The effects of repeated rehabilitation “Tune-Ups” on functional recovery after stroke

TY - ABST

T1 - The effects of repeated rehabilitation “Tune-Ups” on functional recovery after stroke

AU - Clarke, Jared

AU - Mala, Hana

AU - Windle, Victoria

AU - Chernenko, Garry

AU - Corbett, Dale

PY - 2008

Y1 - 2008

N2 - Objectives: For the vast majority of stroke survivors, rehabilitation (i.e. physiotherapy and occupational therapy) is the only treatment option available. Following an initial phase of rehabilitation, many patients are sent home and return periodically for brief periods of therapy … often lasting just days. It is unclear what, if any, benefit this periodic return to therapy has for functional recovery, and if the type and intensity of therapy is optimal for maintaining or further enhancing functional gains. While the beneficial effects of early rehabilitation on neuroplasticity and functional recovery have been modeled in experimental stroke using a combination of enriched environment and rehabilitation (Biernaskie & Corbett, 2001), it remains uncertain if a secondary therapeutic intervention, such as a return to enrichment/rehabilitation ("Tune-Up"), can produce beneficial changes in brain plasticity that might further improve functional recovery. The aim of this study is to examine these questions.   Methods: Rats (n = 53) were exposed to cerebral ischemia or sham surgery and allowed to recover either in standard housing (i.e. “untreated”) or in a combination of enriched environment and rehabilitative reaching (i.e. “enriched/rehab”). Following 9 weeks of treatment, all animals were placed in standard housing for 5 weeks, after which they received 2 weeks of intensive therapy consisting of enhanced enriched environments and structured sensorimotor/cognitive rehabilitative activities (i.e. “Tune-Up” therapy). This was followed by yet another period of rest and “Tune-Up” therapy. A series of behavioural tests were used throughout the study to assess sensorimotor function and monitor recovery. Golgi-Cox analysis was used to examine dendritic arborization and spine densities at the end of the behavioural experiments. Results: Preliminary analysis showed that while early enriched/rehab therapy significantly improved sensorimotor function in both the beam and staircase tests, Tune-Up therapy appears to have had little effect on the recovery of function. Animals that did not receive early rehabilitation did not improve, and those that did receive early rehabilitation did not show any added benefit from the “Tune-Up” therapy. While preliminary Golgi-Cox analysis does not show any significant effect of either therapeutic paradigm on dendritic arborization, all treatment groups did tend to have more complex basilar and apical branching than ischemic animals that received no treatment. Conclusions: Importantly, the current study has reaffirmed the functional benefits of early rehabilitation using a different model of focal ischemia than previously employed in this laboratory. Results to date suggest that “Tune-Up” therapy provides little or no benefit to ischemic rats that received early rehabilitation or to those rats that received no prior therapy. It remains to be determined whether in the absence of “Tune-Up” therapy

AB - Objectives: For the vast majority of stroke survivors, rehabilitation (i.e. physiotherapy and occupational therapy) is the only treatment option available. Following an initial phase of rehabilitation, many patients are sent home and return periodically for brief periods of therapy … often lasting just days. It is unclear what, if any, benefit this periodic return to therapy has for functional recovery, and if the type and intensity of therapy is optimal for maintaining or further enhancing functional gains. While the beneficial effects of early rehabilitation on neuroplasticity and functional recovery have been modeled in experimental stroke using a combination of enriched environment and rehabilitation (Biernaskie & Corbett, 2001), it remains uncertain if a secondary therapeutic intervention, such as a return to enrichment/rehabilitation ("Tune-Up"), can produce beneficial changes in brain plasticity that might further improve functional recovery. The aim of this study is to examine these questions.   Methods: Rats (n = 53) were exposed to cerebral ischemia or sham surgery and allowed to recover either in standard housing (i.e. “untreated”) or in a combination of enriched environment and rehabilitative reaching (i.e. “enriched/rehab”). Following 9 weeks of treatment, all animals were placed in standard housing for 5 weeks, after which they received 2 weeks of intensive therapy consisting of enhanced enriched environments and structured sensorimotor/cognitive rehabilitative activities (i.e. “Tune-Up” therapy). This was followed by yet another period of rest and “Tune-Up” therapy. A series of behavioural tests were used throughout the study to assess sensorimotor function and monitor recovery. Golgi-Cox analysis was used to examine dendritic arborization and spine densities at the end of the behavioural experiments. Results: Preliminary analysis showed that while early enriched/rehab therapy significantly improved sensorimotor function in both the beam and staircase tests, Tune-Up therapy appears to have had little effect on the recovery of function. Animals that did not receive early rehabilitation did not improve, and those that did receive early rehabilitation did not show any added benefit from the “Tune-Up” therapy. While preliminary Golgi-Cox analysis does not show any significant effect of either therapeutic paradigm on dendritic arborization, all treatment groups did tend to have more complex basilar and apical branching than ischemic animals that received no treatment. Conclusions: Importantly, the current study has reaffirmed the functional benefits of early rehabilitation using a different model of focal ischemia than previously employed in this laboratory. Results to date suggest that “Tune-Up” therapy provides little or no benefit to ischemic rats that received early rehabilitation or to those rats that received no prior therapy. It remains to be determined whether in the absence of “Tune-Up” therapy

M3 - Conference abstract in proceedings

SP - C-C3096

BT - Canadian Association of Neuroscience Abstracts

T2 - Canadian Stroke Network Annual General Meeting

Y2 - 16 September 2008 through 17 September 2008

ER -