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PubMed1998

A multicenter study of platelet recovery and utilization in patients after myeloablative therapy and hematopoietic stem cell transplantation.

An observational study was conducted at 18 transplant centers in the United States and Canada to characterize the platelet recovery of patients receiving myeloablative therapy and stem cell transplantation and to determine the clinical variables influencing recovery, determine platelet utilization and cost, and incidence of hemorrhagic events. The study included 789 evaluable patients transplanted in 1995. Clinical, laboratory, and outcome data were obtained from the medical records. Variables associated with accelerated recovery in multivariate models included (1) higher CD34 count; (2) higher platelet count at the start of myeloablative therapy; (3) graft from an HLA-identical sibling donor; and (4) prior stem cell transplant. Variables associated with delayed recovery were (1) prior radiation therapy; (2) posttransplant fever; (3) hepatic veno-occlusive disease; and (4) use of posttransplant growth factors. Disease type also influenced recovery. Recipients of peripheral blood stem cells (PBSC) had faster recovery and fewer platelet transfusion days than recipients of bone marrow (BM). The estimated average 60-day platelet transfusion cost per patient was $4,000 for autologous PBSC and $11,000 for allogeneic BM transplants. It was found that 11% of all patients had a significant hemorrhagic event during the first 60 days posttransplant, contributing to death in 2% of patients. In conclusion, clinical variables influencing platelet recovery should be considered in the design and interpretation of clinical strategies to accelerate recovery. Enhancing platelet recovery is not likely to have a significant impact on 60-day mortality but could significantly decrease health care costs and potentially improve patient quality of life.

Antigens, CD34↗

PubMed2005

The process of recovery in eating disorder sufferers' own words: an Internet-based study.

This exploratory Internet-based study attempts to understand what eating disorder sufferers suggest when they mention the word recovery. All messages (N = 685) posted in a Finnish-language eating disorders discussion group during a 3-month period were analyzed for the contexts of the word recovery using text analysis software and qualitative methods. The discussion group participants' views of recovery changed according to their current stage of change. Mentioning recovery was least likely during precontemplation and relapse. Internet discussion group was seen as helpful in the early stages of change, but as impeding recovery in the last stages. Willpower and ceasing to identify with eating disorders were viewed as essential to recovery. The value of professional help in recovery was viewed as conditional on the eating disorders sufferer's own willingness to change. Internet-based support groups have many potential therapeutic applications. Motivational aspects need to be taken into account in promoting recovery.

Adolescent↗

PubMed2006

Effect of pressure overload and its recovery on the rat carotid artery: change of vascular reactivity and remodeling process.

Compared to chronic hypertension, little is known about the pathophysiology of acute hypertension and its recovery. To characterize this, we investigated the functional and structural properties of the common carotid arteries (CCA) from 35 rats. We established a unilateral and reversible carotid arterial hypertension model using the partial transverse aortic constriction (TAC) technique. By TAC, the right CCAs were made to endure a pressure-overload environment, while the left CCAs remained under normotension. The TACs were removed 2 weeks later, which unloaded the hypertensive effects. We compared the contractile, histological, and molecular responses of the CCA before TAC, during TAC (the hypertension period), and after removal of TAC (the recovery period). Vessel contractility was nearly abolished during 2 weeks of TAC. The recovery process from hypertension showed an initial hypercontractile period within a week. The relaxation response due to acetylcholine, as measured during the recovery period, showed a longer time course than the contractility for recovering its magnitude. During the hypertension period, the media thickness increased and this persisted throughout the recovery period. Apoptosis of the endothelial layer was significantly increased during the hypertension period and this disappeared 2 weeks after recovery. Expression of endothelial NO synthase was not detectable at the end of the hypertension period, but this gradually returned to the basal level after 2 weeks of recovery. Although increased contractility is usually expected in chronic hypertensive vessels, an abrupt pressure overload decreases contractility and the endothelium-dependent relaxation. It also increases endothelial apoptosis and the media thickness. These findings have clinical relevance, and they could be applied to human acute and severe hypertension and its recovery.

Acetylcholine↗

PubMed2002

Induction and recovery phases of methacholine-induced bronchoconstriction using FEV1 according to the degree of bronchial hyperresponsiveness.

Forty-eight patients suffering from intermittent bronchial asthma underwent methacholine challenge test. Response was stronger in 29 patients and less pronounced in 19. The two groups had the same characteristics except for the cumulative methacholine dose which was lower in severe hyperresponsiveness. The patients were studied both in the phase of induced bronchospasm and in the subsequent phase of spontaneous recovery. Dose-response curves to methacholine were analyzed as FEV1% decline/methacholine dose for the induction phase of bronchoconstriction and as FEV1% increase*methacholine dose/time after PD20FEV1 for the recovery phase. The phase of induced bronchospasm as well as spontaneous recovery had a linear pattern in severe hyperresponsiveness; in patients with moderate response, induced bronchoconstriction had a curvilinear pattern whereas spontaneous recovery had a linear pattern. This latter group had to break down an amount of methacholine that was fivefold greater than the former, therefore the mechanism of local homeostasis recovery may be more efficient in moderate hyperresponsiveness. However, in both groups recovery after the bronchospasm was not complete after 60 min (p < 0.01 versus baseline). Furthermore, recovery was faster in the first 15 min than in the remaining time. In conclusion the behavior of methacholine-induced bronchospasm and its spontaneous recovery in both severe and moderate hyperresponsiveness seem to be different although several and not well-established mechanisms may be responsible for this phenomenon.

Administration, Inhalation↗

PubMed2004

Leptin, catecholamines and free fatty acids related to reduced recovery delays after training.

The aim of this study was to observe the effects of exercise on plasma free fatty acids (FFA), the catecholamines (adrenaline, noradrenaline, dopamine) and leptin levels, before and after training, to determine their possible influence on the improvement of the regulation of energy homeostasis. Eleven trained rowers performed two exercise sessions (S1, S2) of 90 min each (70-75% V(.)O(2peak)), separated by a 36-week period of intense endurance training. Leptin, FFA and catecholamine plasma concentrations were measured both at the beginning and at the end of S1 and S2, and after recovery periods of 2 and 24 h. Training modified leptin levels in S2 as opposed to S1 ( P<0.001); in S1 leptin levels remained lower after a 24 h recovery whereas they returned to pre-exercise levels in S2. The respiratory exchange ratio was significantly reduced in S2 compared to S1 ( P=0.018). The FFA and leptin levels were correlated after a 24-h recovery in S1 ( r=0.87; P=0.0082), and after a 2-h recovery in S2 ( r=0.66; P=0.021). All data were expressed as the means and standard errors of the mean. In the two sessions, an immediate exercise effect was observed on the levels of the catecholamines, which did not persist after recovery. This training effect was apparent for all catecholamines in response to exercise, particularly on noradrenaline ( P=0.0006). The noradrenaline and leptin levels were correlated after a 2-h recovery in S2 ( r=-0.74; P=0.0042). We conclude that the effect of training on the response of noradrenaline to exercise seems to be involved in the delay in the normalization of leptin levels. We suggest that the amplitude of the noradrenaline response to exercise induced an increase in fat use and a rapid leptin recovery after exercise. The sensitivity of leptin to changes in the fat stores may be improved after training. Both training effects seemed to be involved in the reduction of the recovery time observed for the leptin levels.

Adult↗

PubMed2005

Drugs to facilitate recovery of neuromuscular blockade and muscle strength.

Several drugs that quicken recovery from neuromuscular blockade caused by vecuronium in anesthetized patients are reviewed. Ulinastatin, a protease inhibitor, is thought to promote the release of acetylcholine at the neuromuscular junction and increases hepatic blood flow and urine volume. For this reason, ulinastatin quickens recovery from neuromuscular blockade in anesthetized patients receiving vecuronium. Additionally, pretreatment with ulinastatin avoids prolongation of vecuronium-induced neuromuscular blockade in patients with hepatic cirrhosis. Gabexate mesilate is also a protease inhibitor. During a continuous infusion of gabexate mesilate, recovery from neuromuscular blockade was quickened. Amino acid-enriched solution supplies energy to the skeletal muscles and causes an increase in muscle strength. An infusion of amino acid-enriched solution hastens recovery from neuromuscular blockade in anesthetized patients. When amino acids supply energy to the skeletal muscles, they simultaneously produce heat in the skeletal muscles. This thermal generation may be closely related to fast recovery from neuromuscular blockade. Amino acid-enriched solution makes recovery from neuromuscular blockade quick and avoids hypothermia during general anesthesia. Milrinone, a phosphodiesterase III inhibitor, is supposed to increase the release of acetylcholine at the neuromuscular junction and make the neuromuscular junction sensitive to acetylcholine. Therefore, recovery from neuromuscular blockade is hastened. Nicorandil enhances membrane K+ conductance in skeletal muscle and increases contraction of the skeletal muscle. Thus, nicorandil quickens recovery from neuromuscular blockade.

Amino Acids↗

PubMed2006

Recovery after coronary artery bypass grafting: patients' and health professionals' views of the hospital experience.

BACKGROUND: Increasing access to revascularisation procedures is a key aspect of a National Service Framework. Coronary artery bypass grafting (CABG) is effective in relieving symptoms and reducing mortality but some patients do not report an improved quality of life or experience a good recovery. AIMS: To describe the recovery trajectory after CABG and identify facilitators and barriers to recovery. METHODS: Semi-structured interviews were conducted with 11 patients who had previously undergone elective, isolated, first-time CABG and with 10 health professionals experienced in caring for these patients. RESULTS: Thematic analysis identified the following themes: definition and timeline of recovery, preparation for surgery including information provision, attitude to surgery and confidence in staff, clinical factors and the in-patient experience. The key finding is the different recovery trajectory between patients with severe versus mild pre-operative symptoms; patients with few pre-CABG symptoms reported a much longer recovery time. CONCLUSIONS: This study has provided insights into the barriers and facilitators to recovery after CABG and the processes involved. Findings have indicated areas where health professionals can intervene to aid patients' long-term recovery and thereby maximise the benefits of CABG.

Aged↗

PubMed2005

Stepwise motor and all-or-none sensory recovery is associated with nonlinear sparing after incremental spinal cord injury in rats.

Spinal cord injury (SCI) causes motor and sensory deficits that impair functional performance. While more functional recovery occurs with greater white matter sparing (WMS), it is unclear which locomotor features are more vulnerable to SCI than others, if recovery of certain features depends on specific amounts of WMS, and whether motor recovery patterns differ from sensory recovery. Locomotor and sensory recovery after graded contusive SCI with cord displacements of 0.3, 0.5, 0.7, 0.9, 1.1, 1.25, and 1.3 mm was examined for 6 weeks in 80 female Sprague-Dawley rats. Seven SCI gradations resulted in three locomotor performance levels measured with BBB (P < 0.01): High: laminectomy (LAM) controls and 0.3 (19.87 +/- 0.35 SEM); Intermediate: 0.5-0.9 (13.71 +/- 0.32); and Low: 1.1-1.3 (9.23 +/- 0.36). Normal paw position was most susceptible to SCI requiring 90% WMS, while consistent plantar stepping was least susceptible depending on 10% WMS. A threshold at the 0.9 severity for coordination, toe clearance, and nearly normal trunk stability and tail usage required 25% WMS. Analysis of interlimb coordination using new phase dispersion (PD) techniques delineated three recovery patterns: synchronous (0.3), modified concordance (0.5, 0.7), and disengaged (0.9, 1.1). Lesion severity correlated to WMS (r(2) = 0.96) and to BBB (r(2) = 0.87) by nonlinear polynomial regressions. Mechanical allodynia developed only after injuries resulting in < or =10% WMS. Nonlinear motor and sensory recovery patterns suggest that small reparative changes may substantially improve function in individuals with SCI. A hierarchical locomotor recovery based on simple segmental versus complex supraspinal motor control is proposed.

Animals↗

PubMed2004

A review of standing balance recovery from stroke.

Recently, interest in the mechanisms underlying balance recovery following stroke has grown, because insight into these mechanisms is necessary to develop effective rehabilitation strategies for different types of stroke. Studies dealing with the recovery of standing balance from stroke are, however, limited to rehabilitation inpatients with a unilateral supratentorial brain infarction or haemorrhage. In most of these patients, stance stability improves in both planes as well as the ability to compensate for external and internal body perturbations and to control posture voluntarily. Although there is evidence of true physiological recovery of paretic leg muscle functions in postural control, particularly during the first three months post-stroke, substantial balance recovery also occurs in patients when there are no clear signs of improved support functions or equilibrium reactions exerted through the paretic leg. This type of recovery probably takes much longer than 3 months. Apparently, mechanisms other than the restoration of paretic leg muscle functions may determine the standing balance recovery in patients after severe stroke. No information is available about the role of stepping responses as an alternative to equilibrium reactions for restoring the ability to maintain upright stance after stroke. The finding that brain lesions involving particularly the parieto-temporal junction are associated with poor postural control, suggests that normal sensory integration is critical for balance recovery. Despite a considerable number of intervention studies, no definitive conclusions can be drawn about the best approach to facilitate the natural recovery of standing balance following stroke.

Biofeedback, Psychology↗

PubMed2004

Dissecting chill coma recovery as a measure of cold resistance: evidence for a biphasic response in Drosophila melanogaster.

Cold resistance in insects has traditionally been measured in terms of survival following a stress, but alternative methods are increasingly being used because of their relevance to the ecology of organisms and their utility in characterizing variation among species, populations and individuals. One such method capable of discriminating among Drosophila species and conspecific Drosophila populations from different environments is adult chill coma recovery time, the time taken for adults to become active again after being knocked down by a cold stress. Here we characterized the chill coma response of D. melanogaster in detail. Adults were exposed to a range of temperatures and stressful periods prior to measuring recovery. Recovery from chill coma in D. melanogaster was biphasic; as flies were stressed under cooler temperatures, recovery times leveled off and then decreased before sharply increasing again as mortality starts to occur. This biphasic response has previously been observed in D. subobscura where it has a somewhat different shape. A second mechanism therefore acts at relatively lower temperatures to ameliorate the effects of the cold stress. When D. melanogaster were reared at 19 and 25 degrees C for two generations, the shape of the curve relating temperature to recovery time was similar, but flies from the warmer temperature had longer recovery times and showed responses that leveled off and then decreased at relatively higher temperatures. As exposure time to cold stress was increased, recovery times also increased except at mild stress levels. Chill coma recovery in D. melanogaster is a complex trait and likely to reflect multiple underlying components.

Acclimatization↗

PubMed2005

Pain medication as an indicator of interference with lifestyle and oral function during recovery after third molar surgery.

Purpose This study was designed to assess the impact of taking pain medications, as a more comprehensive indicator of perceived pain, on the extent of interference with lifestyle and oral function during recovery after third molar surgery. Patients and Methods Recovery data after the removal of 4 third molars were available for patients enrolled in an institutional review board-approved, prospective, multicenter clinical trial. A self-administered health-related quality of life instrument, designed to assess a patients perception of recovery for pain, lifestyle, and oral function, was completed each postsurgery day (PSD) for 14 days. Taking pain medications was a proxy for a patients perceived level of pain, adding a more sensitive behavioral component to the report of pain. Each PSD day, the patients who thought that their pain was sufficient to require taking medications (an opioid, a nonsteroidal anti-inflammatory, or the combination) were compared with patients not taking pain medications. The extent of interference in lifestyle (daily activity, social life, recreation, sleep) and in oral function (eating, chewing, mouth opening) as self-reported on a scale of 1 (no trouble) to 5 (lots of trouble) were compared for those taking and not taking medications using Cochran-Mantel-Haenszel row mean statistics ( P < .05). Results The 445 study patients were mostly female (63%) and white (86%). Median age was 20 years (IQ, 18, 24 years). Median surgery time was 30 minutes (IQ, 20, 40 minutes). Both mandibular third molars were below the occlusal plane in 60%. Almost all patients took pain medication on PSD 1. By PSD 7, 48% of patients were taking pain medication, decreasing to 20% by PSD 11. Patients with pain sufficient to take an analgesic reported a greater extent of interference for all lifestyle and oral function measures. Recovery was significantly delayed for PSD 2 through 14 for patients who took medications ( P < 0.01). Recovery for females taking pain medications was significantly delayed compared with that for males. Conclusions Patients with pain sufficient to prompt taking pain medications were likely to report interference with recovery for lifestyle and oral function. A patients choice to take pain medication appears to be a better indicator of a patients perceived pain and the impact of that pain on recovery than numerical pain scales. This method provides more sensitive behavioral information during the period of recovery after third molar removal.

Activities of Daily Living↗

PubMed2002

Association of educational status with heart rate recovery: a population-based propensity analysis.

PURPOSE: An abnormally attenuated heart rate recovery after exercise is a predictor of mortality that is thought to reflect decreased parasympathetic activity. Lower educational level may be associated with automatic imbalance. We sought to assess the association of educational level with heart rate recovery. SUBJECTS AND METHODS: Among 5246 healthy adults from a population-based cohort who underwent exercise testing, 874 (17%) did not graduate from high school, 1823 (35%) completed high school, and 2549 (49%) attended at least some college. An abnormal heart rate recovery was defined as a difference of </=42 beats per minute between the peak heart rate and that after 2 minutes of recovery. Propensity scores were used to account for differences by educational status. RESULTS: An abnormal heart rate recovery was more common among adults who did not graduate from high school compared with those who attended at least some college (50% [440/874] vs. 28% [701/2549]; odds ratio [OR]: 2.7; 95% confidence interval [CI]: 2.3 to 3.1; P <0.001). After using propensity scores, lower educational status remained associated with an abnormal heart rate recovery (OR = 1.9; 95% CI: 1.6 to 2.4; P <0.001). During 12-years of follow-up, there were 327 deaths. Poor educational status was associated with greater mortality (9% [80/874] vs. 6% [247/4372]; unadjusted hazard ratio [HR] = 1.9; 95% CI: 1.4 to 2.5; P <0.001). However, after accounting for age, sex, and heart rate recovery, educational status was a weaker predictor (HR = 1.3; 95% CI: 1.0 to 1.7). CONCLUSIONS: Educational status is independently associated with an abnormal heart rate recovery.

Adult↗

PubMed2003

Growth factors and stem cells as treatments for stroke recovery.

Both polypeptide growth factors and stem cell populations from bone marrow and umbilical cord blood hold promise as treatments to enhance neurologic recovery after stroke. Growth factors may exert their effects through stimulation of neural sprouting and enhancement of endogenous progenitor cell proliferation, migration, and differentiation in brain. Exogenous stem cells may exert their effects by acting as miniature "factories" for trophic substances in the poststroke brain. The combination of growth factors and stem cells may be more effective than either treatment alone. Stroke recovery represents a new and relatively untested target for stroke therapeutics. Whereas acute stroke treatments focus on agents that dissolve blot clots (thrombolytics) and antagonize cell death (neuroprotective agents), stroke recovery treatments are likely to enhance structural and functional reorganization (plasticity) of the damaged brain. Successful clinical trials of stroke recovery-promoting agents are likely to be quite different from trials testing acute stroke therapies. In particular, the time window of effective treatment to enhance stroke recovery is likely to be far longer than that for acute stroke treatments, perhaps days or weeks rather than minutes or hours after stroke. This longer time window means that time is available for careful screening and testing of potential subjects for stroke recovery trials, both in terms of size and location of cerebral infarcts and in type and severity of neurologic deficits. Detailed baseline information can be obtained for each patient against which eventual clinical outcome can be compared. Finally, separate and detailed outcome measures can be obtained in both the sensorimotor and cognitive neurologic spheres, because it is possible that these two kinds of function may recover differently or be differentially responsive to recovery-promoting treatments. Stroke recovery represents an important and underexplored opportunity for the development of new stroke treatments.

Bone Morphogenetic Protein 7↗

PubMed2000

The delay in recovery from fast inactivation in skeletal muscle sodium channels is deactivation.

1. Using macropatch techniques, we tested the assumption that deactivation underlies the observed delay in the onset to recovery from fast inactivation by comparing open-state deactivation to recovery delay for rat skeletal muscle mutations R1441C and R1441P. 2. Deactivation kinetics from the open state were determined from the exponential decay of tail currents. R1441C and R1441P prolonged open-state deactivation, with the greatest effect produced by R1441P. 3. Delays in the onset to recovery from fast inactivation for R1441P and for R1441C were abbreviated compared to those for rSkM1. Recovery delay was longer in R1441P than R1441C at voltages more negative than -110 mV. Recovery from inactivation exhibited a voltage dependence which, unlike delay, saturated at depolarized voltages. Recovery rate constants were increased to a similar extent for R1441C and R1441P at -150 to -120 mV compared to rSkM1. 4. These results indicate that the delay in the onset to recovery from fast inactivation in skeletal muscle sodium channels is due to deactivation. Lessening of charge immobilization for R1441C and R1441P may contribute to observed biophysical defects underlying the hyperexcitability of muscle fibers containing paramyotonia congenita mutations. The second stage of recovery from fast inactivation may be affected differentially by these mutations.

Animals↗

PubMed1999

Dosage of neostigmine for reversal of rocuronium block from two levels of spontaneous recovery.

Spontaneous recovery, and recovery following neostigmine 20, 35 or 50 microgram.kg-1 administered at 10 or 25% of recovery of the first twitch of the train-of-four, was assessed in 80 patients after rocuronium administration under continued isoflurane anaesthesia. In an additional 40 patients, isoflurane administration was discontinued and neostigmine 35 or 50 microgram.kg-1 was given at 10 or 25% recovery. The administration of neostigmine reduced the recovery times significantly. A neostigmine dose of 20 microgram.kg-1 resulted in slower recovery compared with the higher doses, particularly when reversal was attempted at a first twitch height of 10%. Higher doses of neostigmine given at a first twitch height of 25% resulted in rapid reversal of block [mean (SD) times of 7.0 (4.8) and 6.4 (1.9) min with the 35 and 50 microgram.kg-1 doses, respectively, for attaining a train-of-four ratio of 0.8]. Discontinuing isoflurane did not alter recovery times. The incidence of emetic symptoms did not differ between groups, including one group that received atropine instead of glycopyrronium in combination with neostigmine. We conclude that rocuronium block can be antagonised safely using a neostigmine dose of 35 microgram.kg-1, although recovery may be slightly slower if administered at a first twitch of 10% of control.

Adjuvants, Anesthesia↗

PubMed2003

Patterns of performance degradation and restoration during sleep restriction and subsequent recovery: a sleep dose-response study.

Daytime performance changes were examined during chronic sleep restriction or augmentation and following subsequent recovery sleep. Sixty-six normal volunteers spent either 3 (n = 18), 5 (n= 16), 7 (n = 16), or 9 h (n = 16) daily time in bed (TIB) for 7 days (restriction/augmentation) followed by 3 days with 8 h daily TIB (recovery). In the 3-h group, speed (mean and fastest 10% of responses) on the psychomotor vigilance task (PVT) declined, and PVT lapses (reaction times greater than 500 ms) increased steadily across the 7 days of sleep restriction. In the 7- and 5-h groups speed initially declined, then appeared to stabilize at a reduced level; lapses were increased only in the 5-h group. In the 9-h group, speed and lapses remained at baseline levels. During recovery, PVT speed in the 7- and 5-h groups (and lapses in the 5-h group) remained at the stable, but reduced levels seen during the last days of the experimental phase, with no evidence of recovery. Speed and lapses in the 3-h group recovered rapidly following the first night of recovery sleep; however, recovery was incomplete with speed and lapses stabilizing at a level comparable with the 7- and 5-h groups. Performance in the 9-h group remained at baseline levels during the recovery phase. These results suggest that the brain adapts to chronic sleep restriction. In mild to moderate sleep restriction this adaptation is sufficient to stabilize performance, although at a reduced level. These adaptive changes are hypothesized to restrict brain operational capacity and to persist for several days after normal sleep duration is restored, delaying recovery.

Adaptation, Psychological↗

PubMed2004

Uncontrollable stimulation undermines recovery after spinal cord injury.

Prior studies have shown that neurons within the spinal cord are sensitive to response-outcome relations, a form of instrumental learning. Spinally transected rats that receive shock to one hind leg learn to maintain the leg in a flexed position that minimizes net shock exposure (controllable shock). Prior exposure to uncontrollable stimulation (intermittent shock) inhibits this spinally mediated learning. Here it is shown that uncontrollable stimulation undermines the recovery of function after a spinal contusion injury. Rats received a moderate injury (12.5 mm drop) and recovery was monitored for 6 weeks. In Experiment 1, rats received varying amounts of intermittent tailshock 1-2 days after injury. Just 6 min of intermittent shock impaired locomotor recovery. In Experiment 2, rats were shocked 1, 4, or 14 days after injury. Delaying the application of shock exposure reduced its negative effect on recovery. In Experiment 3, rats received controllable or uncontrollable shock 24 and 48 h after injury. Only uncontrollable shock disrupted recovery of locomotor function. Uncontrollably shocked rats also exhibited higher vocalization thresholds to aversive stimuli (heat and shock) applied below the injury. Across the three experiments, exposure to uncontrollable shock, (1) delayed the recovery of bladder function; (2) led to greater mortality and spasticity; and (3) increased tissue loss (white and gray matter) in the region of the injury. The results indicate that uncontrollable stimulation impairs recovery after spinal cord injury and suggest that reducing sources of uncontrolled afferent input (e.g., from peripheral tissue injury) could benefit patient recovery.

Animals↗

PubMed2005

Voluntary wheel running improves recovery from a moderate spinal cord injury.

Recently, locomotor training has been shown to improve overground locomotion in patients with spinal cord injury (SCI). This has triggered renewed interest in the role of exercise in rehabilitation after SCI. However, there are no mouse models for voluntary exercise and recovery of function following SCI. Here, we report voluntary wheel running improves recovery from a SCI in mice. C57Bl/10 female mice received a 60-kdyne T9 contusion injury with an IH impactor after 3 weeks of voluntary wheel running or 3 weeks of standard single housing conditions. Following a 7-day recovery period, running mice were returned to their running wheels. Weekly open-field behavior measured locomotor recovery using the Basso, Beattie and Bresnahan (BBB) locomotor rating scale and the Basso Mouse Scale (BMS) locomotor rating scale, a scale recently developed specifically for mice. Initial experiments using standard rung wheels show that wheel running impaired recovery, but subsequent experiments using a modified flat-surface wheel show improved recovery with exercise. By 14 days post SCI, the modified flat-surface running group had significantly higher BBB and BMS scores than the sedentary group. A repeated measures ANOVA shows locomotor recovery of modified flat-surface running mice was significantly improved compared to sedentary animals (p < 0.05). Locomotor assessment using a ladder beam task also shows a significant improvement in the modified flat-surface runners (p < 0.05). Finally, fibronectin staining shows no significant difference in lesion size between the two groups. These data represent the first mouse model showing voluntary exercise improves recovery after SCI.

Animals↗