Functional Recovery and Serum Angiogenin Changes According to Intensity of Rehabilitation Therapy After Stroke.

Fecha de publicación: 25/11/2021 Fecha Ahead of Print: 25/11/2021

Autores de IIS La Fe

Maria Rosario Beseler Soto

Autor
Juan Bautista Salom Sanvalero

Autor

Participantes ajenos a IIS La Fe

Garcia-Rodriguez N
Rodriguez S
Tejada PI
Miranda-Artieda ZM
Ridao N
Buxó X
Pérez-Mesquida ME
Pérez LM
Inzitari M
Otero-Villaverde S
Martin-Mourelle R
Molleda M
Quintana M
Olivé-Gadea M
Penalba A
Rosell A

Grupos

Unidad Mixta de Investigación Cerebrovascular

Leader

Juan Bautista Salom Sanvalero

Abstract

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.

Datos de la publicación

ISSN/ISSNe:: 1664-2295, 1664-2295
Tipo:: Article
Páginas:: 767484-767484
DOI:: 10.3389/fneur.2021.767484
Factor de Impacto:: 1,027 SCImago ℠
Cuartil:: Q1 SCImago ℠

Documentos

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Métricas

Filiaciones

Garcia-Rodriguez N:: Neurovascular Research Laboratory, Vall d'Hebron Research Institute, Universitat Autònoma de Barcelona, Barcelona, Spain

Unidad de Rehabilitación Neurológica y Daño Cerebral, Hospital Vall d'Hebron, Barcelona, Spain
Rodriguez S:: Unidad de Rehabilitación Neurológica y Daño Cerebral, Hospital Vall d'Hebron, Barcelona, Spain
Tejada PI:: Unidad de Daño Cerebral del Hospital de Górliz, Osakidetza, Górliz, Spain
Miranda-Artieda ZM:: Unidad de Daño Cerebral del Hospital de Górliz, Osakidetza, Górliz, Spain
Ridao N:: Servei de Medicina Física i Rehabilitació, Parc Taulí Hospital Universitari, Institut d'Investigació i Innovació Parc Taulí I3PT, Sabadell, Spain
Buxó X:: Unidad de Rehabilitación Neurológica y Daño Cerebral, Hospital Vall d'Hebron, Barcelona, Spain
Pérez-Mesquida ME:: Unidad de Rehabilitación Neurológica y Daño Cerebral, Hospital Vall d'Hebron, Barcelona, Spain
Beseler MR:: Servicio de Medicina Física y Rehabilitación, Hospital Universitario y Politécnico La Fe, Valencia, Spain
Salom JB:: Unidad Mixta de Investigación Cerebrovascular, Instituto de Investigación Sanitaria La Fe-Universitat de Valencia, Valencia, Spain

Departamento de Fisiología, Universidad de Valencia, Valencia, Spain
Pérez LM:: RE-FiT Barcelona Research Group, Vall d'Hebron Institute of Research, Parc Sanitari Pere Virgili, Barcelona, Spain

Parc Sanitari Pere Virgili, Area of Intermediate Care, Barcelona, Spain
Inzitari M:: RE-FiT Barcelona Research Group, Vall d'Hebron Institute of Research, Parc Sanitari Pere Virgili, Barcelona, Spain

Universitat Oberta de Catalunya, Barcelona, Spain
Otero-Villaverde S:: Hospital Marítimo de Oza, A Coruña, Spain
Martin-Mourelle R:: Hospital Marítimo de Oza, A Coruña, Spain
Molleda M:: Hospital Universitari Germans Tries i Pujol, Badalona, Spain
Quintana M:: Epilepsy Research Group and Epilepsy Unit, Vall d'Hebron Research Institute and Vall d'Hebron Hospital, Barcelona, Spain
Olivé-Gadea M:: Stroke Group, Vall d'Hebron Research Institute, Barcelona, Spain
Penalba A:: Neurovascular Research Laboratory, Vall d'Hebron Research Institute, Universitat Autònoma de Barcelona, Barcelona, Spain
Rosell A:: Neurovascular Research Laboratory, Vall d'Hebron Research Institute, Universitat Autònoma de Barcelona, Barcelona, Spain

Keywords

angiogenin; biomarker; intensive therapy; recovery; rehabilitation

Campos de estudio

Proyectos asociados

RED DE INVESTIGACION (RENEVAS)

Investigador Principal: ENRIQUE ALBORCH DOMÍNGUEZ

RD06/0026/0006 . INSTITUTO DE SALUD CARLOS III; FUNDACIÓN INSTITUTO DE INVESTIGACIÓN SANITARIA DE SANTIAGO DE COMPOSTELA (FIDIS); FUNDACIÓN PARA LA INVESTIGACIÓN DEL HOSPITAL UNIVERSITARIO LA FE DE LA COMUNIDAD VALENCIANA . 2006