Bfast stroke
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BFAST Stroke: Advances in Rehabilitation and Neuroprotection
Biofeedback and Functional Electric Stimulation in Stroke Rehabilitation
Efficacy of Combined Therapies
Recent research has highlighted the potential benefits of combining biofeedback (BFB) and functional electric stimulation (FES) in the rehabilitation of stroke patients with hemiplegia. A controlled, randomized trial involving 36 patients demonstrated that the concurrent use of BFB and FES significantly improved gait parameters. Specifically, patients showed notable improvements in knee and ankle flexion angles during the swing phase of walking, with statistical significance (p = 0.05 and p = 0.02, respectively). Additionally, enhancements were observed in gait velocity, cycle time, and the symmetry of stance phases, indicating a comprehensive improvement in walking ability.
Treatment Protocol and Outcomes
Patients in the study received 30 minutes of treatment three times per week for six weeks, alongside their general rehabilitation program. The improvements in gait were not only evident during the treatment period but also persisted for four weeks post-treatment, suggesting lasting benefits of the combined therapy. Importantly, the time elapsed since the stroke did not significantly affect the outcomes, indicating that these therapies can be beneficial regardless of the stroke's recency.
Intranasal Delivery of bFGF with Nanoliposomes for Neuroprotection
Innovative Delivery Method
Another promising advancement in stroke treatment is the intranasal delivery of basic fibroblast growth factor (bFGF) using nanoliposomes. This method has been shown to enhance neuroprotection and aid in the recovery of neural injury in a rodent model of cerebral ischemia-reperfusion (I/R) injury. The use of nanoliposomes significantly increased the accumulation of bFGF in brain tissues, particularly in the ischemic penumbra regions such as the hippocampus and pallium (p<0.05).
Functional Recovery and Mechanism
Following three consecutive days of intranasal bFGF-nanoliposomal treatment, rats exhibited significant functional recovery, as evidenced by improved neurologic deficit scores and spontaneous locomotor activity. Additionally, the stroke infarct volume was nearly halved (p<0.001), with these effects persisting for 21 days post-treatment. The neuroprotective effects were linked to the activation of the PI3-K/Akt pathway, as they could be blocked by the PI3-K/Akt inhibitor LY294002, underscoring the pathway's role in the therapeutic action.
Conclusion
The integration of biofeedback and functional electric stimulation offers a promising approach to improving gait and overall mobility in stroke patients, with lasting benefits observed beyond the treatment period. Concurrently, the intranasal delivery of bFGF using nanoliposomes represents a groundbreaking method for enhancing neuroprotection and functional recovery in stroke, leveraging the PI3-K/Akt pathway. These advancements underscore the potential for innovative therapies to significantly improve outcomes for stroke patients.
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