Role of Stress-Inducible Protein-1 in Recruitment of Bone Marrow Derived Cells Into the Ischemic Brains.

Role of stress-inducible protein-1 in recruitment of bone marrow derived cells into the ischemic brains.

EMBO Mol Med. 2013 Jul 8;
Lee SD, Lai TW, Lin SZ, Lin CH, Hsu YH, Li CY, Wang HJ, Lee W, Su CY, Yu YL, Shyu WC

Stress-inducible protein-1 (STI-1) is the proposed ligand for the cellular prion protein (PrP(C) ), which is thought to facilitate recovery following stroke. Whether STI-1 expression is affected by stroke and how its signalling facilitates recovery remain elusive. Brain slices from patients that died of ischemic stroke were collected for STI-1 immunohistochemistry. These findings were compared to results from cell cultures, mice with or without the PrP(C) knockout, and rats. Based on these findings, molecular and pharmacological interventions were administered to investigate the underlying mechanisms and to test the possibility for therapy in experimental stroke models. STI-1 was upregulated in the ischemic brains from humans and rodents. The increase in STI-1 expression in vivo was not cell-type specific, as it was found in neurons, glia and endothelial cells. Likewise, this increase in STI-1 expression can be mimicked by sublethal hypoxia in primary cortical cultures (PCCs) in vitro, and appear to have resulted from the direct binding of the hypoxia inducible factor-1? (HIF-1?) to the STI-1 promoter. Importantly, this STI-1 signalling promoted bone marrow derived cells (BMDCs) proliferation and migration in vitro and recruitment to the ischemic brain in vivo, and augmenting its signalling facilitated neurological recovery in part by recruiting BMDCs to the ischemic brain. Our results thus identified a novel mechanism by which ischemic insults can trigger a self-protective mechanism to facilitate recovery. HubMed – rehab

[Analysis of the effect of physical group activities in patients with acquired brain injury in the subacute phase].

Rev Neurol. 2013 Jul 16; 57(2): 64-70
Garcia-Hernandez JJ, Mediavilla-Saldana L, Perez-Rodriguez M, Perez-Tejero J, Gonzalez-Alted C

INTRODUCTION. The term acquired brain injury (ABI) refers to any kind of non-degenerative injury that occurs in the brain. Group physical activities (GPA) are an effective treatment that improves the functional capacity. AIMS. To analyse the efficacy of a GPA programme in persons with ABI in the subacute phase so that they can be re-integrated physically in the community. PATIENTS AND METHODS. Thirty-three patients with ABI, aged 33.18 ± 10.39 years, took part in a 10-week GPA programme (circuit workshops, simple equilibrium, dual equilibrium, dual displacement and physical-sports activities). At the start and the end of the programme the following variables were evaluated: speed (10-metre walking speed test), resistance (six-minute walk test), dynamic balance (Step Test), functional capacity (Timed Up and Go), safety perception scale (Activities-specific Balance Confidence Scale) and Physical Activity and Disability Survey (PADS), the average per hour intensity of the activity and the number of steps outside the rehabilitation centre (using physical activity monitors). The t test for related samples was used to evaluate the differences among the variables. RESULTS. Significant differences were found (p <= 0.05) in the variables speed, resistance, balance, functional capacity, perception of safety, perception of general activity performance (question 3 of the PADS) and number of steps. CONCLUSIONS. GPA programmes improve physical capacities, perception of safety, performance of activity in general and the number of steps, which can lead to greater participation in the community. HubMed – rehab

Impact of tendon suturing on the interference fixation strength of quadrupled hamstring tendon grafts.

Arch Orthop Trauma Surg. 2013 Jul 9;
Höher J, Offerhaus C, Steenlage E, Weiler A, Scheffler S

Interference screw fixation of soft tissue grafts has been a widely used fixation technique for cruciate ligament reconstruction. Suturing of the graft construct prior to graft fixation has been proposed to increase fixation strength; however, the effect on mechanical properties has not been well characterized. The goal of this study was to determine whether uniform suturing of the tendon graft affects (1) ultimate fixation strength of the hamstring tendon graft and (2) motion of the tendon in the bone tunnel during cyclic loading when comparing sutured grafts vs. unsutured grafts.Eight pairs of matched mature porcine tibias (age <2 years) and eight paired fresh-frozen human quadrupled hamstring tendon grafts were used. One quadrupled graft from each pair was placed into one of two groups. In the group A a single cerclage suture 3 cm from the doubled end of the graft was placed to join the four tendon strands. In group B a heavy suture was used to tightly unite the four strands of tendon graft to provide a better grip for the interference screw during fixation. The grafts were placed in tibial bone tunnels that matched the graft's diameter and fixed with an interference screw. The looped end of the graft and the attached tibia were rigidly fixed in a material testing machine. The graft constructs were subjected to 100 cycles of 20-250 N load, followed by a load-to-failure test. In addition, a motion analysis system was used during cyclic testing to better determine the amount of elongation at the graft-tunnel interface. Statistical analysis of the failure load and stiffness and the overall elongation following cyclical loading was performed using the Wilcoxon rank sum test. Level of significance was set at p < 0.05.Elongation at the tendon-bone interface during sub-maximal cyclic loading was 2.4 ± 1.4 mm (unsutured) vs. 2.0 ± 0.7 mm (sutured) (p > 0.05). Failure load of the grafts without sutures (634 ± 86 N) was significantly lower than with the sutures (837 ± 183 N). Ultimate stiffness of group A (283 ± 34 N/mm) was lower than that of group B (331 ± 51 N/mm); however, this was not statistically significant (p = 0.051).This study confirms that suturing of the graft construct before interference screw fixation may increase ultimate failure load. However, an improvement of structural properties in response to cyclic loading with sub-maximal loads could not be confirmed. Clinicians using interference screw fixation may suture the graft to improve fixation strength; however, suturing does not appear to allow a more aggressive rehabilitation after surgery. HubMed – rehab

Management of catastrophising and kinesiophobia improves rehabilitation after fusion for lumbar spondylolisthesis and stenosis. A randomised controlled trial.

Eur Spine J. 2013 Jul 9;
Monticone M, Ferrante S, Teli M, Rocca B, Foti C, Lovi A, Brayda Bruno M

To evaluate the effect of a rehabilitation programme including the management of catastrophising and kinesiophobia on disability, dysfunctional thoughts, pain, and the quality of life in patients after lumbar fusion for degenerative spondylolisthesis and/or lumbar spinal stenosis.This was a parallel-group, randomised, superiority-controlled study in which 130 patients were randomly assigned to a programme consisting of exercises and cognitive-behavioural therapy (experimental group, 65 subjects) or exercises alone (control group, 65 subjects). Before treatment (T1), 4 weeks later (post-treatment analysis, T2) and 12 months after the end of treatment (follow-up, T3), all the patients completed a booklet containing the Oswestry Disability Index (ODI, primary outcome), the Tampa Scale for Kinesiophobia, the Pain Catastrophising Scale, a pain Numerical Rating Scale, and the Short-Form Health Survey. A linear mixed model for repeated measures was used for each outcome measure.The ODI linear mixed model revealed significant main effects of group (F(1,122.8) = 95.78, p < 0.001) and time (F(2,120.1) = 432.02, p < 0.001) in favour of the experimental group. There was a significant group × time interaction effect (F(2,120.1) = 20.37, p < 0.001). The analyses of all of the secondary outcome measures revealed a significant effect of time, group and interaction in favour of the experimental group.The rehabilitation programme, including the management of catastrophising and kinesiophobia, was superior to the exercise programme in reducing disability, dysfunctional thoughts, and pain, and enhancing the quality of life of patients after lumbar fusion for degenerative spondylolisthesis and/or LSS. The effects lasted for at least 1 year after the intervention ended. HubMed – rehab

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