Skeletal muscle changes after hemiparetic stroke and potential beneficial effects of exercise intervention strategies

J Rehabil Res Dev, 2008 · DOI: · Published: January 1, 2008

Neurology Rehabilitation Musculoskeletal Medicine

Simple Explanation

Stroke can lead to significant changes in muscles, including atrophy and a shift towards faster muscle fibers, which can affect walking ability. These muscle changes might be linked to inflammation and problems with how the body uses insulin. Exercise, like treadmill training, could help reverse these muscle changes, improving fitness and walking in stroke patients. Exercise may modify or reverse skeletal muscle abnormalities. Research suggests that understanding and targeting these muscle abnormalities could lead to new treatments to improve muscle health and reduce disability after stroke.

Study Duration

Not specified

Participants

60 chronic hemiparetic stroke patients

Evidence Level

Not specified

Key Findings

1
Contralateral leg muscle shows atrophy compared to the ipsilateral leg in chronic stroke patients.
2
Contralateral leg muscle exhibits a shift towards fast-twitch myosin heavy chain isoforms.
3
Treadmill exercise can reverse the contralateral leg MHC profile abnormalities.

Research Summary

Stroke is a major cause of disability, and muscle abnormalities in the contralateral leg may contribute to this disability. These abnormalities include muscle atrophy, altered contractile protein expression, and inflammation. Exercise, particularly treadmill training, may help reverse these muscle abnormalities and improve outcomes after stroke. Study results may provide a biological rationale and new molecular targets for novel pharmacological therapeutics aimed at improving muscle structure and metabolic function after stroke.

Practical Implications

Rehabilitation Strategies

Exercise interventions, particularly aerobic and resistance training, should be considered to address muscle abnormalities after stroke.

Therapeutic Targets

Targeting inflammatory pathways in skeletal muscle may offer a new approach to reducing disability and cardiovascular risk after stroke.

Personalized Medicine

Understanding individual muscle phenotypes after stroke could lead to more tailored rehabilitation programs.

Study Limitations

1
The current studies cannot explain the direction of these relationships; i.e., whether the atrophy and the shift in MHC expression are caused by or are a result of the gait deficit.
2
The effects of exercise on muscle structure and function have never been systematically studied after stroke.
3
Lack of detailed investigation into the underlying molecular mechanisms of muscle atrophy and phenotype shift.

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