Functional Recovery and Serum Angiogenin Changes According to Intensity of Rehabilitation Therapy After Stroke
Background: Rehabilitation is still the only treatment available to improve functional status after the acute phase of stroke. Most clinical guidelines highlight the need to design rehabilitation treatments considering starting time, intensity, and frequency, according to the tolerance of the patien...
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Frontiers Media S.A.
2021
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oai:doaj.org-article:487cfa4eeb5c430f99fe0bb9d56bbecf2021-11-30T22:00:30ZFunctional Recovery and Serum Angiogenin Changes According to Intensity of Rehabilitation Therapy After Stroke1664-229510.3389/fneur.2021.767484https://doaj.org/article/487cfa4eeb5c430f99fe0bb9d56bbecf2021-11-01T00:00:00Zhttps://www.frontiersin.org/articles/10.3389/fneur.2021.767484/fullhttps://doaj.org/toc/1664-2295Background: Rehabilitation is still the only treatment available to improve functional status after the acute phase of stroke. Most clinical guidelines highlight the need to design rehabilitation treatments considering starting time, intensity, and frequency, according to the tolerance of the patient. However, there are no homogeneous protocols and the biological effects are under investigation.Objective: To investigate the impact of rehabilitation intensity (hours) after stroke on functional improvement and serum angiogenin (ANG) in a 6-month follow-up study.Methods: A prospective, observational, longitudinal, and multicenter study with three cohorts: strokes in intensive rehabilitation therapy (IRT, minimum 15 h/week) vs. conventional therapy (NO-IRT, <15 h/week), and controls subjects (without known neurological, malignant, or inflammatory diseases). A total of seven centers participated, with functional evaluations and blood sampling during follow-up. The final cohort includes 62 strokes and 43 controls with demographic, clinical, blood samples, and exhaustive functional monitoring.Results: The median (IQR) number of weekly hours of therapy was different: IRT 15 (15–16) vs. NO-IRT 7.5 (5–9), p < 0.01, with progressive and significant improvements in both groups. However, IRT patients showed earlier improvements (within 1 month) on several scales (CAHAI, FMA, and FAC; p < 0.001) and the earliest community ambulation achievements (0.89 m/s at 3 months). There was a significant difference in ANG temporal profile between the IRT and NO-IRT groups (p < 0.01). Additionally, ANG was elevated at 1 month only in the IRT group (p < 0.05) whereas it decreased in the NO-IRT group (p < 0.05).Conclusions: Our results suggest an association of rehabilitation intensity with early functional improvements, and connect the rehabilitation process with blood biomarkers.Nicolás Garcia-RodriguezNicolás Garcia-RodriguezSusana RodriguezPedro Ignacio TejadaZuberoa Maite Miranda-ArtiedaNatalia RidaoXavi BuxóMaría Engracia Pérez-MesquidaMaria Rosario BeselerJuan B. SalomJuan B. SalomLaura M. PérezLaura M. PérezMarco InzitariMarco InzitariSergio Otero-VillaverdeRosa Martin-MourelleMercedes MolledaManuel QuintanaMarta Olivé-GadeaAnna PenalbaAnna RosellFrontiers Media S.A.articleangiogeninintensive therapyrehabilitationbiomarkerrecoveryNeurology. Diseases of the nervous systemRC346-429ENFrontiers in Neurology, Vol 12 (2021) |
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angiogenin intensive therapy rehabilitation biomarker recovery Neurology. Diseases of the nervous system RC346-429 |
| spellingShingle |
angiogenin intensive therapy rehabilitation biomarker recovery Neurology. Diseases of the nervous system RC346-429 Nicolás Garcia-Rodriguez Nicolás Garcia-Rodriguez Susana Rodriguez Pedro Ignacio Tejada Zuberoa Maite Miranda-Artieda Natalia Ridao Xavi Buxó María Engracia Pérez-Mesquida Maria Rosario Beseler Juan B. Salom Juan B. Salom Laura M. Pérez Laura M. Pérez Marco Inzitari Marco Inzitari Sergio Otero-Villaverde Rosa Martin-Mourelle Mercedes Molleda Manuel Quintana Marta Olivé-Gadea Anna Penalba Anna Rosell Functional Recovery and Serum Angiogenin Changes According to Intensity of Rehabilitation Therapy After Stroke |
| description |
Background: Rehabilitation is still the only treatment available to improve functional status after the acute phase of stroke. Most clinical guidelines highlight the need to design rehabilitation treatments considering starting time, intensity, and frequency, according to the tolerance of the patient. However, there are no homogeneous protocols and the biological effects are under investigation.Objective: To investigate the impact of rehabilitation intensity (hours) after stroke on functional improvement and serum angiogenin (ANG) in a 6-month follow-up study.Methods: A prospective, observational, longitudinal, and multicenter study with three cohorts: strokes in intensive rehabilitation therapy (IRT, minimum 15 h/week) vs. conventional therapy (NO-IRT, <15 h/week), and controls subjects (without known neurological, malignant, or inflammatory diseases). A total of seven centers participated, with functional evaluations and blood sampling during follow-up. The final cohort includes 62 strokes and 43 controls with demographic, clinical, blood samples, and exhaustive functional monitoring.Results: The median (IQR) number of weekly hours of therapy was different: IRT 15 (15–16) vs. NO-IRT 7.5 (5–9), p < 0.01, with progressive and significant improvements in both groups. However, IRT patients showed earlier improvements (within 1 month) on several scales (CAHAI, FMA, and FAC; p < 0.001) and the earliest community ambulation achievements (0.89 m/s at 3 months). There was a significant difference in ANG temporal profile between the IRT and NO-IRT groups (p < 0.01). Additionally, ANG was elevated at 1 month only in the IRT group (p < 0.05) whereas it decreased in the NO-IRT group (p < 0.05).Conclusions: Our results suggest an association of rehabilitation intensity with early functional improvements, and connect the rehabilitation process with blood biomarkers. |
| format |
article |
| author |
Nicolás Garcia-Rodriguez Nicolás Garcia-Rodriguez Susana Rodriguez Pedro Ignacio Tejada Zuberoa Maite Miranda-Artieda Natalia Ridao Xavi Buxó María Engracia Pérez-Mesquida Maria Rosario Beseler Juan B. Salom Juan B. Salom Laura M. Pérez Laura M. Pérez Marco Inzitari Marco Inzitari Sergio Otero-Villaverde Rosa Martin-Mourelle Mercedes Molleda Manuel Quintana Marta Olivé-Gadea Anna Penalba Anna Rosell |
| author_facet |
Nicolás Garcia-Rodriguez Nicolás Garcia-Rodriguez Susana Rodriguez Pedro Ignacio Tejada Zuberoa Maite Miranda-Artieda Natalia Ridao Xavi Buxó María Engracia Pérez-Mesquida Maria Rosario Beseler Juan B. Salom Juan B. Salom Laura M. Pérez Laura M. Pérez Marco Inzitari Marco Inzitari Sergio Otero-Villaverde Rosa Martin-Mourelle Mercedes Molleda Manuel Quintana Marta Olivé-Gadea Anna Penalba Anna Rosell |
| author_sort |
Nicolás Garcia-Rodriguez |
| title |
Functional Recovery and Serum Angiogenin Changes According to Intensity of Rehabilitation Therapy After Stroke |
| title_short |
Functional Recovery and Serum Angiogenin Changes According to Intensity of Rehabilitation Therapy After Stroke |
| title_full |
Functional Recovery and Serum Angiogenin Changes According to Intensity of Rehabilitation Therapy After Stroke |
| title_fullStr |
Functional Recovery and Serum Angiogenin Changes According to Intensity of Rehabilitation Therapy After Stroke |
| title_full_unstemmed |
Functional Recovery and Serum Angiogenin Changes According to Intensity of Rehabilitation Therapy After Stroke |
| title_sort |
functional recovery and serum angiogenin changes according to intensity of rehabilitation therapy after stroke |
| publisher |
Frontiers Media S.A. |
| publishDate |
2021 |
| url |
https://doaj.org/article/487cfa4eeb5c430f99fe0bb9d56bbecf |
| work_keys_str_mv |
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