跑步机能促进中风后脑功能重新建立
跑步机能促进中风后脑功能重新建立——研究表明跑步机练习能改善中风患者的行走能力[url]http://www.dxy.cn/bbs/post/view?bid=116&id=12661324&sty=1&tpg=1&age=0[/url]
2008年8月28日——根据一项新的研究，跑步机运动可能通过重新建立部分脑的“连接”改善中风患者的行走能力。
该研究还表明跑步机运动可能比传统的、用于中风后恢复的伸展运动更好。跑步机练习对行走能力和整体适应力都有更好的效果。
马里兰和巴尔地摩退伍军人事务医学中心大学（Maryland and Baltimore Veterans Affairs Medical Center）的研究员比较了37例接受“递增跑步机练习治疗”的患者与34例接受伸展运动的患者。这些患者均还有慢性轻偏瘫。他们中风后至少6月，其身体的某一侧有肌力减退和感觉减退。这些患者都得到了常规康复。
跑步机练习组的目标是：每周进行每组40分钟，共3组的跑步机练习，60%的患者的心率有储备。他们开始时以慢速练习，每两周增加一次时间和强度。训练计划持续6个月。
伸展运动组练习的组数和次数都与跑步机组相同，每组的练习时长也一样。他们在指导员的帮助下在软垫上接受传统的伸展练习。
研究者以下面3种方式记录结果：1.通过MRI观察脑功能；2.测量行走能力；3.评价整体适应力。跑步机组的患者在3个方面都取得了更好的结果。
通过影像学检查，72%的参加跑步机练习的患者的部分脑的活动有所增加。而接受伸展运动的患者的脑活动变化并不是在每个患者身上都有。
在这些患者模仿步行动作，进行屈膝运动时，研究者检查其脑MRI的变化。MRI结果显示这些使用跑步机练习的中风患者的血液的含氧量和脑干、小脑的血流都有增加，而使用伸展练习的患者却没有这些改变。
研究者表示，血流氧含量和血流的增加表明小脑和脑干被“复原”以代替被中风破坏的皮质的部分行走功能。
“我们观察到，我们称它相当于神经重建——一种反映脑适应力的脑激活作用。”Andreas Luft博士在新闻发布会上说道。Luft博士是该研究主要作者之一，是瑞典苏黎世大学神经科的临床神经病学和神经恢复学教授。
跑步机组患者的行走速度和适应力的提升都比伸展运动组的患者更大。这对中风患者是很重要的。因为他们行动的不便将可能引起心血管疾病和糖尿病。
在该研究中，美国心脏病协会 (Journal of the American Heart Association)杂志，学者们在争论是否应该在中风患者的长期治疗中包括跑步机练习。
“跑步机练习有希望能刺激新的或废用的脑功能弧，甚至能在常规康复治疗后还能改善中风患者的行走能力”Luft说道。
Treadmill Rewires Brain After Stroke
——Study Shows Exercising on Treadmill Improves Walking Ability of Stroke Patients
Aug. 28, 2008 -- Treadmill exercise may improve stroke survivors' walking ability by rewiring parts of the brain, according to a new study.
The study also shows treadmill exercise may be better than stretching, the traditional exercise prescribed after a stroke, both for walking and overall fitness.
Researchers at the University of Maryland and Baltimore Veterans Affairs Medical Center compared 37 patients who performed "progressive task repetitive treadmill therapy" with 34 patients who did stretching. The patients had chronic hemiparesis, which is weakness on one side of the body, at least six months after a stroke. The patients had all completed conventional rehabilitation.
The treadmill group was given the goal of three 40-minute sessions per week on the treadmill at 60% of their heart rate reserve. They started out slower, adding duration and intensity every two weeks. The exercise program lasted six months.
The stretching group had the same number of sessions, and the length of each session was also the same. They performed a variety of traditional stretches on a raised mat table with the assistance of an instructor.
Researchers measured results in three ways: by looking at brain activity on MRIs, by measuring walking ability, and by evaluating overall fitness level. The treadmill group performed better in all three categories.
Treadmill participants increased their activity in certain parts of the brain by 72% on imaging tests. Brain activity changes did not occur in patients who did stretching exercise.
Researchers checked brain MRIs while participants did knee-flexing exercises that mimic walking. The MRIs showed increased blood oxygenation and flow in the brain stem and cerebellum of the stroke survivors who had used the treadmill but not in those who did stretching.
Researchers say the increases in blood oxygenation and flow indicated that the cerebellum and brain stem had been "recruited" to replace some of the walking functions of the cortical brain that had been damaged by the strokes.
"We saw what we call an equivalent of neuroplasticity -- a change in brain activation that reflects the brain's adaptability," says Andreas Luft, MD, in a news release. Luft is one of the study's lead authors and a professor of clinical neurology and neurorehabilitation in the department of neurology at the University of Zurich, Switzerland.
The treadmill group also increased their walking speed and their fitness more than those in the stretching group. This is particularly important because stroke survivors' immobility can lead to cardiovascular disease and diabetes.
In the study, published in Stroke: Journal of the American Heart Association, the authors argue that treadmill exercise should be included in long-term therapy programs for stroke survivors.
"It is promising that treadmill exercise can stimulate new or underused brain circuits and improve walking in stroke survivors even after completion of conventional rehabilitation therapy," Luft says.
[url]http://www.webmd.com/stroke/news/20080827/treadmill-rewires-brain-after-stroke[/url] 学习中……
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