抗阻和牵拉运动对脑卒中患者肌肉功能改善及其信号调控机制的研究

项目名称： 抗阻和牵拉运动对脑卒中患者肌肉功能改善及其信号调控机制的研究

项目编号： No.81501944

项目类型： 青年科学基金项目

立项/批准年度： 2016

项目学科： 医药、卫生

项目作者： 王丽

作者单位： 苏州大学

项目金额： 18万元

中文摘要： 脑卒中患者多存在肌无力和萎缩等肌肉功能失调现象。抗阻或牵拉训练可有效刺激肌肉，改善肌肉力量和体积，其机制与雷帕霉素机能靶蛋白（mTOR）信号通路激活有关。然而，如何合理有效运动改善脑卒中患者肌肉功能及其信号机制尚不明确。我们研究发现缺血性脑损伤小鼠mTOR信号通路相关蛋白活性显著降低，而健康小鼠运动训练后其活性增加。本课题拟进一步研究抗阻和牵拉训练对脑卒中后肌肉功能的改善作用及mTOR信号通路的调控机制。首先，通过对脑卒中偏瘫严重者实施患侧牵拉、健侧抗阻训练及两者结合干预；其次，对无或轻偏瘫者采用双侧牵拉、抗阻训练及抗阻附加牵拉干预，旨在证实结合运动干预方式对脑卒中患者肌肉功能更好的改善效果。最后，通过对缺血性脑损伤动物模型实施运动与信号激活或抑制干预，探索mTOR信号通路在运动介导的脑卒中后肌肉康复中的重要作用。以上研究将为脑卒中患者的运动康复提供新的证据和指导，并帮助探索新的康复手段。

中文关键词： 脑卒中；骨骼肌；运动训练；功能恢复；信号通路

英文摘要： Muscle function disorders, including muscle weak and atrophy, are common in stroke patients. Both resistance training and stretching are powerful ways stimulating muscle to increase its mass and strength, which is largely through activating the mechanistic target of rapamycin (mTOR) related signaling pathways. However, it is still unclear how to exercise efficiently to restore muscle function in stroke patients as well as its underlying signaling mechanism. Our research found that the mTOR pathway related signaling protein activity is significantly decreased in cerebral ischemic injury mice than in healthy ones. Meanwhile, exercise effectively activate mTOR signaling pathway activity in healthy mice. Based on our previous work, the present project aims at further studying the improvement of muscle function in stroke patients through stretching and resistance exercise and the signaling mechanism involved. Firstly, severely paralyzed patients are subjected to stretching on the affected side, resistance training on the unaffected side, or stretching on the affected side and resistance training on the unaffected side combined. Secondly, mild or not paralyzed patients are subjected to bilateral resistance training, stretching or resistance training followed by stretching. The purpose of these studies is to determine the enhanced effects of combined exercise on two sides or combined exercise styles. Additionally, the important role of mTOR related signaling pathway in exercise mediated muscle rehabilitation after stroke is explored through the cerebral ischemic injury mouse that accept exercise and signaling protein activator or inhibitor intervention. These studies will provide new evidence and guidance for exercise rehabilitation and help to discover novel rehabilitation therapies in stroke patients.

英文关键词： stroke;skeletal muscle;exercise training;function restoration;signaling pathway