Constraint-induced movement therapy and rehabilitation exercises lessen motor deficits and volume of brain injury after striatal hemorrhagic stroke in rats

Constraint-induced movement therapy (CIMT) promotes motor recovery after occlusive stroke in humans, but its efficacy after intracerebral hemorrhage (ICH) has not been investigated clinically or in the laboratory. In this study we tested whether CIMT and a rehabilitation exercise program would lesse...

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Bibliographic Details
Published in:Stroke (1970) 2003-04, Vol.34 (4), p.1021-1026
Main Authors: DEBOW, Suzanne B, DAVIES, Melissa L. A, CLARKE, Heather L, COLBOURNE, Frederick
Format: Article
Language:English
Subjects:
Animals
Behavior, Animal
Biological and medical sciences
Brain - pathology
Cerebral Hemorrhage - pathology
Cerebral Hemorrhage - rehabilitation
Cerebral Hemorrhage - therapy
Combined Modality Therapy
Corpus Striatum
Diseases of the nervous system
Exercise Therapy - methods
Immobilization
Male
Medical sciences
Motor Skills Disorders - rehabilitation
Motor Skills Disorders - therapy
Movement
Radiotherapy. Instrumental treatment. Physiotherapy. Reeducation. Rehabilitation, orthophony, crenotherapy. Diet therapy and various other treatments (general aspects)
Rats
Rats, Sprague-Dawley
Stroke - pathology
Stroke - therapy
Stroke Rehabilitation
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Summary:Constraint-induced movement therapy (CIMT) promotes motor recovery after occlusive stroke in humans, but its efficacy after intracerebral hemorrhage (ICH) has not been investigated clinically or in the laboratory. In this study we tested whether CIMT and a rehabilitation exercise program would lessen motor deficits after ICH in rats. Rats were subjected to striatal ICH (via infusion of collagenase) or sham stroke. Seven days later, treatment began with CIMT (8 h/d of ipsilateral forelimb restraint), rehabilitation exercises (eg, reaching, walking; 1 h/d), or both for 7 days. Some rats were not treated. Motor deficits were assessed up to the 60-day survival time, after which the volume of tissue lost was determined. Untreated ICH rats made more limb slips traversing a horizontal ladder and showed an asymmetry toward less use of the contralateral paw in the cylinder test of limb use asymmetry (day 28). These rats were also significantly less successful in the Montoya staircase test (days 55 to 59) of skilled reaching. Neither therapy alone provided much benefit. However, the combination of daily exercises and CIMT substantially and persistently improved recovery. Unexpectedly, this group had a statistically smaller volume of tissue lost than untreated ICH rats. The combination of focused rehabilitation exercises and CIMT effectively promotes functional recovery after ICH, while either therapy alone is less effective. This therapy may work in part by reducing the volume of tissue lost, likely through reducing atrophy while promoting remodeling.
ISSN:0039-2499
1524-4628
DOI:10.1161/01.str.0000063374.89732.9f