OBJECTIVE: To investigate the effect of aerobic exercise versus control (stretching/balance) on inflammatory and oxidative stress biomarkers in stroke survivors and whether these changes are associated with improvements in physical and metabolic health. DESIGN: Randomized controlled trial SETTING: The general communities of Baltimore, MD and Atlanta, GA. PARTICIPANTS: 246 older (> 50 years), chronic (> 6 months) stroke survivors with hemiparetic gait were recruited, with 51 completing pre-intervention testing and 39 completing post-intervention testing. Participants were required to have completed all conventional physical therapy and be capable of walking three minutes on a treadmill. INTERVENTION: Participants completed six months of 2x per week stretching/balance (ST; n = 19) or 3x per week aerobic treadmill rehabilitation (TM; n = 20). MAIN OUTCOME MEASURES: Peak oxygen uptake rate (VO2peak), 6-minute walking distance (6MWD), fasting plasma glucose, insulin, oxidative stress and inflammatory biomarkers were assessed pre- and post-intervention. Homeostatic Model Assessment of Insulin Resistance (HOMA-IR) was calculated. RESULTS: Physical function and metabolic health parameters tended to improve following TM, but not ST (ST versus TM: VO2peak: -9% versus 24% (p < 0.01); 6MWD: 1% versus 15% (p = 0.05); insulin: -1% versus -31% (p = 0.05); HOMA-IR: -3% versus -29% (p = 0.06)). Plasma concentrations of nitrotyrosine, protein carbonyls, and oxidized low density lipoprotein (oxLDL) tended to decrease from pre-intervention concentrations in response to TM compared to ST (ST versus TM: nitrotyrosine: 2% versus -28% (p = 0.01); protein carbonyls: -4% versus -34% (p = 0.08); oxLDL: -3% versus -32% (p < 0.01)). Changes in circulating concentrations of C-reactive protein, protein carbonyls, and oxLDL were negatively associated with changes in VO2peak and 6MWD (r's -0.40 to 0.76) and positively associated with fasting plasma insulin and HOMA-IR (r's = 0.52 to 0.81) (p's < 0.01). CONCLUSIONS: Six months of TM tends to be associated with increased functional capacity and reduced oxidative stress in chronic stroke survivors. Our findings identify potentially modifiable systemic markers of inflammation and oxidative stress important to stroke rehabilitation and provide potential targets for novel therapeutics in future studies.

Full text (sometimes free) may be available at these link(s):      help

• DOI
• PubMed
• PDF locator
• publisher