Aerobic Training and Mobilization Early Post-stroke: Cautions and Considerations

Knowledge gaps exist in how we implement aerobic exercise programs during the early phases post-stroke. Therefore, the objective of this review was to provide evidence-based guidelines for pre-participation screening, mobilization, and aerobic exercise training in the hyper-acute and acute phases post-stroke. In reviewing the literature to determine safe timelines of when to initiate exercise and mobilization we considered the following factors: arterial blood pressure dysregulation, cardiac complications, blood-brain barrier disruption, hemorrhagic stroke transformation, and ischemic penumbra viability. These stroke-related impairments could intensify with inappropriate mobilization/aerobic exercise, hence we deemed the integrity of cerebral autoregulation to be an essential physiological consideration to protect the brain when progressing exercise intensity. Pre-participation screening criteria are proposed and countermeasures to protect the brain from potentially adverse circulatory effects before, during, and following mobilization/exercise sessions are introduced. For example, prolonged periods of standing and static postures before and after mobilization/aerobic exercise may elicit blood pooling and/or trigger coagulation cascades and/or cerebral hypoperfusion. Countermeasures such as avoiding prolonged standing or incorporating periodic lower limb movement to activate the venous muscle pump could counteract blood pooling after an exercise session, minimize activation o...
Source: Frontiers in Neurology - Category: Neurology Source Type: research

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CONCLUSION: Thus, diabetes mellitus itself was not an independent factor associated with IAD. A larger IAD was preferentially associated with the presence of PAD, and this association was modified by age. PMID: 31813900 [PubMed - as supplied by publisher]
Source: Journal of Atherosclerosis and Thrombosis - Category: Cardiology Tags: J Atheroscler Thromb Source Type: research
ConclusionChildren and adolescents diagnosed with stroke present a worse performance in the electrophysiological and behavioral evaluations of central auditory processing when compared to a control group.ResumoIntroduçãoO processamento auditivo central refere-se à eficiência e eficácia com que o sistema nervoso central utiliza informações auditivas e pode estar alterado em distúrbios neurológicos e lesões cerebrais, como acidentes vasculares cerebrais. No entanto, apesar das evidências de possíveis alterações na populaç&a...
Source: Brazilian Journal of Otorhinolaryngology - Category: ENT & OMF Source Type: research
Publication date: Available online 10 December 2019Source: Canadian Journal of DiabetesAuthor(s): Antoine B.M. Clarke, Hanaa Ahsan, Jennifer Harrington, Farid H. MahmudAbstractBackgroundThe factors associated with allied healthcare professional (HCP) time spent face-to-face with patients in clinic have not been well described in type 1 diabetes (T1D) given the introduction of resource-intensive technologies and gaps in socioeconomic circumstances.ObjectiveTo evaluate clinical and social factors associated with non-physician HCP time in a pediatric T1D practice.MethodsNon-physician HCP workload data, including time spent in...
Source: Canadian Journal of Diabetes - Category: Endocrinology Source Type: research
Publication date: Available online 25 September 2019Source: Canadian Journal of DiabetesAuthor(s): Tyler B. Dubois, Scot H. Simpson, Dean T. EurichAbstractObjectivesOur aim in this study was to determine whether differences exist in time to treatment intensification in newly treated type 2 diabetes patients in Canada and the United States (US).MethodsTwo separate retrospective cohorts of diabetes patients were used from Canada and the US. Time to treatment intensification (i.e. addition of a second antihyperglycemic agent after initial metformin use) was determined using multivariate Cox proportional hazard models.ResultsA...
Source: Canadian Journal of Diabetes - Category: Endocrinology Source Type: research
Yafeng Wang1,2,3, Yanan Wu2, Tao Li1,2,3, Xiaoyang Wang2,4 and Changlian Zhu2,3* 1Department of Neonatology (NICU), Children’s Hospital Affiliated Zhengzhou University, Zhengzhou, China 2Henan Key Laboratory of Child Brain Injury, Institute of Neuroscience and Third Affiliated Hospital of Zhengzhou University, Zhengzhou, China 3Department of Clinical Neuroscience, Center for Brain Repair and Rehabilitation, Institute of Neuroscience and Physiology, University of Gothenburg, Gothenburg, Sweden 4Department of Physiology, Sahlgrenska Academy, Institute of Neuroscience and Physiology, University of Gothenburg, ...
Source: Frontiers in Physiology - Category: Physiology Source Type: research
Conclusions: Anemia on admission was associated with higher mortality and an increased risk of poor outcome in patients with ICH. However, the results were limited by the high heterogeneity of included studies. Prospective, multi-center or population-based, large sample cohort studies are needed in the future. Introduction Intracerebral hemorrhage (ICH) is the second most common cause of stroke and a highly lethal disease (1), which still lacks effective therapeutic interventions (2, 3). Although age, baseline ICH volume and neurological status on admission are well-known predictors of outcome of ICH (4), none of t...
Source: Frontiers in Neurology - Category: Neurology Source Type: research
CONCLUSION: CP-CML patients treated with different TKIs (ponatinib, bosutinib, imatinib, dasatinib, and nilotinib) did not have different incidence of cardiovascular events (MACE, AOEs, VTEs) in this small cohort of real-world patients with ≥6-month of follow-up. The results were consistent among patients with prior use of one and two TKI types.DisclosuresLevy: Takeda (Millennium Pharmaceuticals, Inc.): Consultancy. Xie: STATinMED Research: Employment. Wang: STATinMED Research: Employment. Neumann: Takeda (Millennium Pharmaceuticals, Inc.): Employment. Srivastava: Takeda (Millennium Pharmaceuticals, Inc.): Employment. N...
Source: Blood - Category: Hematology Authors: Tags: 903. Outcomes Research-Non-Malignant Hematology: Poster II Source Type: research
Background— Patients with ST-segment–elevation myocardial infarction are at increased risk of cerebrovascular events. We assessed the incidence, predictors, and implications of cerebrovascular events in patients with ST-segment–elevation myocardial infarction managed with a primary percutaneous coronary intervention strategy. Methods and Results— In the Harmonizing Outcomes With Revascularization and Stents in Acute Myocardial Infarction (HORIZONS-AMI) trial, 72 of 3602 patients (2.0%) experienced at least 1 cerebrovascular event (stroke: 63 patients; transient ischemic attack: 12 patients) during ...
Source: Circulation: Cardiovascular Interventions - Category: Cardiology Authors: Tags: Catheter-based coronary interventions: stents, Acute myocardial infarction, Acute Stroke Syndromes Source Type: research
Conclusions VHL/PBRM1 mutations confirmed 3rd subtype identified and under review but appears to be mis-classified tumors.  Shows value of molecular methods rather than new mechanistic insights. Integration with survival outcome—suggests molecular detailing can be prognostic Full integrative analysis in process Preliminary data can be found at http://tcga-data.nci.hih.gov/tcga/ FoxO Transcription Factors in mTORC1- Activated Renal Tumorigenesis:  Implications for the RCC Treatment Boyi Gan, MD Anderson Cancer Center FoxO Family Transcription Factors:  mammals possess FoxO...
Source: Kidney Cancer Association - Category: Urology & Nephrology Source Type: news
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