Treadmill exercise by stroke survivors can benefit their hearts and brains, a group of researchers found.
Most people know that regular exercise improves fitness, lowers blood pressure and burns calories. There is widespread agreement that physical activity is good for everyone, and that exercise is one of the best ways to stave off many miseries that accumulate with the passing years. And when people do have heart attacks or break bones, exercise is a key component in rehabilitation.
But maybe not for stroke. Most doctors believed that after several months people trying to regain function after a stroke had gone as far as they were going to. If people didn’t get better after half a year they simple weren’t going to.
Recent research demonstrated that although there may be plateaus in the course of recovery, exercise can improve function years after the stroke occurred.
Findings appeared in the March issue of the Cleveland Clinic Journal of Medicine.
The research, led by Andreas Luft of Germany’s University of Tubingen and a group of Baltimore scientists, examined the effect of six months of treadmill exercise training in university labs in chronically disabled stroke survivors.
Treadmill exercise improves fitness and walking ability in patients when initiated 6 months or more following stroke, the research found. Rapid improvement, even with rehabilitation, is rare. Between 80 percent and 90 percent of stroke survivors have a motor deficit, with walking impairments the most common. Most stroke survivors also have diminished fitness capabilities.
The study looked at peak oxygen consumption during treadmill walking between stroke survivors and healthy, but sedentary volunteers. The stroke survivors had approximately 50 percent lower levels of peak fitness- using 75 percent of their functional capacity compared with 27 percent with the healthy volunteers. Stroke volunteers also showed a poorer gait and required greater oxygen consumption to sustain their walking speeds.
The clinical program the volunteers participated in lasted 6 months and involved moderate activity training, primarily on the treadmill. The program’s lower-limb workouts include using a treadmill modified with handrails and other safety devices, as well as stair-stepping, shifting weight from foot to foot, and other exercises tailored to the patient’s abilities. The upper extremity exercises include reaching, grasping, and other repetitive movements.
For the study, 32 chronically disabled stroke survivors took part in the research. The volunteers participated in the treadmill program three times a week.
Source: Luft et. al “Post-stroke exercise rehabilitation: What we know about retraining the motor system
and how it may apply to retraining the heart.” Cleveland Clinic Journal of Medicine, Vol. 75, Supplement 2, March 2008, S83
Tuesday, April 22, 2008
Diabetes Medication Can Help Heart Health
The type of medicine matters when it comes to heart health among diabetics.
A new study has found evidence that medications that lower blood sugar levels can slow the progression of a condition that can lead to heart attacks.
Known as the PERISCOPE trial, the study looked at 543 patients with coronary disease and type 2 diabetes to see how insulin producing drugs compared with insulin providing drugs in combating coronary atherosclerosis, a build up of fat deposits in the artery walls that can lead to stroke or heart attack.
Dr. Steven E. Nissen of the Department of Cardiovascular Medicine at Cleveland Clinic Foundation was the lead author of the study, which was published in the April 2 issue of the Journal of the American Medical Association.
The research demonstrates for the first time the ability of a blood sugar lowering medication to slow the artery buildup in patients with diabetes. Cardiovascular diseases are the cause of death in approximately 75 percent of patients with diabetes.
Patients with diabetes often take oral medications to lower their blood sugar levels. There are two main types of drugs that function quite differently. One type of drug simulates insulin secretion, known as secretagogues. The other type of drug reduces insulin resistance, known as insulin sensitizers.
The research compared the effects of pioglitazone, a type of insulin sensitizer, with that of glimepiride, an insulin secreting drug, on the progression of the artery wall fat buildup in patients with Type 2 diabetes.
Treatment with the insulin sensitizer resulted in a lower rate of progression of coronary atherosclerosis compared with the insulin secreting drug in patients with type 2 diabetes and coronary artery disease, the study authors conclude.
The 543 patients with coronary disease and type 2 diabetes, who participated in the double-blind, randomized trial at 97 hospitals in North and South America, received the insulin secreting drug for 18 months.
To be eligible, patients had to be age 35 to 85 with a HbA1c, measure of blood sugar, level between 6.0% and 9.0%, if taking a blood sugar lowering medication or a 6.5% to 10% if not on medication. Patients were excluded if they had uncontrolled high blood pressure or liver disease. Participants were tested beforehand to make sure less than half of their arteries were blocked.
In addition to slowing the progression of coronary atherosclerosis, participants registered cholesterol and blood pressure levels below the target guidelines for patients with diabetes.
Source: Nissen et al., “Comparison of Pioglitazone vs. Glimepiride on Progression of Coronary Atherosclerosis in Patients with Type 2 Diabetes.” April 2, 2008 Journal of American Medical Association.
A new study has found evidence that medications that lower blood sugar levels can slow the progression of a condition that can lead to heart attacks.
Known as the PERISCOPE trial, the study looked at 543 patients with coronary disease and type 2 diabetes to see how insulin producing drugs compared with insulin providing drugs in combating coronary atherosclerosis, a build up of fat deposits in the artery walls that can lead to stroke or heart attack.
Dr. Steven E. Nissen of the Department of Cardiovascular Medicine at Cleveland Clinic Foundation was the lead author of the study, which was published in the April 2 issue of the Journal of the American Medical Association.
The research demonstrates for the first time the ability of a blood sugar lowering medication to slow the artery buildup in patients with diabetes. Cardiovascular diseases are the cause of death in approximately 75 percent of patients with diabetes.
Patients with diabetes often take oral medications to lower their blood sugar levels. There are two main types of drugs that function quite differently. One type of drug simulates insulin secretion, known as secretagogues. The other type of drug reduces insulin resistance, known as insulin sensitizers.
The research compared the effects of pioglitazone, a type of insulin sensitizer, with that of glimepiride, an insulin secreting drug, on the progression of the artery wall fat buildup in patients with Type 2 diabetes.
Treatment with the insulin sensitizer resulted in a lower rate of progression of coronary atherosclerosis compared with the insulin secreting drug in patients with type 2 diabetes and coronary artery disease, the study authors conclude.
The 543 patients with coronary disease and type 2 diabetes, who participated in the double-blind, randomized trial at 97 hospitals in North and South America, received the insulin secreting drug for 18 months.
To be eligible, patients had to be age 35 to 85 with a HbA1c, measure of blood sugar, level between 6.0% and 9.0%, if taking a blood sugar lowering medication or a 6.5% to 10% if not on medication. Patients were excluded if they had uncontrolled high blood pressure or liver disease. Participants were tested beforehand to make sure less than half of their arteries were blocked.
In addition to slowing the progression of coronary atherosclerosis, participants registered cholesterol and blood pressure levels below the target guidelines for patients with diabetes.
Source: Nissen et al., “Comparison of Pioglitazone vs. Glimepiride on Progression of Coronary Atherosclerosis in Patients with Type 2 Diabetes.” April 2, 2008 Journal of American Medical Association.
Thursday, April 17, 2008
Conversation with Howard Eichenbaum
Howard Eichenbaum describes himself as “cognitive neuroscientist.”
The Boston University researcher combines biology and psychology for his job, which is a cross between psychologist and neuroscientist.
As part of the Center for Memory and Brain, Eichenbaum studies rats’ brains to learn how memory functions in animals, including humans. Eichenbaum hopes that understanding psychology and biology can help researchers make strides in alleviating human memory loss.
Eichenbaum earned an undergraduate degree in biology before he switched to psychology in graduate school. He obtained both degrees from the University of Michigan, before doing his postdoctoral fellowship at the Massachusetts Institute of Technology.
Eichenbaum works as a faculty member in the Department of Psychology at Boston University. The field of biopsychology began to emerge while Eichenbaum was in graduate school.
Biopsychology, sometimes referred to as psychobiology, arose from the identification of brain areas involved in certain behaviors and emotions three decades ago; from the discovery in the 1950s that some psychological problems can be treated chemically; and from identifying chemicals, called neurotransmitters, that pass messages from one brain cell to the next.
After studying biopsychology, Eichenbaum decided to pursue an approach that combines both biology and psychology in his own research. In his studies, Eichenbaum takes a molecular biology approach in learning the electrical activities of the neurons of the brain. He uses his biological background to understand the brain’s circuitry in order to identify what happens with the synapses and neurons, in essence how neurons communicate with one another.
From a psychologist standpoint, Eichenbaum concerns himself with human behavior. In particular, Eichenbaum wants to examine memory, known as conscious recollection. He studies how people remember the order of events and how the brain can code sequence of events and play it back again.
Understanding the brain could help address memory disorders, common in aging, as well as diseases such as Alzheimer’s, Eichenbaum says.
Biology could also play a role in creating cures for such conditions. Researchers believe that a protein called beta-amyloid that builds up into plaques in the brain and kills nerve cells, could be at the root of Alzheimer’s. Drug studies are being done to attempt to break up this process, which is known as “amyloid cascade.” One anti-inflammatory drug being tested for its potential as an Alzheimer’s drug would target the enzyme, called gamma secretase that is believed to play a role in the amyloid build-up. Several drugs originally approved for other diseases, such as diabetes and prostate cancer, attempt to modify the brain processes that cause Alzheimer’s even though the processes aren’t fully understood.
Scientists have identified proteins responsible for strengthening the gaps where information is exchanged between neurons.
Understanding cell interaction in the brain could lead to new strategies for memory preservation to combat disease or aging, Eichenbaum says.
The Boston University researcher combines biology and psychology for his job, which is a cross between psychologist and neuroscientist.
As part of the Center for Memory and Brain, Eichenbaum studies rats’ brains to learn how memory functions in animals, including humans. Eichenbaum hopes that understanding psychology and biology can help researchers make strides in alleviating human memory loss.
Eichenbaum earned an undergraduate degree in biology before he switched to psychology in graduate school. He obtained both degrees from the University of Michigan, before doing his postdoctoral fellowship at the Massachusetts Institute of Technology.
Eichenbaum works as a faculty member in the Department of Psychology at Boston University. The field of biopsychology began to emerge while Eichenbaum was in graduate school.
Biopsychology, sometimes referred to as psychobiology, arose from the identification of brain areas involved in certain behaviors and emotions three decades ago; from the discovery in the 1950s that some psychological problems can be treated chemically; and from identifying chemicals, called neurotransmitters, that pass messages from one brain cell to the next.
After studying biopsychology, Eichenbaum decided to pursue an approach that combines both biology and psychology in his own research. In his studies, Eichenbaum takes a molecular biology approach in learning the electrical activities of the neurons of the brain. He uses his biological background to understand the brain’s circuitry in order to identify what happens with the synapses and neurons, in essence how neurons communicate with one another.
From a psychologist standpoint, Eichenbaum concerns himself with human behavior. In particular, Eichenbaum wants to examine memory, known as conscious recollection. He studies how people remember the order of events and how the brain can code sequence of events and play it back again.
Understanding the brain could help address memory disorders, common in aging, as well as diseases such as Alzheimer’s, Eichenbaum says.
Biology could also play a role in creating cures for such conditions. Researchers believe that a protein called beta-amyloid that builds up into plaques in the brain and kills nerve cells, could be at the root of Alzheimer’s. Drug studies are being done to attempt to break up this process, which is known as “amyloid cascade.” One anti-inflammatory drug being tested for its potential as an Alzheimer’s drug would target the enzyme, called gamma secretase that is believed to play a role in the amyloid build-up. Several drugs originally approved for other diseases, such as diabetes and prostate cancer, attempt to modify the brain processes that cause Alzheimer’s even though the processes aren’t fully understood.
Scientists have identified proteins responsible for strengthening the gaps where information is exchanged between neurons.
Understanding cell interaction in the brain could lead to new strategies for memory preservation to combat disease or aging, Eichenbaum says.
Conversation with Yu-Ling Shao
The Erickson Foundation, a Baltimore-based private foundation established in 1998, conducts aging research and wellness programs for older adults.
The Foundation wants to develop legitimate aging research, says Yu-Ling Shao, the foundation’s coordinator of research and new ventures.
Shao has been with the Foundation since 1999. He studied biology and chemistry as an undergraduate student and earned a graduate degree in hospital administration before moving to his current role.
Shao conducts research into aging issues, studying bone strength, balance and osteoporosis among other issues. The Foundation wants to be on the frontlines of creating a wellness program for older adults, Shao says.
The Foundation often partners with researchers from universities to develop new programs. For example, the group paired with aging researchers at California State University-Fullerton to develop a program designed to reduce physical frailty and the number of falls among older adults. Known as FallProof!, the structured balance and mobility training program, has been taught to employees at Erickson Communities, operator of retirement homes across the country. Balance and mobility disorders resulting in falls among the aging population pose a serious public health problem in the United States, Shao says.
While separate entities, The Erickson Foundation often uses Erickson Retirement communities as a test bed for their aging research initiatives, Shao says.
Many of the senior citizens have also taken to using the fitness equipment offered at the retirement centers and participating in health programs.
The Foundation also wants to study video games and virtual reality equipment.
“Gaming has true potential to become a legitimate tool in the toolbox of the health-medical professional,” Shao says.
Nintendo's Wii game console has been widely used at Erickson communities but primarily for socialization and fun, not rehabilitation.
The residents at Sedgebrook, an Erickson community located near Chicago, got a Wii system in December 2006.
“They are truly the ones that started the rage here,” says Erickson spokeswoman Kate Newton Schmelyun. “Their enthusiasm for the game is completely infectious.” The 17 other communities received systems in mid-2007.
While each community has at least one gaming system for residents to play, several have more than one system, and have organized leagues and regular events around the Wii.
“The vast majority of our residents live completely independently, but we also have assisted living and skilled nursing neighborhoods at each campus, and those residents play Wii, too,” Schmelyun says.
Shao says the Wii has the potential to help stroke patients regain some muscle function.
“There is a beauty to the Wii and other types of systems for folks who really through injjury or diseases have lost the ability to move their muscles,” Shao says.
While the Wii simulates full body movement without the regular effort levels, ultimately the Nintendo game console was designed for entertainment value. The Wii doesn't offer cardiovascular component for those who have the ability to regularly perform the tasks, such as bowling or tennis, Shao says.
Other companies are developing products to work along with video games. For example, Cateye Game Bike is a stationary bicycle that can connect to the four main video game systems to provide an interactive virtual reality experience.
The Game Bike has heart rate control programs that allow the user to track the maximum heart rate.
“This type of gaming system may not be for everyone, but one developing argument is that for older adults who are able or willing to engage in light to moderate physical activity in a gaming context, efforts should be made to include it,” Shao says.
The Foundation wants to develop legitimate aging research, says Yu-Ling Shao, the foundation’s coordinator of research and new ventures.
Shao has been with the Foundation since 1999. He studied biology and chemistry as an undergraduate student and earned a graduate degree in hospital administration before moving to his current role.
Shao conducts research into aging issues, studying bone strength, balance and osteoporosis among other issues. The Foundation wants to be on the frontlines of creating a wellness program for older adults, Shao says.
The Foundation often partners with researchers from universities to develop new programs. For example, the group paired with aging researchers at California State University-Fullerton to develop a program designed to reduce physical frailty and the number of falls among older adults. Known as FallProof!, the structured balance and mobility training program, has been taught to employees at Erickson Communities, operator of retirement homes across the country. Balance and mobility disorders resulting in falls among the aging population pose a serious public health problem in the United States, Shao says.
While separate entities, The Erickson Foundation often uses Erickson Retirement communities as a test bed for their aging research initiatives, Shao says.
Many of the senior citizens have also taken to using the fitness equipment offered at the retirement centers and participating in health programs.
The Foundation also wants to study video games and virtual reality equipment.
“Gaming has true potential to become a legitimate tool in the toolbox of the health-medical professional,” Shao says.
Nintendo's Wii game console has been widely used at Erickson communities but primarily for socialization and fun, not rehabilitation.
The residents at Sedgebrook, an Erickson community located near Chicago, got a Wii system in December 2006.
“They are truly the ones that started the rage here,” says Erickson spokeswoman Kate Newton Schmelyun. “Their enthusiasm for the game is completely infectious.” The 17 other communities received systems in mid-2007.
While each community has at least one gaming system for residents to play, several have more than one system, and have organized leagues and regular events around the Wii.
“The vast majority of our residents live completely independently, but we also have assisted living and skilled nursing neighborhoods at each campus, and those residents play Wii, too,” Schmelyun says.
Shao says the Wii has the potential to help stroke patients regain some muscle function.
“There is a beauty to the Wii and other types of systems for folks who really through injjury or diseases have lost the ability to move their muscles,” Shao says.
While the Wii simulates full body movement without the regular effort levels, ultimately the Nintendo game console was designed for entertainment value. The Wii doesn't offer cardiovascular component for those who have the ability to regularly perform the tasks, such as bowling or tennis, Shao says.
Other companies are developing products to work along with video games. For example, Cateye Game Bike is a stationary bicycle that can connect to the four main video game systems to provide an interactive virtual reality experience.
The Game Bike has heart rate control programs that allow the user to track the maximum heart rate.
“This type of gaming system may not be for everyone, but one developing argument is that for older adults who are able or willing to engage in light to moderate physical activity in a gaming context, efforts should be made to include it,” Shao says.
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