma, C, Park, Y, Tran, V, Jones, DP, Hafer-Macko, CE, Ryan, AS
Journal of stroke and cerebrovascular diseases : the official journal of National Stroke Association. 2019;(12):104453
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Abstract
BACKGROUND Understanding the metabolic response to exercise may aid in optimizing stroke management. Therefore, the purpose of this pilot study was to evaluate plasma metabolomic profiles in chronic stroke survivors following aerobic exercise training. METHODS Participants (age: 62 ± 1 years, body mass index: 31 ± 1 kg/m2, mean ± standard error of the mean) were randomized to 6 months of treadmill exercise (N = 17) or whole-body stretching (N = 8) with preintervention and postintervention measurement of aerobic capacity (VO2peak). Linear models for microarray data expression analysis was performed to determine metabolic changes over time, and Mummichog was used for pathway enrichment analysis following analysis of plasma samples by high-performance liquid chromatography coupled to ultrahigh resolution mass spectrometry. RESULTS VO2peak change was greater following exercise than stretching (18.9% versus -.2%; P < .01). Pathway enrichment analysis of differentially expressed metabolites results showed significant enrichment in 4 pathways following treadmill exercise, 3 of which (heparan-, chondroitin-, keratan-sulfate degradation) involved connective tissue metabolism and the fourth involve lipid signaling (linoleate metabolism). More pathways were altered in pre and post comparisons of stretching, including branched-chain amino acid, tryptophan, tyrosine, and urea cycle, which could indicate loss of lean body mass. CONCLUSIONS These preliminary data show different metabolic changes due to treadmill training and stretching in chronic stroke survivors and suggest that in addition to improved aerobic capacity, weight-bearing activity, like walking, could protect against loss of lean body mass. Future studies are needed to examine the relationship between changes in metabolomic profiles to reductions in cardiometabolic risk after treadmill rehabilitation.
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Exercise intensity affects acute neurotrophic and neurophysiological responses poststroke.
Boyne, P, Meyrose, C, Westover, J, Whitesel, D, Hatter, K, Reisman, DS, Cunningham, D, Carl, D, Jansen, C, Khoury, JC, et al
Journal of applied physiology (Bethesda, Md. : 1985). 2019;(2):431-443
Abstract
Aerobic exercise may acutely prime the brain to be more responsive to rehabilitation, thus facilitating neurologic recovery from conditions like stroke. This aerobic priming effect could occur through multiple mechanisms, including upregulation of circulating brain-derived neurotrophic factor (BDNF), increased corticospinal excitability, and decreased intracortical inhibition. However, optimal exercise parameters for targeting these mechanisms are poorly understood. This study tested the effects of exercise intensity on acute BDNF and neurophysiological responses. Sixteen ambulatory persons >6 mo poststroke performed three different 20-min exercise protocols in random order, approximately 1 wk apart, including the following: 1) treadmill high-intensity interval training (HIT-treadmill); 2) seated-stepper HIT (HIT-stepper); and 3) treadmill moderate-intensity continuous exercise (MCT-treadmill). Serum BDNF and transcranial magnetic stimulation measures of paretic lower limb excitability and inhibition were assessed at multiple time points during each session. Compared with MCT-treadmill, HIT-treadmill elicited significantly greater acute increases in circulating BDNF and corticospinal excitability. HIT-stepper initially showed BDNF responses similar to HIT-treadmill but was no longer significantly different from MCT-treadmill after decreasing the intensity in reaction to two hypotensive events. Additional regression analyses showed that an intensity sufficient to accumulate blood lactate appeared to be important for eliciting BDNF responses, that the interval training approach may have facilitated the corticospinal excitability increases, and that the circulating BDNF response was (negatively) related to intracortical inhibition. These findings further elucidate neurologic mechanisms of aerobic exercise and inform selection of optimal exercise-dosing parameters for enhancing acute neurologic effects. NEW & NOTEWORTHY Acute exercise-related increases in circulating BDNF and corticospinal excitability are thought to prime the brain for learning. Our data suggest that these responses can be obtained among persons with stroke using short-interval treadmill high-intensity interval training, that a vigorous aerobic intensity sufficient to generate lactate accumulation is needed to increase BDNF, that interval training facilitates increases in paretic quadriceps corticospinal excitability, and that greater BDNF response is associated with lesser intracortical inhibition response.
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A study of the relationship between the quality of lifestyle counselling and later adherence to the lifestyle changes based on patients with stroke and TIA.
Oikarinen, A, Engblom, J, Kyngäs, H, Kääriäinen, M
Clinical rehabilitation. 2018;(4):557-567
Abstract
OBJECTIVE To identify associations between lifestyle counselling quality and adherence to lifestyle changes during the 12-month period after discharge. SETTING Neurology unit. SUBJECTS Stroke and transient ischaemic attack (TIA) patients ( n = 98). DESIGN Longitudinal explorative study that utilized data initially collected for quasi-experimental study. MAIN MEASURES The exploratory measures of Counselling Quality were collected at the hospital on the day of discharge between January 2010 and October 2011, and the outcome measures of Adherence to Lifestyle Change and clinical values were collected 3, 6 and 12 months after discharge. RESULTS There were significant associations between the exploratory and outcome measures over time. Three of the counselling quality parameters, counselling interaction, advantages and resources, were found to be significantly associated with adherence to lifestyle change. In particular, counselling interactiveness was positively associated with physical activity at 3 ( B = 0.31, SD = 0.10, P = 0.004) and 12 ( B = 0.29, SD = 0.13, P = 0.030) months, as was advantages of following the advice at 3 ( B = 0.33, SD = 0.11, P = 0.006) and 12 ( B = 0.34, SD = 0.14, P = 0.021) months. Counselling resources were associated with lower body mass index throughout the entire follow-up period, that is, at 3 ( B = -0.06, SD = 0.02, P = 0.006), 6 ( B = -0.05, SD = 0.02, P = 0.040) and 12 months ( B = -0.05, SD = 0.02, P = 0.022). Furthermore, all aspects of counselling quality were positively related to support from nurses. CONCLUSION Adherence to lifestyle change is more likely to be attained if lifestyle counselling is interactive, the advantages of following the given advice are perceived as beneficial and the counsellor has sufficient resources.