DOI QR코드

DOI QR Code

Relationship of Physical Impairment, function and Insulin Resistance in stroke patients

  • Received : 2013.07.18
  • Accepted : 2013.09.10
  • Published : 2013.09.28

Abstract

Insulin resistance is a risk factor for stroke or recurrent stroke. Sedentary behavior increases insulin resistance. This study aimed to identify the relationship between physical impairments and functions and insulin resistance, examining which physical impairments specifically influence insulin resistance the most. The subjects of this study were 63 stroke patients. The subject's insulin resistance and physical impairments and functions were measured using the Chedoke-McMaster Stroke Assessment (CMSA) and Stroke Impairment Assessment Set (SIAS). The study results exhibited that insulin resistance is statistically significantly related to the variable of foot according to the CMSA(r=.95, p<.05) and to the variable of lower extremity sensory function (touch) in relation to the SIAS(r=.91, p<.05). This study also revealed close correlations between insulin resistance and the variables of ankle control(${\beta}=-1.05$, p<.05) and low extremity tactile sensations(${\beta}=-1.82$, p<.05).

References

  1. National statistical office, Annual statistics report of causes of death, National statistical office, Daejeon, 2011.
  2. World health organization, International classification of functioning, disability and health, WHO, Switzerland, 2001.
  3. E.J. Roth, A.W. Heinemann, L.L. Lovell, R.L. Harvey, J.R. McGuire and S. Diaz, "Impairment and Disability: Their Relation during Stroke Rehabilitation," Archive of Physical Medicine and Rehabilitation, vol. 79, no. 3, Mar. 1998, pp. 329-335. https://doi.org/10.1016/S0003-9993(98)90015-6
  4. E.J. Roth and R.L. Harvey, Rehabilitation of Stroke Syndrome, Physical Medicine and Rehabilitation, Philadelphia, 2000.
  5. G.E. Gresham, P.W. Duncan and W.B. Stason, Post-Stroke Rehabilitation, US Department of Health and Human Services, 1997.
  6. C. Boquardus, S. Lillioja, D.M. Mott, C. Hellenbeck and G. Reaven, "Relationship between Degree of Obesity and in vivo Insulin Action in Man," American Journal of Physiology, vol. 248, no. 3, Mar. 1985, pp. E286-291.
  7. W.N. Kernan, S.E. Inzucchi, C.M. Viscoli, L.M. Brass, D.M. Bravata and R.I. Horwitz, "Insulin Resistance and Risk for Stroke," Neurology, vol. 59, no. 6, Sep. 2002, pp. 809-815. https://doi.org/10.1212/WNL.59.6.809
  8. M. Pyorala, H. Miettinen, M. Laakso and K. Pyorala, "Hyperinsulinemia and the Risk of Stroke in Healthy Middle-Aged Men," Stroke, vol. 29, no. 9, Sep. 1998, pp. 1860-1866. https://doi.org/10.1161/01.STR.29.9.1860
  9. A.R. Folsom, M.L. Rasmussen, L.E. Chambless, G. Howard, L.S. Cooper, M.I. Schmidt and G. Heiss, "Prospective Associations of Fasting Insulin, Body Fat Distribution, and Diabetes with Risk of Ischemic Stroke," Diabetes Care, vol. 22, no. 7, Jul. 1999, pp. 1077-1083. https://doi.org/10.2337/diacare.22.7.1077
  10. H.J. Helmerhorst, K. Wijndaele, S. Brage, N.J. Wareham and U. Ekelund, " Objectively Measured Sedentary Time may Predict Insulin Resistance Independent of Moderateand Vigorous-intensity Physical Activity," Diabetes, vol. 58, no. 8, Aug. 2009, pp. 1776-1779. https://doi.org/10.2337/db08-1773
  11. U. Ekelund, S. Brage, S.J. Griffin and N.J. Wareham, "Objectively Measured Moderate-and Vigorous-intensity Physical Activity but not Sedentary Time Predicts Insulin Resistance in High-risk Individuals," Diabetes Care, vol. 32, no. 6, Jun. 2009, pp. 1081-1086. https://doi.org/10.2337/dc08-1895
  12. H.M. Blanck, M.L. McCullough, A.V. Patel, C. Gillespie, E.E. Calle, V.E. Cokkinides, D.A. Galuska, L.K. Khan and M.K. Serdula, "Sedentary Behavior, Recreational Physical Activity, and 7-Year Weight Gain Among Postmenopausal U.S. Women," Obesity, vol. 15, no. 6, Jun. 2007, pp. 1578-1588. https://doi.org/10.1038/oby.2007.187
  13. A. Esteqhanati, O. Khalilzadeh, A. Rashidi, A. Meysamie, F. Asqari, M. Abbasi, S. Rastad and M.M. Gouya, "Association Between Physical Activity and Insulin Resistance in Iranian Adults," Preventive Medicine, vol. 49, no. 5, Nov. 2009, pp. 402-406. https://doi.org/10.1016/j.ypmed.2009.09.005
  14. H.S. Jorgensen, H. Nakayama, H.O. Raaschou and T.S. Olsen, "Recovery of Walking Function in Stroke Patients," Archive of Physical Medicine and Rehabilitation, vol. 76, no. 1, Jan. 1995, pp. 27-32. https://doi.org/10.1016/S0003-9993(95)80038-7
  15. D.K. Sommerfeld, E.U. Eek, A.K. Svensson, L.W. Holmgvist and M.H. von Arbin, "Spasticity after Stroke," Stroke, vol. 35, no. 1, Jan. 2004, pp. 134-139. https://doi.org/10.1161/01.STR.0000126608.41606.5c
  16. S. Nadeau, A.B. Arsenault, D. Gravel and D. Bourbonnais, "Analysis of the Clinical Factors Determining Natural and Maximal Gait Speed in Adults with a Stroke," American Journal of Physical Medicine and Rehabilitation, vol. 78, no. 2, Apr. 1999, pp. 123-130. https://doi.org/10.1097/00002060-199903000-00007
  17. A.T. Patel, P.W. Duncan, S.M. Lai and S. Studenski, "The Relation Between Impairments and Functional Outcomes Poststroke," Archive of Physical Medicine and Rehabilitation, vol. 81, no. 10, Oct. 2000, pp. 1357-1363. https://doi.org/10.1053/apmr.2000.9397
  18. P.Y. Lin, Y.R. Yang, .S.J. Cheng and R.Y. Wang, "The Relation between Ankle Impairments and Gait Velocity and Symmetry in People with Stroke," Archive of Physical Medicine and Rehabilitation, vol. 87, no. 4, Apr. 2006, pp. 562-568. https://doi.org/10.1016/j.apmr.2005.12.042
  19. A. Lamontagne, F. Malouin, C.L. Richards and F. Dumas, "Mechanisms of Disturbed Motor Control in Ankle Weakness during Gait after Stroke," Gait and Posture, vol. 15, no. 3, Jun. 2002, pp. 244-255. https://doi.org/10.1016/S0966-6362(01)00190-4
  20. S.J. Olney, M.P. Griffin and T.N. Monga, "Work and Power in Gait of Stroke Patients," Archive of Physical Medicine and Rehabilitation, vol. 72, no. 5, Apr. 1991, pp. 309-314.
  21. L. Han, D. Law-Gibson and M. Reding, "Key Neurological Impairments Influence Function-Related Group Outcomes after Stroke," Stroke, vol. 33, no. 7, Jul. 2002, pp. 1920-1924. https://doi.org/10.1161/01.STR.0000019792.59599.CC
  22. G. Kwakkel, R.C. Wagenaar, B.J. Kollen and G.J. Lankhorst, "Predicting Disability in Stroke," Age and Ageing, vol. 25, no. 6, Nov. 1996, pp. 479-489. https://doi.org/10.1093/ageing/25.6.479
  23. M.L. Dombovy, B.A. Sandok and J.R. Basford, "Rehabilitation for Stroke," Stroke, vol. 17, no. 3, Jun. 1986, pp. 363-369. https://doi.org/10.1161/01.STR.17.3.363
  24. B. Balkau, L. Mhamdi, J.M. Oppert, J. Nolan, A. Golay, F. Porcellati, M. Laakso and E. Ferrannini, "Physical Activity and Insulin Sensitivity," Diabetes, vol. 57, no. 10, Oct. 2008, pp. 2613-2618. https://doi.org/10.2337/db07-1605
  25. R.L. Bradley, J.Y. Jeon, F.F. Liu and E. Maratos-Flier, "Voluntary Exercise Improves Insulin Sensitivity and Adipose Tissue Inflammation in Diet-Induced Obese Mise," American Journal of Physiology Endocrinology and Metabolism, vol. 295, no. 3, Sep. 2008, pp. E586-594. https://doi.org/10.1152/ajpendo.00309.2007
  26. A. Nowak, L. Pilaczynska-Szczesniak, E. Sliwicka, E. Deskur-Smielecka, J. Karolkiewicz and A. Piechowiak, "Insulin Resistance and Glucose Tolerance in Obese Women," Journal of Sports Medicine and Physical Fitness, vol. 48, no. 2, Jun. 2008, pp. 252-258.