Deans' stroke musings

Changing stroke rehab and research worldwide now.Time is Brain!Just think of all the trillions and trillions of neurons that DIE each day because there are NO effective hyperacute therapies besides tPA(only 12% effective). I have 493 posts on hyperacute therapy, enough for researchers to spend decades proving them out. These are my personal ideas and blog on stroke rehabilitation and stroke research. Do not attempt any of these without checking with your medical provider. Unless you join me in agitating, when you need these therapies they won't be there.

What this blog is for:

Shortly after getting out of the hospital and getting NO information on the process or protocols of stroke rehabilitation and recovery I started searching on the internet and found that no other survivor received useful information. This is an attempt to cover all stroke rehabilitation information that should be readily available to survivors so they can talk with informed knowledge to their medical staff. It's quite disgusting that this information is not available from every stroke association and doctors group.
My back ground story is here:http://oc1dean.blogspot.com/2010/11/my-background-story_8.html

Tuesday, December 13, 2016

Estimated Prestroke Peak VO2 Is Related to Circulating IGF-1 Levels During Acute Stroke

The real trial needed is whether IGF-1 can be improved post-stroke and will that lead to better recoveries? Survivors don't really care that peak VO2 prestroke leads to better IGF-1 and better recoveries. What can be done post-stroke that leads to better recovery? I had incredible aerobic fitness and that probably saved my life, didn't seem to help with my arm and hand recovery. 
http://nnr.sagepub.com/content/31/1/65?etoc
  1. Anna E. Mattlage, PhD1
  2. Michael A. Rippee, MD1
  3. Michael G. Abraham, MD1
  4. Janice Sandt, MS2
  5. Sandra A. Billinger, PhD1
  1. 1University of Kansas Medical Center, Kansas City, KS, USA
  2. 2University of Kansas Hospital, Kansas City, KS, USA
  1. Sandra A. Billinger, University of Kansas Medical Center, Department of Physical Therapy and Rehabilitation Science, 3901 Rainbow Blvd, Mail Stop 2002, Kansas City, KS 66160, USA. Email: sbillinger@kumc.edu

Abstract

Background. Insulin-like growth factor-1 (IGF-1) is neuroprotective after stroke and is regulated by insulin-like binding protein-3 (IGFBP-3). In healthy individuals, exercise and improved aerobic fitness (peak oxygen uptake; peak VO2) increases IGF-1 in circulation. Understanding the relationship between estimated prestroke aerobic fitness and IGF-1 and IGFBP-3 after stroke may provide insight into the benefits of exercise and aerobic fitness on stroke recovery.  
Objective. The purpose of this study was to determine the relationship of IGF-1 and IGFBP-3 to estimated prestroke peak VO2 in individuals with acute stroke. We hypothesized that (1) estimated prestroke peak VO2 would be related to IGF-1 and IGFBP-3 and (2) individuals with higher than median IGF-1 levels will have higher estimated prestroke peak VO2 compared to those with lower than median levels.  
Methods. Fifteen individuals with acute stroke had blood sampled within 72 hours of hospital admission. Prestroke peak VO2 was estimated using a nonexercise prediction equation. IGF-1 and IGFBP-3 levels were quantified using enzyme-linked immunoassay. Results. Estimated prestroke peak VO2 was significantly related to circulating IGF-1 levels (r = .60; P = .02) but not IGFBP-3. Individuals with higher than median IGF-1 (117.9 ng/mL) had significantly better estimated aerobic fitness (32.4 ± 6.9 mL kg−1 min−1) than those with lower than median IGF-1 (20.7 ± 7.8 mL kg−1 min−1; P = .03). 
Conclusions. Improving aerobic fitness prior to stroke may be beneficial by increasing baseline IGF-1 levels. These results set the groundwork for future clinical trials to determine whether high IGF-1 and aerobic fitness are beneficial to stroke recovery by providing neuroprotection and improving function.

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