Post-stroke Constraint-induced Movement Therapy Increases Functional Recovery, Angiogenesis, and Neurogenesis with Enhanced Expression of HIF-1α and VEGF

StreszczenieNeuroplastyczność jest zjawiskiem powszechnym w działaniu układu nerwowego, a samoistne i spontaniczne zdrowienie jest normą we wczesnym okresie poudarowym. Zmiany plastyczne leżą u podstaw przywracania funkcji po uszkodzeniu mózgu. Reprezentacje czuciowe i ruchowe pól korowych mogą być modyfikowane przez dopływ bodźców ze środowiska. Odpowiednio dobrane strategie postępowania fizjoterapeutycznego mają wpływ na spontaniczną neuroplastyczność. Przedstawiono podstawowe założenia działań terapeutycznych mających korzystny wpływ, na omawiane zjawisko reorganizacji układu nerwowego oraz uczenia się kontekstualnego, szczególnie w odniesieniu do zagadnienia Terapii Ruchem Wymuszonym Koniecznością. Opisano protokół Tauba dotyczący tej terapii oraz stanowiący jej podwalinę zespół wyuczonego nieużywania. Przybliżono zagadnienie shapingu i praktyki zadaniowej (ćwiczeń zadaniowych). Głównym celem opisywanej terapii jest przywrócenie spontanicznego i automatycznego wykorzystania kończyny niedowładnej w czynnościach dnia codziennego.Na zjawisko plastyczności istotny wpływ mają: wzbogacone środowisko, odległość czasu od zachorowania, liczba powtórzeń zadań ruchowych oraz znajomość wykonywanych czynności co potwierdzają dowody naukowe.Prawidłowo prowadzona terapia pozwala przenieść osiągnięte umiejętności poza ściany kliniki i przyczynia się do funkcjonalnej niezależności pacjentów.

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Efficacy of Constraint-Induced Movement Therapy for Post-Stroke Upper Extremity Hemiparesis Patients Attending a Day-Care Center

Rigakuryoho Kagaku ◽

10.1589/rika.24.929 ◽

2009 ◽

Vol 24 (6) ◽

pp. 929-933

Author(s):

Taichi KURAYAMA ◽

Anna WATANABE ◽

Minami TAKAMOTO ◽

Nami SHIGETA ◽

Yuki HASEGAWA ◽

...

Keyword(s):

Upper Extremity ◽

Day Care ◽

Care Center ◽

Movement Therapy ◽

Day Care Center ◽

Post Stroke ◽

Constraint Induced Movement Therapy

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Abstract 3573: Successful Regeneration After Experimental Stroke by G-CSF is not Further Enhanced by Constraint-Induced Movement Therapy

Stroke ◽

10.1161/str.43.suppl_1.a3573 ◽

2012 ◽

Vol 43 (suppl_1) ◽

Author(s):

Kai Diederich ◽

Verena Quennet ◽

Henrike Bauer ◽

Wolf-Rüdiger Schäbitz ◽

Clemens Sommer ◽

...

Keyword(s):

Enhanced Recovery ◽

Movement Therapy ◽

Therapeutic Benefit ◽

Experimental Stroke ◽

Treatment Groups ◽

Post Stroke ◽

Constraint Induced Movement Therapy ◽

Male Wistar Rats ◽

Sequential Combination ◽

Cortical Regions

Background and Purpose Both application of granulocyte-colony stimulating factor (G-CSF) and constraint-induced movement therapy (CIMT) have been shown to improve recovery after experimental stroke. The aim of the present study was to determine whether concurrent or sequential combination of both therapies will further enhance the therapeutic benefit and whether specific modifications in the abundance of various neurotransmitter receptors do occur. Methods Adult male Wistar rats were subjected to photothrombotic ischemia and assigned to the following treatment groups (n=20 each): (1) ischemic control (saline); (2) CIMT (CIMT between post-stroke day 2 and 11; (3) G-CSF (10μg/kg G-CSF daily between post-stroke day 2 and 11 (4), combined concurrent group (CIMT plus 10μg/kg G-CSF daily between post- stroke day 2 and 11; (5) combined sequential group (CIMT between post-stroke day 2 and 11 and 10μg/kg G-CSF daily between post-stroke day 12 and 21, respectively). Rats were functionally tested before and up to 4 weeks after ischemia. Quantitative receptor autography was performed for NMDA, AMPA and GABAA receptors. Results Significant improvement of functional outcome was seen in all groups treated with G-CSF alone and in either combination with CIMT, while CIMT alone failed to enhance recovery. Infarct sizes and remaining cortical tissue did not differ in the various treatment groups. Failure of significant benefit in the CIMT group was associated with a shift towards inhibition in perilesional and remote cortical regions. Conclusions Our findings unveil G-CSF as the key player for enhanced recovery after experimental stroke, preventing a shift towards inhibition as seen in the solitary CIMT group.

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Contralesional plasticity following constraint-induced movement therapy benefits outcome: contributions of the intact hemisphere to functional recovery

Reviews in the Neurosciences ◽

10.1515/revneuro-2021-0085 ◽

2021 ◽

Vol 0 (0) ◽

Author(s):

Abigail L. Kerr

Keyword(s):

Functional Recovery ◽

Daily Living ◽

Animal Studies ◽

Movement Therapy ◽

Lesion Size ◽

Neural Mechanisms ◽

Constraint Induced Movement Therapy ◽

Current Review ◽

Paretic Limb

Abstract Stroke is a leading cause of death and disability worldwide. A common, chronic deficit after stroke is upper limb impairment, which can be exacerbated by compensatory use of the nonparetic limb. Resulting in learned nonuse of the paretic limb, compensatory reliance on the nonparetic limb can be discouraged with constraint-induced movement therapy (CIMT). CIMT is a rehabilitative strategy that may promote functional recovery of the paretic limb in both acute and chronic stroke patients through intensive practice of the paretic limb combined with binding, or otherwise preventing activation of, the nonparetic limb during daily living exercises. The neural mechanisms that support CIMT have been described in the lesioned hemisphere, but there is a less thorough understanding of the contralesional changes that support improved functional outcome following CIMT. Using both human and non-human animal studies, the current review explores the role of the contralesional hemisphere in functional recovery of stroke as it relates to CIMT. Current findings point to a need for a better understanding of the functional significance of contralesional changes, which may be determined by lesion size, location, and severity as well stroke chronicity.

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