PMID- 23352685
OWN - NLM
STAT- MEDLINE
DCOM- 20140929
LR  - 20211021
IS  - 1532-8511 (Electronic)
IS  - 1052-3057 (Print)
IS  - 1052-3057 (Linking)
VI  - 23
IP  - 2
DP  - 2014 Feb
TI  - Resistive training improves insulin sensitivity after stroke.
PG  - 225-9
LID - S1052-3057(12)00441-7 [pii]
LID - 10.1016/j.jstrokecerebrovasdis.2012.12.014 [doi]
AB  - BACKGROUND: Insulin resistance is highly prevalent after stroke, contributing to 
      comorbid cardiovascular conditions that are the leading cause of death in the 
      stroke population. This study determined the effects of unilateral resistive 
      training (RT) of both the paretic and nonparetic legs on insulin sensitivity in 
      stroke survivors. METHODS: We studied 10 participants (mean age 65 +/- 2 years; 
      mean body mass index 27 +/- 4 kg/m2) with hemiparetic gait after remote (>6 months) 
      ischemic stroke. All subjects underwent 1-repetition maximum (1-RM) strength 
      testing, 9 had an oral glucose tolerance test (OGTT), and 7 completed a 2-hour 
      hyperglycemic clamp (with glucose elevation targeted at 98 mg/dL above baseline 
      fasting level) before and after 12 weeks (3x/week) of progressive, high 
      repetition, high-intensity RT. Body composition was assessed by dual-energy x-ray 
      absorbtiometry in all participants. RESULTS: Leg press and leg extension 1-RM 
      increased in the paretic leg by 22% (P < .05) and 45% (P < .01), respectively. 
      Fasting insulin decreased 23% (P < .05), with no change in fasting glucose. The 
      16% reduction in OGTT insulin area under the curve (AUC) across training was not 
      statistically significant (P = .18). There was also no change in glucose AUC. 
      First-phase insulin response during the hyperglycemic clamp (0-10 minutes) 
      decreased 24% (P < .05), and second-phase insulin response (10-120 minutes) 
      decreased 26% (P < .01). Insulin sensitivity increased by 31% after RT according 
      to clamp calculations (P < .05). CONCLUSIONS: These findings provide the first 
      preliminary evidence that RT may reduce hyperinsulinemia and improve insulin 
      sensitivity after disabling stroke.
CI  - Published by Elsevier Inc.
FAU - Ivey, Frederick M
AU  - Ivey FM
AD  - Department of Neurology, University of Maryland School of Medicine, Baltimore, 
      Maryland; Baltimore Veterans Administration Medical Center, Geriatrics Research, 
      Education and Clinical Center (GRECC) and Maryland Exercise and Robotics Center 
      of Excellence (MERCE), Baltimore, Maryland. Electronic address: 
      fivey@grecc.umaryland.edu.
FAU - Ryan, Alice S
AU  - Ryan AS
AD  - Department of Medicine, University of Maryland School of Medicine, Baltimore, 
      Maryland; Baltimore Veterans Administration Medical Center, Geriatrics Research, 
      Education and Clinical Center (GRECC) and Maryland Exercise and Robotics Center 
      of Excellence (MERCE), Baltimore, Maryland.
LA  - eng
GR  - P60AG12583/AG/NIA NIH HHS/United States
GR  - K01 AG019242/AG/NIA NIH HHS/United States
GR  - P30-AG028747/AG/NIA NIH HHS/United States
GR  - K01-AG019242/AG/NIA NIH HHS/United States
GR  - R01 AG019310/AG/NIA NIH HHS/United States
GR  - P60 AG012583/AG/NIA NIH HHS/United States
GR  - R01-AG19310/AG/NIA NIH HHS/United States
GR  - P30 DK079637/DK/NIDDK NIH HHS/United States
GR  - P30 AG028747/AG/NIA NIH HHS/United States
PT  - Journal Article
PT  - Research Support, N.I.H., Extramural
PT  - Research Support, U.S. Gov't, Non-P.H.S.
DEP - 20130122
PL  - United States
TA  - J Stroke Cerebrovasc Dis
JT  - Journal of stroke and cerebrovascular diseases : the official journal of National 
      Stroke Association
JID - 9111633
RN  - 0 (Biomarkers)
RN  - 0 (Blood Glucose)
RN  - 0 (Insulin)
SB  - IM
MH  - Absorptiometry, Photon
MH  - Aged
MH  - Area Under Curve
MH  - Biomarkers/blood
MH  - Blood Glucose/metabolism
MH  - Body Composition
MH  - Disability Evaluation
MH  - Energy Metabolism
MH  - Glucose Clamp Technique
MH  - Glucose Tolerance Test
MH  - Humans
MH  - Hyperinsulinism/blood/diagnosis/*etiology/physiopathology
MH  - Insulin/blood
MH  - *Insulin Resistance
MH  - Lower Extremity
MH  - Middle Aged
MH  - Muscle Strength
MH  - Muscle, Skeletal/metabolism/*physiopathology
MH  - Predictive Value of Tests
MH  - Recovery of Function
MH  - *Resistance Training
MH  - Stroke/blood/complications/diagnosis/physiopathology
MH  - *Stroke Rehabilitation
MH  - Time Factors
MH  - Treatment Outcome
PMC - PMC3883794
MID - NIHMS467339
OTO - NOTNLM
OT  - Diabetes
OT  - energy metabolism
OT  - exercise
OT  - rehabilitation
OT  - stroke recovery
EDAT- 2013/01/29 06:00
MHDA- 2014/09/30 06:00
PMCR- 2014/02/01
CRDT- 2013/01/29 06:00
PHST- 2012/06/25 00:00 [received]
PHST- 2012/12/19 00:00 [revised]
PHST- 2012/12/24 00:00 [accepted]
PHST- 2013/01/29 06:00 [entrez]
PHST- 2013/01/29 06:00 [pubmed]
PHST- 2014/09/30 06:00 [medline]
PHST- 2014/02/01 00:00 [pmc-release]
AID - S1052-3057(12)00441-7 [pii]
AID - 10.1016/j.jstrokecerebrovasdis.2012.12.014 [doi]
PST - ppublish
SO  - J Stroke Cerebrovasc Dis. 2014 Feb;23(2):225-9. doi: 
      10.1016/j.jstrokecerebrovasdis.2012.12.014. Epub 2013 Jan 22.