Role Of Exercise Training And Electroacupuncture On The Neural Plasticity Of Rats After Cerebral Ischemia-reperfusion And The Functional Improvement Of Stroke Patients

Partâ… Effects of intensive exercise training on motor function and the expression of MAP-2,GFAP in rats after cerebral ischemia-reperfusionObjective To explore the effects of conventional and intensive exercise training on motor function and the expression of MAP-2 , GFAP in the hippocampus and around the cerebral infracted area of rats after cerebral ischemia-reperfusion.Methods The middle cerebral artery occlusion (MCAO) models was used.The middle cerebral arteries(MCA) of rats were occluded for 1 hour, then reperfused for 7,14 and 21 days. Fifty-four MCAO model-rats were randomized into a control group(Group A), a conventional exercise training group(Group B) and an intensive exercise training group(Group C). Neurologic functional behavior tests (postural reflex test, limb use asymmetrical test and corner test) were performed to test motor function. Immunohistochemistry was used to detect the expression of MAP-2, GFAP in the hippocampus and around the cerebral infracted area of rats.Results Except on the 24h after cerebral ischemia-reperfusion, there were some differences of neurological function behavior tests'scores in three groups on the 7th, 14th and 21th day. The scores of Group B and C, except the score of corner test of Group B on the 21th day, were significant better than that of Group A on the 7th(P<0.05), 14th (P<0.05 or 0.01)and 21th day(P<0.05 or 0.01). The scores of Group C, except the score of limb use asymmetrical test of Group C on the 21th day, were significant better than that of Group B on the 14th and 21th day(P<0.05). In the hippocampus and around the cerebral infracted area of rats, significant increase of MAP-2 immunoreactivity on the 14th day(P<0.05) and 21th day (P<0.01)and GFAP immunoreactivity on the 7th(P<0.05),14th (P<0.05)and 21th day (P<0.01)were detected in Group B and C , compared with that of group A. Significant increase of MAP-2 and GFAP immunoreactivity of Group C were detected on the 14th (P <0.05 or 0.01)and 21th day(P<0.05), compared with that of Group B.Conclusion Exercise training can promote motor functional recovery. The function enhancement may be partially due to the upregulation of MAP-2 and GFAP. Intensive exercise training is more effective.Partâ…¡Effects of exercise training combined with electroacupuncture on the expression of Nestin in the hippocampus dentate gyrus after cerebral ischemia-reperfusionObjective To explore the effects of exercise training combined with electro- acupuncture on the expression of Nestin in the hippocampus dentate gyrus(DG) after cerebral ischemia-reperfusion.Methods Fifty-four Wistar rats were randomly divided into control group (Group A), exercise training group (Group B), and exercise training combined with electroacupuncture group (Group C). The middle cerebral arteries (MCA) of rats were occluded for 1 h, then reperfused for 7, 14 and 21 days. Immunohistochemistry was used to detect the expression of Nestin in the hippocampus dentate gyrus of rats. Results There was the largest number of Nestin-positive cells in the DG in all groups on the 7th day after cerebral ischemia-reperfusion. Nestin-positive cells in ipsilateral DG were significantly more than those in the counter part at different time points (P<0.01). Significant increase of Nestin expression were detected in rats of Group B and Group C at different time points after cerebral ischemia-reperfusion, compared with that of Group A(P<0.01). We also found that Nestin-positive cells of Group C were significantly more than those of Group B in ipsilateral DG on the 7th day and 14th day after cerebral ischemia-reperfusion(P<0.01).Conclusion The increase of Nestin-positive cells in the DG existed time-regularity and in situ proliferation characteristic after cerebral ischemia- reperfusion. Exercise training and electroacupuncture can significantly promote the expression of Nestin.Partâ…¢Effects of training time of exercise training and rehabilitation participation of patients on the functional prognosis in stroke patientsObjective To explore the effects of training time of exercise training and rehabilitation participation of patients on the functional prognosis in Stroke Patients. Methods Sixty stroke patients were assigned to the conventional rehabilitation group (Group A) and the intensive rehabilitation group(Group B) randomly. There were 30 patients in each group. The patients in two groups were both received exercise training. The training time of Group A was 30-45 min/d, Group B was 45-60min/d. The Motor Function of Function Independence Measure (FIM) was used to assess motor comprehensive function at pre-therapy and 4 weeks after training. The rehabilitation participation of all patients was evaluated through the Pittsburgh Rehabilitation Participation Scale (PRPS) after every motor training.Results There were no significant differences between FIM motor function scores of two groups before therapy. But FIM motor function scores of Group B were significant higher than that of Group A after training (P<0.05), and FIM motor function scores change between pre-therapy and 4 weeks after training in Group B were significant higher than that in Group A (P<0.01). And the scores of PRPS in Group A (r=0.787, P<0.01) and Group B (r=0.573, P<0.05) were significantly related with FIM motor function scores change between pre-therapy and 4 weeks after training.Conclusion The training time of exercise training can effect the improvement of immediate motor function of stroke patients;The rehabilitation participation of patients also effect significantly the patients'functional prognosis.Partâ…£Clinical research of exercise training and electroacupuncture on the therapeutic effects in hemiplegia patients with strokeObjective To explore the effects of exercise training and electroacupuncture on the functional outcomes in hemiplegia patients with stroke at different time.Methods Fifty acute stroke patients were assigned to the rehabilitation group (25 cases) and control group (25 cases) randomly. The drug treatments in two groups were almost the same. The patients in rehabilitation group were received exercise training and electroacupuncture. Simplified Fugl-meyer Motor Functional Assessment (S-FMMFA), Barthel Index (BI), the WHO Quality of Life-brief version (WHOQOL-BREF) and Functional Comprehensive Assessment Scale (FCA) were used to assess motor function, ADL, QOL and comprehensive function at pre-therapy and 1, 3 and 6 months after the onset of stroke.Results The Scores in both rehabilitation and control groups were similar at pre-therapy and 1 months after the onset of stroke. The patients in the rehabilitation group at 3 and 6 months demonstrated much higher scores in S-FMMFA(P<0.01), BI(P<0.01) and in physical, psychological, environmental domains(P<0.05), the subjective QOL and health items of WHOQOL-BREF(P<0.05 or 0.01) than those in the control group. The FCA scores in the rehabilitation group at 6 months were also higher than those in the control group(P<0.01).Conclusion Early exercise training and electroacupuncture can effectively improve motor function, ADL and QOL of stroke patients. The continuing rehabilitation therapy is helpful for improving the patients'comprehensive function.