Poststroke rehabilitative mechanisms in individualized fatigue level-controlled treadmill training -- a Rat Model Study

TL;DR

This study demonstrates that individualized fatigue-controlled treadmill training in a rat model improves post-stroke motor recovery by reducing fatigue and optimizing cortical and corticomuscular functions, compared to forced training.

Contribution

It provides new insights into the mechanisms of individualized training, showing how fatigue management enhances neural recovery post-stroke in a rat model.

Findings

Fatigue-controlled training leads to better motor recovery.

Individualized training reduces central fatigue.

Enhanced inter-hemispheric balance and corticomuscular control observed.

Abstract

Individualized training improved post-stroke motor function rehabilitation efficiency. However, the mechanisms of how individualized training facilitates recovery is not clear. This study explored the cortical and corticomuscular rehabilitative effects in post-stroke motor function recovery during individualized training. Sprague-Dawley rats with intracerebral hemorrhage (ICH) were randomly distributed into two groups: forced training (FOR-T, n=13) and individualized fatigue-controlled training (FAT-C, n=13) to receive training respectively from day 2 to day 14 post-stroke. The FAT-C group exhibited superior motor function recovery and less central fatigue compared to the FOR-T group. EEG PSD slope analysis demonstrated a better inter-hemispheric balance in FAT-C group compare to the FOR-T group. The dCMC analysis indicated that training-induced fatigue led to a short-term down-regulation of descending corticomuscular coherence (dCMC) and an up-regulation of ascending dCMC. In the long term, excessive fatigue hindered the recovery of descending control in the affected hemisphere. The individualized strategy of peripheral fatigue-controlled training achieved better motor function recovery, which could be attributed to the mitigation of central fatigue, optimization of inter-hemispheric balance and enhancement of descending control in the affected hemisphere.