Effects of early exercise on muscle and cardiovascular health after stroke

早期锻炼对中风后肌肉和心血管健康的影响

基本信息

批准号：
8477224
负责人：
Terrence G Forrester
金额：
$ 40.61万
依托单位：
UNIVERSITY OF MARYLAND BALTIMORE
依托单位国家：
美国
项目类别：
财政年份：
2011
资助国家：
美国
起止时间：
2011-04-01 至 2016-01-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/8477224
关键词：
Acute Address Adult Aerobic Affect African African American Aging American Area Atrophic Body Composition Cardiovascular Deconditioning Cardiovascular system Caring Chronic Chronic Phase Clinic Deposition Environment Equilibrium Exercise Experimental Designs Face Fasting Fatty acid glycerol esters Gait Glucose Guidelines Health Healthcare Heterogeneity Individual Inflammation Insulin Insulin Resistance Intervention Intervention Studies Intramuscular Jamaica Knowledge Laboratory Finding Leg Limb structure Link Medical Metabolic Metabolism Methodology Modeling Muscle Muscle Proteins Muscular Atrophy Myosin Heavy Chains Natural History Non-Insulin-Dependent Diabetes Mellitus Oral Phenotype Physical therapy exercises Prevalence Protein Biosynthesis Proteins Randomized Recovery Recurrence Regulation Rehabilitation therapy Reporting Research Risk Risk Factors Skeletal Muscle Stimulus Stroke Stroke prevention Structural Protein Structure Survivors Syndrome TNF gene Testing Thigh structure Time Training Training Programs Tumor Necrosis Factor-alpha Underrepresented Minority Universities Weight-Bearing state West Indies chronic stroke cost daily functioning feeding fitness glucose tolerance health disparity hemiparesis hemiparetic stroke impaired glucose tolerance improved improved mobility indexing insulin sensitivity molecular phenotype post stroke prevent programs public health relevance rehabilitation service response restoration sarcopenia stable isotope

项目摘要

DESCRIPTION (provided by applicant): Stroke leads to profound physical deconditioning and abnormalities in paretic leg muscle including shift to fast twitch muscle phenotype, inflammation and gross atrophy that worsen cardiometabolic health by promoting insulin resistance. Yet, no prior studies have considered stroke as a catabolic syndrome in aging that can be modified by early exercise to improve muscle and cardiometabolic health. In chronic stroke, we have exercise models that improve mobility, restore fitness levels nearly 40%, and reverse impaired glucose tolerance (IGT) and T2DM status in 58% of cases, even years after stroke. Lab findings suggest our exercise programs increase total myofibrillar protein and proportion of slow twitch in paretic leg muscle, implicating both altered protein synthesis and regulation of muscle molecular phenotype as mechanisms underlying the benefits of exercise post-stroke. This study investigates the hypothesis that in African-Jamaican adults with recent stroke, structured exercise across the sub-acute recovery period and into the chronic phase of stroke care will improve P leg muscle and cardiometabolic health, compared to controls receiving best medical care. Aims and associated hypotheses are to compare effects of 6 months structured and progressive exercise vs. best medical care implemented early after stroke in African-Jamaican adults on: Aim #1. Paretic & non-paretic leg mixed muscle protein synthesis and breakdown in the fed and fasted state, TNF-1 expression, thigh muscle volume and strength. Hypothesis 1: Paretic leg muscle has reduced protein synthesis and increased breakdown compared to non- paretic leg; Exercise will increase mixed muscle protein synthesis and reduce breakdown to increase muscle volume and strength by mechanism(s) of reducing inflammation in paretic leg, compared to controls. Aim #2. Glucose tolerance, fitness, and muscle phenotype. Hypothesis 2: Exercise will improve fitness levels, insulin and glucose response to oral glucose challenge, and increase paretic leg slow twitch muscle phenotype.

描述（由申请人提供）：中风会导致严重的身体不适和瘫痪腿部肌肉异常，包括向快肌表型转变、炎症和严重萎缩，从而通过促进胰岛素抵抗而恶化心脏代谢健康。然而，之前没有研究认为中风是衰老过程中的一种分解代谢综合征，可以通过早期锻炼来改善肌肉和心脏代谢健康。对于慢性中风，我们的运动模型可以改善活动能力，恢复近 40% 的健康水平，并在 58% 的病例中逆转糖耐量受损 (IGT) 和 T2DM 状态，甚至在中风发生数年后也是如此。实验室研究结果表明，我们的锻炼计划增加了麻痹腿部肌肉中的肌原纤维蛋白总量和慢抽比例，这表明蛋白质合成的改变和肌肉分子表型的调节是中风后锻炼益处的机制。这项研究调查了这样一个假设：在最近患有中风的非洲牙买加成年人中，与接受最佳医疗护理的对照组相比，在亚急性恢复期和中风护理慢性阶段进行结构化锻炼将改善 P 腿肌肉和心脏代谢健康。目的和相关假设是比较 6 个月的结构化渐进运动与非洲牙买加成年人中风后早期实施的最佳医疗护理对以下目标的影响：目标 #1。进食和禁食状态下的麻痹和非麻痹腿部混合肌肉蛋白质合成和分解、TNF-1 表达、大腿肌肉体积和强度。假设1：与非麻痹腿相比，麻痹腿肌肉的蛋白质合成减少，分解增加；与对照组相比，运动将增加混合肌肉蛋白质的合成并减少分解，从而通过减少瘫痪腿部炎症的机制来增加肌肉体积和力量。目标#2。葡萄糖耐量、健康和肌肉表型。假设 2：运动将改善健康水平、胰岛素和葡萄糖对口服葡萄糖挑战的反应，并增加麻痹腿慢肌表型。