Exercise Test And Aerobic Training For Stroke Hemiplegia Of Different Stages

Objective:We explored aerobic training for stroke hemiplegia of different stages, and studied the effect of aerobic training,as the insulin sensitivity,other stroke recurrence danger factors,functional recovery , and muscle change on different stage hemiplegia patients.We also observed hemiplegia muscles'change after the aerobic training.Methods:1. Aerobic training and insulin resistence in stroke hemiplegias of different stages.Sixty-seven stroke patients were devided into the early stage (2 week-3 month),the middle stage (3-6 month) and the later stage ( > 6month).Besides routine rehabilitation training for all groups during six weeks ,the aerobic training group underwent aerobic training using ergometer for thirty minutes, three times per week. But all groups had equal rehabilitation training time (two hours physical therapy,five days one week),The Fugl-Meyer motor function scores ,modified Barthel index ,Rivermed index, blood-fat, plasm glucose and insulin level at 0 and 120 minutes during OGTT are assessed , HOMA-IR index was caculated in the beginning and six weeks later for all the patients. Lower extremity ergometer exercise test must be repeated at the end of the study recording the exercise time. All the data recorded was analyzed with paired T test. HOMA-IR was analysis during different stages by ANOVA.2. Evaluate the vadility of an ultrasound-based method of examining quadriceps femoris in stroke hemiplegias during aerobic training. The thickness of bilateral rectus femoris (RF) and vastus intermedius(VI) and the cross-sectional area(CSA) of RF was examined in 10 healthy subjects(n=20)in a relaxed position and three isometric contraction states using B ultrasound scanning by two examiners. The data was analyzed with paired T test .Half of these subjects (n=10)were also measured by MRI at rest. The data was also analyzed with paired T test .To study the effect of aerobic training in stroke hemiplegia's RF, every six patients from aerobic training group and control group were chosen with random ,Their CSA of RF affectived were examined using B ultrasound scanning in the beginning and six weeks later.Results:1. Aerobic training and insulin resistence in stroke hemiplegias of different stages.①Aerobic training groups of all stages and the control groups of middle and later stages all showed longer time(P<0.05) in exercise test .There is no difference(P>0.05)between aerobic training group and control groups in middle and later stages.②The patients plasm glucose(2h,OGTT) decreasd when insulin sensitivity was inhanced in the aerobic training groups(P<0.05),while the insulin sensitivity of control groups had little change(P>0.05).③HOMA-IR was not been found changes during different stages(P>0.05).④The patients improved their ADLs and Rivermed Index(P<0.05) ,while the later stage patients didn't improve their Fugl-Meyer motor ability (P<0.05). No difference(P>0.05)between training group and control groups.⑤There is no change in patients blood-fat, CRP in all groups.(P<0.05).2. Evaluate the vadility of an ultrasound-based method of examining quadriceps femoris in stroke hemiplegias during aerobic training.①There is no significant difference between MRI and ultrasound scanning about thickness of RF and VI, nor the RF- CSA (p>0.05).②No significant difference was found between different examiners (p>0.05).③There was a significant difference (p < 0.05) between relaxed position and the other three isometric contraction conditions evaluated by the thickness of RF and VI. There was no significant difference in the other three isometric contraction conditions(p>0.05). There was also no significant difference among measurements of RF- CSA(p>0.05).④No significant difference in RF- CSA of control group nor train group by ultrasound scanning (p>0.05).Conclusion:The aerobic training can be helpful to improve the patients insulin sensitivity and endurance capacity,but be little helpful to increase muscle bulk. It can be recommended at the every stages after stroke. Motor ability and endurence can be more enhanced when aerobic training was ongoing at the early stage.Ultrasound scanning had good validity and reliability of measuring quadriceps shape compared with MRI.