Razi Journal of Medical Sciences

fa مروری بر تأثیر انواع تمرینات ورزشی بر تغییرات سلولی-مولکولی نورون‌های عصبی در دوره توان‌بخشی پس از سکته مغزی ایسکمیک Review of The Effect of Different Types of Exercise on Cellular-Molecular Changes of Neurons in The Rehabilitation Period after Ischemic Stroke فیزیولوژی ورزش Exercise Physiology مروري review article زمینه و هدف: بازماندگان پس از سکته مغزی، دچار اختلالات حرکتی، ضعف حافظه و مشکلات شناختی میشوند. ورزش میتواند استراتژی مناسبی برای توان‌بخشی این بیماران باشد. هدف از این مطالعه مروری، بررسی مطالعات گذشته در خصوص اثر محافظتی و تمایز پذیری عصبی انواع تمرینات ورزشی در دوره توان‌بخشی پس از سکته مغزی ایسکمیک میباشد. روش کار: جهت یافتن مقالات با محوریت تأثیر انواع تمرینات ورزشی بر روی سلولهای عصبی آسیبدیده پس از سکته مغزی، از بانک‌های اطلاعاتی و وبگاه‌های متعدد از جمله: Google Scholar، PubMed، Web of Science و Scopus استفاده شد. سپس با در نظر گرفتن معیارهای ورود و خروج، فرآیند مرور، غربالگری و حذف اطلاعات تکراری و غیر مرتبط، کلیه مقالات در بازه زمانی سال‌های 2005 تا 2021 انتخاب و در نهایت 65 مقاله مرتبط با موضوع، مورد بررسی قرار گرفت. یافتهها: با توجه به بررسیهای صورت گرفته در خصوص تأثیر انواع تمرینات ورزشی در بازههای زمانی مختلف پس از سکته مغزی، تمرینات ورزشی مختلف، تغییرات متفاوتی را در سلولهای عصبی ایجاد میکنند که این اثرات وابسته به زمان شروع تمرینات پس از سکته مغزی و نوع تمرینات ورزشی، میباشند. نتیجهگیری: بر اساس نتایج به دست آمده در مطالعات، تمرینات ورزشی با شدت کم در فاز حاد تا یک هفته پس از سکته مغزی و تمرینات با شدت بالا در فاز مزمن، بیش از یک هفته پس از سکته مغزی، بیشترین تأثیرات آنابولیک را در سلولهای عصبی آسیب‌دیده خواهند داشت که در این زمینه میتوان استراتژیهایی مانند ورزشهای با شدت و مدت فزاینده را در نظر گرفت البته نیاز به بررسیهای بیشتر در این زمینه وجود دارد. Background & Aims: Many studies have shown that after ischemic stroke, survivors experience motor dysfunction, memory impairment, and cognitive problems. Exercise is an effective and widely used factor in rehabilitation strategy to improve cognitive recovery and motor control following ischemic conditions caused by stroke, which is effective by increasing signaling pathways related to neurogenesis, synaptogenesis, etc. Recognizing and examining these factors as a result of exercise can be a principled solution to prescribe the most efficient and effective training method for the faster recovery of people suffering from stroke. Stroke is a type of injury related to blood vessels in different levels of the brain. A clinical study of people who had a stroke showed that over several years after the stroke, people who had different types of exercise in their rehabilitation program showed good functional results in neurological rehabilitation, but in groups Without exercise, most people developed aggravated neurological disorders, with mortality in this group being much higher than in the other group. Lack of blood supply to nerve cells in the CNS causes neurological and cognitive disorders, in which all parts of the nerve cell such as the cell body, axons, axonal terminus, and dendritic cavity in the penumbra region Deprived of blood affects the healing processes of various therapies, often involving neurogenesis and angiogenesis, which regenerate damaged cells in neural circuits. The neuroplasticity process in the central nervous system is divided into two parts: structural and functional changes, which have the ability to adapt to learning processes, and cognitive memory following neurological damage, which are dynamic processes that a number of centers Different parts of the central nervous system will undergo numerous changes and interactions. However, by natural mechanisms, the body produces simultaneous changes after ischemic brain injury, but these changes are not sufficient to reverse and repair the damage. In normal conditions or in conditions of brain injuries, rehabilitation can be created as a dynamic process in the nervous system with the aim of adapting to different conditions. Recently, exercise has been considered an effective and practical factor to increase cognitive function and motor function in rehabilitation conditions that increase dendritic branching and axonal myelination through neuroplasticity processes such as increased neural activity and postsynaptic stimulation ability. These phenomena can occur after a stroke. Due to the importance of recognizing and examining the effective factors in the rehabilitation period after stroke, exercise in recent years has shown a very effective role in improving the physical and cognitive condition of these patients. Therefore, the aim of this study was to identify the effective mechanisms in the neurogenic and angiogenic process and also to inhibit apoptotic processes due to exercise as effective factors in improving motor function and cognitive ability after stroke. Methods: To conduct this study, search the Google Scholar, PubMed, Web of Science databases on the effect of various types of exercise on neuronal molecular and cellular changes in the post-ischemic stroke rehabilitation period from 2005 to 2021. Mainly in the title, abstract of articles, and keywords in the studied articles, the words, Ischemic stroke, Rehabilitation, Endurance training, cognitive training, Neuroplasticity, were searched. The inclusion criteria for the selected papers were to be published in Latin in international and prestigious journals, and in general to be about the effect of exercise on molecular cellular signaling in the post-stroke rehabilitation period. Finally, based on the standard principles and the title of the articles, the title of the present study was done with 65 articles Results: In this review, we discussed recent studies on the cellular and molecular mechanisms of exercise-induced neuroplasticity and Neuroprotective after stroke, analyzed the type of exercise rehabilitation. Studies from 2005 to 2021 have shown that exercise, depending on the type, can inhibit nerve cell-degrading factors and rehabilitate them, as well as the formation of new neurons in the penumbra region with cellular and molecular changes specific to neurogenesis. In general, among the various training methods, high-intensity interval training had more advantages, which was also very important considering the time to start training after a stroke. Finally, it was found that the types of exercise in post-stroke rehabilitation will vary greatly based on the type of exercise that should be used based on the type and amount of stroke, in order to determine the exact effects of different types of exercise, more research is needed in the future. Conclusion: It seems that one of the effective strategies in designing exercises for rehabilitation and recovery disorders caused by stroke is to use incremental methods in duration and intensity levels that start with very low-intensity exercises and increase the intensity of exercises over time. سکته مغزی ایسکمیک, توان‌بخشی, تمرینات استقامتی, تمرینات شناختی, تمایز پذیری عصبی Ischemic stroke, Rehabilitation, Endurance training, cognitive training, Neuroplasticity 89 104 http://rjms.iums.ac.ir/browse.php?a_code=A-10-6113-1&slc_lang=fa&sid=1 Moein Fasihiyan معین فصیحیان 3900319475328460067615 3900319475328460067615 No PhD Student in Sports Physiology, Department of Sports Sciences, University of Shahid Beheshti, Tehran, Iran دانشجوی دکتری، گروه فیزیولوژی ورزشی، دانشکده علوم ورزشی و تندرستی، دانشگاه شهید بهشتی، تهران، ایران Maryam Taheri مریم طاهری 3900319475328460067616 3900319475328460067616 No Phd Student In Sports Physiology, Department Of Sports Sciences, University Of Shahid beheshti, Tehran, Iran دانشجوی دکتری، گروه فیزیولوژی ورزشی، دانشکده علوم ورزشی و تندرستی، دانشگاه شهید بهشتی، تهران، ایران Khosrow Ebrahim خسرو ابراهیم 3900319475328460067617 3900319475328460067617 No Professor, Department of Sports Physiology, Faculty of Sports and Health Sciences, Shahid Beheshti University, Tehran, Iran استاد، گروه فیزیولوژی ورزشی، دانشکده علوم ورزشی و تندرستی، دانشگاه شهید بهشتی، تهران، ایران Maryam Nourshahi مریم نورشاهی m-nourshahi@sbu.ac.ir 3900319475328460067618 3900319475328460067618 Yes Associate Professor, Department of Sports Physiology, Faculty of Sports and Health Sciences, Shahid Beheshti University, Tehran, Iran دانشیار، گروه فیزیولوژی ورزشی، دانشکده علوم ورزشی و تندرستی، دانشگاه شهید بهشتی، تهران، ایران