Effects of moderate to high-intensity multimodal circuit training on molecular biomarkers of learning and inflammation in individuals who have had a stroke: randomized clinical trial

• Grant number: 24/02169-7
• Support Opportunities: Regular Research Grants
• Start date: July 01, 2024
• End date: June 30, 2026
• Field of knowledge: Health Sciences - Physiotherapy and Occupational Therapy
• Agreement: CNPq
• Principal Investigator: Thiago Luiz de Russo
• Grantee: Thiago Luiz de Russo
• Host Institution: Centro de Ciências Biológicas e da Saúde (CCBS). Universidade Federal de São Carlos (UFSCAR). São Carlos , SP, Brazil
• Associated research grant: 23/04712-7 - EFFICACY OF MULTIMODAL CIRCUIT TRAINING WITH MODERATE TO HIGH INTENSITY TO INCREASE THE NUMBER OF STEPS AND TO REDUCE SEDENTARY TIME IN PEOPLE WHO HAD STROKE: A RANDOMIZED CLINICAL TRIAL, AP.R
• Associated scholarship(s): 24/15042-5 - Effects of Moderate- to High-Intensity Multimodal Circuit Training on Molecular Biomarkers of Learning and Inflammation in People Who Have Had a Stroke: A Randomized Clinical Trial, BP.JD

Abstract

Introduction: Individuals who have had a stroke generally exhibit low levels of physical activity but high levels of sedentary behavior, regardless of the post-stroke phase. These movement behaviors can impact the cardiovascular system of these individuals, increasing the likelihood of new cerebrovascular events. Previous studies by our group have shown that serum concentrations of biomarkers linked to neuroprotection, such as insulin-like growth factor-1 (IGF-1) and brain-derived neurotrophic factor (BDNF), are decreased in individuals who have had a stroke. Additionally, we have shown that the more inactive a person who has had a stroke is, the higher the activity of inflammatory enzymes, such as matrix metalloproteinase-9 (MMP-9). Understanding how moderate to high-intensity multimodal circuit training interferes with serum biomarkers can provide insights into the modulatory mechanisms of aerobic exercise in individuals who have had a stroke. High-intensity exercise has been associated with the regulation of various biomarkers that are related to the cognitive, motor, and cardiovascular benefits of exercise itself. Circuit training increases the ability to walk and facilitates postural transfers; however, there is a gap as to whether this strategy allows for the regulation of molecular mechanisms related to behavioral change and control of cardiovascular alterations. It also brings perspectives for studying the application of drugs as adjuncts to training. Objective: To verify the effects of circuit training on molecular biomarkers linked to neuroplasticity/learning pathways and inflammation in individuals who have had a stroke. Methodology: This is a randomized clinical trial that will follow the CONSORT recommendations (regular FAPESP project 2023/04712-7). Individuals affected by stroke in the chronic phase and who are able to walk independently will be randomized into two groups: an intervention group that will receive a progressive multimodal circuit training protocol with moderate to high intensity (HR of 50-80% of reserve HR); and the control group will receive sessions of balance training of light intensity (HR <40%). Both groups will receive the exercise protocol three times a week for 12 weeks. Evaluations will be conducted pre- and post-intervention, including measurements of the number of steps and time spent sitting with an activity monitor, as well as blood samples collected from the antecubital vein to measure concentrations of BDNF, Irisin, VEGF, IGF-1, IGFBP3, TNF-alpha, and IL-10 by ELISA method, and gelatinase activity such as MMP-2 and -9. If the variables have a normal and homogeneous distribution, the Two-Way ANOVA test with repeated measures will be applied. For the correlation between sedentary behavior variables and biomarkers, a Pearson test will be performed. A significance level of 5% will be considered. (AU)