1.
A Home- and Community-Based Physical Activity Program Can Improve the Cardiorespiratory Fitness and Walking Capacity of Stroke Survivors.
Marsden, DL, Dunn, A, Callister, R, McElduff, P, Levi, CR, Spratt, NJ
Journal of stroke and cerebrovascular diseases : the official journal of National Stroke Association. 2016;(10):2386-98
Abstract
BACKGROUND The cardiorespiratory fitness of stroke survivors is low. Center-based exercise programs that include an aerobic component have been shown to improve poststroke cardiorespiratory fitness. This pilot study aims to determine the feasibility, safety, and preliminary efficacy of an individually tailored home- and community-based exercise program to improve cardiorespiratory fitness and walking capacity in stroke survivors. METHODS Independently ambulant, community-dwelling stroke survivors were recruited. The control (n = 10) and intervention (n = 10) groups both received usual care. In addition the intervention group undertook a 12-week, individually tailored, home- and community-based exercise program, including once-weekly telephone or e-mail support. Assessments were conducted at baseline and at 12 weeks. Feasibility was determined by retention and program participation, and safety by adverse events. Efficacy measures included change in cardiorespiratory fitness (peak oxygen consumption [VO2peak]) and distance walked during the Six-Minute Walk Test (6MWT). Analysis of covariance was used for data analysis. RESULTS All participants completed the study with no adverse events. All intervention participants reported undertaking their prescribed program. VO2peak improved more in the intervention group (1.17 ± .29 L/min to 1.35 ± .33 L/min) than the control group (1.24 ± .23 L/min to 1.24 ± .33 L/min, between-group difference = .18 L/min, 95% confidence interval [CI]: .01-.36). Distance walked improved more in the intervention group (427 ± 123 m to 494 ± 67m) compared to the control group (456 ± 101m to 470 ± 106m, between-group difference = 45 m, 95% CI: .3-90). CONCLUSIONS Our individually tailored approach with once-weekly telephone or e-mail support was feasible and effective in selected stroke survivors. The 16% greater improvement in VO2peak during the 6MWT achieved in the intervention versus control group is comparable to improvements attained in supervised, center-based programs.
2.
[Effect of antioxidant therapy on neurotrophins and processes of rehabilitation after stroke].
Karakulova, YV, Selyanina, NV, Zhelnin, AV, Filimonova, TA, Cepilov, SV
Zhurnal nevrologii i psikhiatrii imeni S.S. Korsakova. 2016;(8):36-39
Abstract
The aim of the research was to study the effect of the inclusion in the scheme cytoflavin patient care during the recovery period of ischemic stroke in the neuropsychological changes in the status and content of neurotrophins in serum. For this purpose we surveyed 52 patients who underwent a first ischemic stroke (29 women and 23 men) aged 52-74 years. Patients were divided into 2 groups: primary (25 patients) received in addition to basic therapy cytoflavin: intravenously at 20 ml per 400 ml of 5% glucose solution, 1 time a day for 10 days, then into 2 tablets 2 times a day for half an hour before food for a month, and the comparison group (27 patients) who received standard treatment. The control group consisted of 12 healthy people. In addition to standard clinical and laboratory tests were carried out a comprehensive neuropsychological study and evaluation of the data on the scale NIHSS, Bartell, Beck, Spielberger-Hanin, test «frontal dysfunction of the battery» and the Mini-Mental State Examination. Furthermore, determination carried neurotrophic factors: nerve growth factor (NGF) and brain-derived neurotrophic factor brain (BDNF). The study was conducted in the dynamics: before treatment and 2 months after treatment. Patients in the recovery period of the first ischemic stroke revealed moderate manifestations of neuropsychological disorders status and reduction of neurotrophic factors. Inclusion in cytoflavin scheme increased the efficiency of the treatment, which was manifested in a more pronounced when compared with the results of basic therapy, positive dynamics of neurological symptoms and improved cognitive function, accompanied by an increase in BDNF levels. The data on the efficacy and safety allow us to recommend its inclusion in the scheme of treatment of patients in the recovery period after the first carotid ischemic stroke.