Correlation of Brain-Derived Neurotrophic Factor and Fugl-Meyer Score Changes after Telerehabilitation in Stroke
-
Husnul Mubarak
,
Andi Asadul Islam
,
Andi Kurnia Bintang
,
Muhammad Nasrum Massi
,
Hening Laswati Putra
,
Jumraini Tammasse
,
Susi Aulina
,
Agussalim Bukhari
,
Firdaus Hamid
,
Andi Alfian Zainuddin
,
Edwin Putra Pomada
Abstract
Introduction: Early post-stroke rehabilitation reduces disability and improves quality of life. However, limited access to rehabilitation facilities presents a significant challenge. Home-based telerehabilitation has emerged as a viable solution to reach distant stroke populations. Motor recovery relies on penumbral reorganization and restructuring. Brain-derived neurotrophic factor (BDNF) plays a crucial role in regulating synaptic plasticity. However, the impact of additional rehabilitation sessions on BDNF levels and motor function in post-stroke patients remains unexplored.
Materials and Methods: A randomized controlled trial was conducted from June to September 2023, involving 50 patients with stroke. A medical history was assessed using a questionnaire, and motor function was evaluated using the Fugl-Meyer assessment (FMA). Blood samples were collected to measure BDNF levels. The intervention included prescribing home-based exercises using a telerehabilitation application on cell phones for 12 weeks. BDNF levels and FMA scores were reassessed at the end of the study.
Results: Significant increases in BDNF and FMA scores were observed in the mobile-based telerehabilitation group. The increase in BDNF and FMA levels in the intervention group exceeded that of the control group.
Conclusion: Mobile-based telerehabilitation is superior to conventional home exercise programs for delivering home-based therapeutic exercises.
Chen J, Liu M, Sun D, Jin Y, Wang T, Ren C. Effectiveness and neural mechanisms of home-based telerehabilitation in patients with stroke based on fMRI and DTI: A study protocol for a randomized controlled trial. Medicine. 2018; 97(3):e9605. [DOI:10.1097/MD.0000000000009605] [PMID]
Dodakian L, McKenzie AL, Le V, See J, Pearson-Fuhrhop K, Burke Quinlan E, et al. A home-based telerehabilitation program for patients with stroke. Neurorehabilitation and Neural Repair. 2017; 31(10-11):923-33. [DOI:10.1177/1545968317733818] [PMID]
Markus HS, Brainin M. COVID-19 and stroke-a global world stroke organization perspective. International Journal of Stroke. 2020; 15(4):361-4. [DOI:10.1177/1747493020923472] [PMID]
Sarfo FS, Ulasavets U, Opare-Sem OK, Ovbiagele B. Tele-rehabilitation after stroke: An updated systematic review of the literature. Journal of Stroke and Cerebrovascular Diseases. 2018; 27(9):2306-18. [DOI:10.1016/j.jstrokecerebrovasdis.2018.05.013] [PMID]
Khan F, Amatya B. Medical rehabilitation in pandemics: Towards a new perspective. Journal of Rehabilitation Medicine. 2020; 52(4):jrm00043. [DOI:10.2340/16501977-2676] [PMID]
Jiao Y, Liu YW, Chen WG, Liu J. Neuroregeneration and functional recovery after stroke: Advancing neural stem cell therapy toward clinical application. Neural Regeneration Research. 2021; 16(1):80-92. [Link]
Singh AA, Katiyar S, Song M. Phytochemicals targeting BDNF signaling for treating neurological disorders. Brain Sciences. 2025; 15(3):252. [DOI:10.3390/brainsci15030252] [PMID]
Cefis M, Chaney R, Wirtz J, Méloux A, Quirié A, Leger C, et al. Molecular mechanisms underlying physical exercise-induced brain BDNF overproduction. Frontiers in Molecular Neuroscience. 2023; 16:1275924. [DOI:10.3389/fnmol.2023.1275924] [PMID]
Adachi N, Numakawa T, Richards M, Nakajima S, Kunugi H. New insight in expression, transport, and secretion of brain-derived neurotrophic factor: Implications in brain-related diseases. World Journal of Biological Chemistry. 2014; 5(4):409-28. [DOI:10.4331/wjbc.v5.i4.409] [PMID]
Sasi M, Vignoli B, Canossa M, Blum R. Neurobiology of local and intercellular BDNF signaling. Pflugers Archiv. 2017; 469(5-6):593-610. [DOI:10.1007/s00424-017-1964-4] [PMID]
Ashcroft SK, Ironside DD, Johnson L, Kuys SS, Thompson-Butel AG. Effect of exercise on brain-derived neurotrophic factor in stroke survivors: A systematic review and meta-analysis. Stroke. 2022; 53(12):3706-16. [DOI:10.1161/STROKEAHA.122.039919] [PMID]
Mitre M, Mariga A, Chao MV. Neurotrophin signalling: Novel insights into mechanisms and pathophysiology. Clinical Science. 2017; 131(1):13-23. [DOI:10.1042/CS20160044] [PMID]
Dhingra N, Diepart M, Dziekan G, Khamassi S, Otaiza F, Wilburn S, et al. WHO guidelines on drawing blood: Best practices in phlebotomy. Geneva: World Health Organization; 2010. [Link]
Vijayan M, Reddy PH. Stroke, vascular dementia, and alzheimer's disease: Molecular links. Journal of Alzheimer's Disease. 2016; 54(2):427-43. [DOI:10.3233/JAD-160527] [PMID]
Boehme AK, Esenwa C, Elkind MS. Stroke risk factors, genetics, and prevention. Circulation Research. 2017; 120(3):472-95. [DOI:10.1161/CIRCRESAHA.116.308398] [PMID]
Global Burden of Metabolic Risk Factors for Chronic Diseases Collaboration (BMI Mediated Effects); Lu Y, Hajifathalian K, Ezzati M, Woodward M, Rimm EB, et al. Metabolic mediators of the effects of body-mass index, overweight, and obesity on coronary heart disease and stroke: A pooled analysis of 97 prospective cohorts with 1·8 million participants. Lancet. 2014; 383(9921):970-83. [DOI:10.1016/S0140-6736(13)61836-X] [PMID]
Eichler S, Salzwedel A, Rabe S, Mueller S, Mayer F, Wochatz M, et al. The effectiveness of telerehabilitation as a supplement to rehabilitation in patients after total knee or hip replacement: Randomized controlled trial. JMIR Rehabilitation and Assistive Technologies. 2019; 6(2):e14236. [DOI:10.2196/14236] [PMID]
Amirabadi N, Hessam M, Monjezi S, Molhemi F, Mehravar M, Hosseinpour P. Effectiveness of telerehabilitation intervention to improve pain and physical function in people with patellofemoral pain syndrome: Study protocol for a randomized controlled trial. Trials. 2024; 25(1):195. [DOI:10.1186/s13063-024-08047-3] [PMID]
Dias JF, Oliveira VC, Borges PRT, Dutra FCMS, Mancini MC, Kirkwood RN, et al. Effectiveness of exercises by telerehabilitation on pain, physical function and quality of life in people with physical disabilities: A systematic review of randomised controlled trials with GRADE recommendations. British Journal of Sports Medicine. 2021; 55(3):155-62. [DOI:10.1136/bjsports-2019-101375] [PMID]
Pratama AD, Farelin AD, Karnadipa T, Pahlawi R, Noviana M, Abdullah F. The application of telerehabilitation for pain reduction and improving quality of life in workers with work-related musculoskeletal disorders: Systematic review. Paper presented at: The 5th International Conference on Vocational Education Applied Science and Technology 2022. 28 October 2022; Teluk Betung, Indonesia. [DOI:10.3390/proceedings2022083045]
Sari F, Oskay D, Tufan A. Effects of a telerehabilitation-based exercise program in patients with systemic sclerosis. Zeitschrift fur Rheumatologie. 2024; 83(Suppl 1):167-74. [DOI:10.1007/s00393-023-01346-1] [PMID]
Pathak A, Gyanpuri V, Dev P, Dhiman NR. The Bobath concept (NDT) as rehabilitation in stroke patients: A systematic review. Journal of Family Medicine and Primary Care. 2021; 10(11):3983-90. [DOI:10.4103/jfmpc.jfmpc_528_21] [PMID]
Geng H, Li M, Tang J, Lv Q, Li R, Wang L. Early rehabilitation exercise after stroke improves neurological recovery through enhancing angiogenesis in patients and cerebral ischemia rat model. International Journal of Molecular Sciences. 2022; 23(18):10508. [DOI:10.3390/ijms231810508] [PMID]
Pumprasart T, Pramodhyakul N, Piriyaprasarth P. The effect of the Bobath therapy programme on upper limb and hand function in chronic stroke individuals with moderate to severe deficits. International Journal of Therapy and Rehabilitation. 2019; 26(10):1-12. [DOI:10.12968/ijtr.2018.0124]
Kollen BJ, Lennon S, Lyons B, Wheatley-Smith L, Scheper M, Buurke JH, et al. The effectiveness of the Bobath concept in stroke rehabilitation: What is the evidence? Stroke. 2009; 40(4):e89-97. [DOI:10.1161/STROKEAHA.108.533828] [PMID]
Alves SS, Ocamoto GN, de Camargo PS, Santos ATS, Terra AMSV. Effects of virtual reality and motor imagery techniques using Fugl Meyer Assessment scale in post-stroke patients. International Journal of Therapy and Rehabilitation. 2018; 25(11):587-96. [DOI:10.12968/ijtr.2018.25.11.587]
Junata M, Cheng KC, Man HS, Lai CW, Soo YO, Tong RK. Kinect-based rapid movement training to improve balance recovery for stroke fall prevention: A randomized controlled trial. Journal of Neuroengineering and Rehabilitation. 2021; 18(1):150. [DOI:10.1186/s12984-021-00922-3] [PMID]
Wu Z, Xu J, Yue C, Li Y, Liang Y. Collaborative care model based telerehabilitation exercise training program for acute stroke patients in China: A randomized controlled trial. Journal of Stroke and Cerebrovascular Diseases. 2020; 29(12):105328. [DOI:10.1016/j.jstrokecerebrovasdis.2020.105328] [PMID]
Chen J, Sun D, Zhang S, Shi Y, Qiao F, Zhou Y, et al. Effects of home-based telerehabilitation in patients with stroke. Neurology. 2020; 95(17):e2318-30. [DOI:10.1212/WNL.0000000000010821]
Federico S, Cacciante L, De Icco R, Gatti R, Jonsdottir J, Pagliari C, et al. Telerehabilitation for stroke: A personalized multi-domain approach in a pilot study. Journal of Personalized Medicine. 2023; 13(12):1692. [DOI:10.3390/jpm13121692] [PMID]
Pelosi AD, Roth N, Yehoshua T, Itah D, Braun Benyamin O, Dahan A. Personalized rehabilitation approach for reaching movement using reinforcement learning. Scientific Reports. 2024; 14(1):17675. [DOI:10.1038/s41598-024-64514-6] [PMID]
Scrivener K, Dorsch S, McCluskey A, Schurr K, Graham PL, Cao Z, et al. Bobath therapy is inferior to task-specific training and not superior to other interventions in improving lower limb activities after stroke: A systematic review. Journal of Physiotherapy. 2020; 66(4):225-35. [DOI:10.1016/j.jphys.2020.09.008] [PMID]
Díaz-Arribas MJ, Martín-Casas P, Cano-de-la-Cuerda R, Plaza-Manzano G. Effectiveness of the Bobath concept in the treatment of stroke: A systematic review. Disability and Rehabilitation. 2020; 42(12):1636-49. [DOI:10.1080/09638288.2019.1590865] [PMID]
Schmolesky MT, Webb DL, Hansen RA. The effects of aerobic exercise intensity and duration on levels of brain-derived neurotrophic factor in healthy men. Journal of Sports Science & Medicine. 2013; 12(3):502. [PMID]
Ament W, Verkerke GJ. Exercise and fatigue. Sports Medicine. 2009; 39(5):389-422. [DOI:10.2165/00007256-200939050-00005] [PMID]
Upadhyaya P, Nandyala A, Ailani J. Primary exercise headache. Current Neurology and Neuroscience Reports. 2020; 20(5):9. [DOI:10.1007/s11910-020-01028-4] [PMID]
Sandoe CH, Kingston W. Exercise headache: A review. Current Neurology and Neuroscience Reports. 2018; 18(6):28. [DOI:10.1007/s11910-018-0840-8] [PMID]
Wilson PB. 'I think I'm gonna hurl': A narrative review of the causes of nausea and vomiting in sport. Sports. 2019; 7(7):162. [DOI:10.3390/sports7070162] [PMID]
| Issue | Vol 19 No 4 (2025) | |
| Section | Research Article(s) | |
| DOI | https://doi.org/10.18502/jmr.v19i4.19775 | |
| Keywords | ||
| Stroke Brain-derived neurotrophic factor Telerehabilitation Recovery of function | ||
| Rights and permissions | |
|
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License. |
