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Integrative Stroke Recovery

September 30, 2013 Written by JP       [Font too small?]

Yearly, almost 800,000 adults in the United States will suffer a stroke. Of those, approximately 77% will be first time strokes. The remainder are classified as recurrent attacks. While sobering, there is also some optimistic news to report on the stroke front. Between the years of 1999 and 2009, incidents of stroke have declined by 33%. According to the American Heart Association, this improvement is largely attributable to better management of blood pressure, diabetes and other modifiable risk factors, including smoking cessation and weight management. In addition, dietary changes can also play a valuable role in preventing so-called “brain attacks”. In a previous column, I offered my own dietary prescription for a “Stroke Protection Diet”.

After a stroke has occurred, a multimodal treatment protocol is generally put into place. Conventional therapies, including mirror work, occupational, physical and speech therapy, are commonplace. Other, more experimental approaches, such as hyperbaric oxygen therapy, are increasingly being utilized to complement standard care. That is, when it’s available and for those who can afford it.

The use of alternative medicine in post stroke patients isn’t yet widespread. That’s why it’s vitally important that family, friends and patients inform themselves and their physicians about the following affordable, evidence-based options. Various forms of acupuncture (electrical, scalp and traditional) have been shown to enhance cerebral activity and function, mood and physical control in stroke survivors. Tailored yoga practice improves balance and reduces fear of falling. The simple act of listening to music benefits “focused attention” and “verbal memory”, while simultaneously decreasing confusion and depression. Lastly, optimal nutrition, which can include the use of nutritional supplements, protein shakes and a zinc-enriched diet has also demonstrated potential with regard to neurological recovery.

Note: Please check out the “Comments & Updates” section of this blog – at the bottom of the page. You can find the latest research about this topic there!

To learn more about the studies referenced in today’s column, please click on the following links:

Study 1 - Hyperbaric Oxygen Induces Late Neuroplasticity in Post Stroke Patients (link)

Study 2 - Rehabilitation of Stroke Patients Using Yamamoto New Scalp (link)

Study 3 - Clinical Effects of Scalp Electrical Acupuncture in Stroke: A Sham- (link)

Study 4 – Effect of Acupuncture Therapy for Postponing Wallerian Degeneration … (link)

Study 5 - Acupuncture Regulates the Glucose Metabolism in Cerebral Functional … (link)

Study 6 - Poststroke Balance Improves with Yoga: A Pilot Study (link)

Study 7 – Music Listening Enhances Cognitive Recovery and Mood After Middle (link)

Study 8 - Normalization of Zinc Intake Enhances Neurological Retrieval of Patients (link)

Study 9 - Protein Supplementation May Enhance the Spontaneous Recovery of (link)

Study 10 - Intensive Nutritional Supplements Can Improve Outcomes in Stroke (link)

Electroacupuncture (EA) May Increase Blood Flow Thereby Preventing Ischemic Injury

Source: Journal of Applied Physiology December 1, 2011 vol. (link)

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14 Comments & Updates to “Integrative Stroke Recovery”

  1. JP Says:

    Tai Chi reduces post-stroke fall risk:

    http://www.archives-pmr.org/article/S0003-9993%2814%2900010-0/abstract

    Arch Phys Med Rehabil. 2014 Jan 17. pii: S0003-9993(14)00010-0. doi: 10.1016/j.apmr.2014.01.001.

    Effect of Tai Chi on Physical Function, Fall Rates and Quality of Life Among Older Stroke Survivors.

    Taylor-Piliae RE1, Hoke TM2, Hepworth JT2, Latt LD3, Najafi B3, Coull BM3.

    OBJECTIVE:To examine the effect of a 12-week Tai Chi (TC) intervention on physical function and quality of life.

    DESIGN:Single-blind, randomized controlled trial.

    SETTING:General community.

    PARTICIPANTS: Community-dwelling survivors of stroke (N=145; 47% women; mean age, 70y; time poststroke: 3y; ischemic stroke: 66%; hemiparesis: 73%) who were aged ≥50 years and were ≥3 months poststroke.

    INTERVENTIONS:Yang style 24-posture short-form TC (n=53), strength and range of movement exercises (SS) (n=44), or usual care (UC) (n=48) for 12 weeks. The TC and SS groups attended a 1-hour class 3 times per week, whereas the UC group had weekly phone calls.

    MAIN OUTCOME MEASURES:

    Physical function: Short Physical Performance Battery, fall rates, and 2-minute step test; quality of life: Medical Outcomes Study 36-Item Short-Form Health Survey, Center for Epidemiologic Studies Depression Scale, and Pittsburgh Sleep Quality Index.

    RESULTS:During the intervention, TC participants had two thirds fewer falls (5 falls) than the SS (14 falls) and UC (15 falls) groups (χ2=5.6, P=.06). There was a significant group by time interaction for the 2-minute step test (F2,142=4.69, P<.01). Post hoc tests indicated that the TC (t53=2.45, P=.02) and SS (t44=4.63, P<.01) groups had significantly better aerobic endurance over time, though not in the UC group (t48=1.58, P=.12). Intervention adherence rates were 85%.

    CONCLUSIONS: TC and SS led to improved aerobic endurance, and both are suitable community-based programs that may aid in stroke recovery and community reintegration. Our data suggest that a 12-week TC intervention was more effective in reducing fall rates than SS or UC interventions. Future studies examining the effectiveness of TC as a fall prevention strategy for community-dwelling survivors of stroke are recommended.

    Be well!

    JP

  2. JP Says:

    Update: Flax oil may protect the brain from stroke damage and possibly promote recovery …

    http://www.nutritionj.com/content/pdf/s12937-015-0012-5.pdf

    Nutrition Journal 2015, 14:20

    Oral consumption of α-linolenic acid increases serum BDNF levels in healthy adult humans

    Background aims Dietary omega-6 and omega-3 fatty acids have remarkable impacts on the levels of DHA in the brain and retina. Low levels of DHA in plasma and blood hamper visual and neural development in children and cause dementia and cognitive decline in adults. The level of brain-derived neurotrophic factors (BDNF) changes with dietary omega-3 fatty acid intake. BDNF is known for its effects on promoting neurogenesis and neuronal survival. Methods In this study, we examined the effect of the oral consumption of α-Linolenic acid (ALA) on blood levels of BDNF and Malondialdehyde (MDA) in healthy adult humans. 30 healthy volunteers, 15 men and 15 women, were selected randomly. Each individual served as his or her own control. Before consuming the Flaxseed oil capsules, 5cc blood from each individual was sampled in order to measure the plasma levels of BDNF and MDA as baseline controls. During the experiment, each individual was given 3 oral capsules of flaxseed oil, containing 500mg of alpha linolenic acid, daily for one week. Then, plasma levels of BDNF and MDA were tested. Results The plasma levels of BDNF and MDA significantly (P < 0.05) increased in individuals who received the oral capsules of ALA. Plasma levels of BDNF increased more in the women in comparison with the men. Conclusion ALA treatment could be a feasible approach to reduce size of infarcts in stroke patients. Thus, ALA could be used in adjunction with routine stroke therapies to minimize brain lesions caused by stroke.

    Be well!

    JP

  3. JP Says:

    Update: Relaxation training CD reduces post-stroke anxiety …

    http://cre.sagepub.com/content/early/2015/03/12/0269215515575746.abstract

    Clin Rehabil March 16, 2015

    Objective: To consider relaxation as a potential treatment for anxiety in stroke survivors living in the community, including feasibility and acceptability.

    Design: Randomised two group design (intervention and control).

    Participants: All participants (n = 21) were stroke survivors living in the community who reported experiencing anxiety (Hospital Anxiety and Depression Scale – Anxiety Subscale ⩾ 6).

    Interventions: The intervention group were asked to listen to a self-help autogenic relaxation CD, five times a week, for at least one month. Participants completed the Hospital Anxiety and Depression Scale at screening and then monthly for three months.

    Results: At each assessment following screening, participants who received the relaxation training were significantly more likely to report reduced anxiety compared to those who had not received the training (Month 1 P = 0.002; Month 2 P < 0.001; Month 3 P = 0.001). After one month, seven of the intervention group (n = 10) had completed the relaxation training as directed and planned to continue using it. The intervention appeared practical to deliver and relatively inexpensive, with minimal adverse effects.

    Conclusions: Preliminary evidence suggests that autogenic relaxation training delivered in a self-help CD format is a feasible and acceptable intervention, and that anxiety is reduced in stroke survivors who received the intervention. Future studies should seek to recruit a larger and more heterogeneous sample of 70 participants.

    Be well!

    JP

  4. JP Says:

    Update:

    http://stroke.ahajournals.org/content/early/2015/03/30/STROKEAHA.114.008270.abstract

    Stroke. 2015 Mar 31.

    Multivitamin Use and Risk of Stroke Mortality: The Japan Collaborative Cohort Study.

    BACKGROUND AND PURPOSE: An effect of multivitamin supplement on stroke risk is uncertain. We aimed to examine the association between multivitamin use and risk of death from stroke and its subtypes.

    METHODS: A total of 72 180 Japanese men and women free from cardiovascular diseases and cancers at baseline in 1988 to 1990 were followed up until December 31, 2009. Lifestyles including multivitamin use were collected using self-administered questionnaires. Cox proportional hazards regression models were used to estimate hazard ratios (HRs) of total stroke and its subtypes in relation to multivitamin use.

    RESULTS: During a median follow-up of 19.1 years, we identified 2087 deaths from stroke, including 1148 ischemic strokes and 877 hemorrhagic strokes. After adjustment for potential confounders, multivitamin use was associated with lower but borderline significant risk of death from total stroke (HR, 0.87; 95% confidence interval, 0.76-1.01), primarily ischemic stroke (HR, 0.80; 95% confidence interval, 0.63-1.01), but not hemorrhagic stroke (HR, 0.96; 95% confidence interval, 0.78-1.18). In a subgroup analysis, there was a significant association between multivitamin use and lower risk of mortality from total stroke among people with fruit and vegetable intake <3 times/d (HR, 0.80; 95% confidence interval, 0.65-0.98). That association seemed to be more evident among regular users than casual users. Similar results were found for ischemic stroke.

    CONCLUSIONS: Multivitamin use, particularly frequent use, was associated with reduced risk of total and ischemic stroke mortality among Japanese people with lower intake of fruits and vegetables.

    Be well!

    JP

  5. JP Says:

    Update 05/27/15:

    http://www.mdpi.com/2072-6643/7/5/3796/htm

    Nutrients. 2015 May 19;7(5):3796-812.

    Improved blood biomarkers but no cognitive effects from 16 weeks of multivitamin supplementation in healthy older adults.

    Supplementation with vitamins, minerals and phytonutrients may be beneficial for cognition, especially in older adults. The aim of this study was to assess the effects of multivitamin supplementation in older adults on cognitive function and associated blood biomarkers. In a randomised, double blind, placebo-controlled trial, healthy women (n = 68) and men (n = 48) aged 55-65 years were supplemented daily for 16 weeks with women’s and men’s formula multivitamin supplements. Assessments at baseline and post-supplementation included computerised cognitive tasks and blood biomarkers relevant to cognitive aging. No cognitive improvements were observed after supplementation with either formula; however, several significant improvements were observed in blood biomarkers including increased levels of vitamins B6 and B12 in women and men; reduced C-reactive protein in women; reduced homocysteine and marginally reduced oxidative stress in men; as well as improvements to the lipid profile in men. In healthy older people, multivitamin supplementation improved a number of blood biomarkers that are relevant to cognition, but these biomarker changes were not accompanied by improved cognitive function.

    Be well!

    JP

  6. JP Says:

    Updated 07/15/15:

    Note: Improved HRV may reduce the risk of atrial fibrillation and stroke risk …

    http://www.ncbi.nlm.nih.gov/pubmed/26170587

    Int J Yoga. 2015 Jul-Dec;8(2):96-102.

    Resting heart rate variability after yogic training and swimming: A prospective randomized comparative trial.

    CONTEXT: Resting heart rate variability (HRV) is a measure of the modulation of autonomic nervous system (ANS) at rest. Increased HRV achieved by the exercise is good for the cardiovascular health. However, prospective studies with comparison of the effects of yogic exercises and those of other endurance exercises like walking, running, and swimming on resting HRV are conspicuous by their absence.

    AIMS: Study was designed to assess and compare the effects of yogic training and swimming on resting HRV in normal healthy young volunteers.

    SETTINGS AND DESIGN: Study was conducted in Department of Physiology in a medical college. Study design was prospective randomized comparative trial.

    SUBJECTS AND METHODS: One hundred sedentary volunteers were randomly ascribed to either yoga or swimming group. Baseline recordings of digital electrocardiogram were done for all the subjects in cohorts of 10. After yoga training and swimming for 12 weeks, evaluation for resting HRV was done again.

    STATISTICAL ANALYSIS USED: Percentage change for each parameter with yoga and swimming was compared using unpaired t-test for data with normal distribution and using Mann-Whitney U test for data without normal distribution.

    RESULTS: Most of the HRV parameters improved statistically significantly by both modalities of exercise. However, some of the HRV parameters showed statistically better improvement with yoga as compared to swimming.

    CONCLUSION: Practicing yoga seems to be the mode of exercise with better improvement in autonomic functions as suggested by resting HRV.

    Be well!

    JP

  7. JP Says:

    Updated 1/18/16:

    http://online.liebertpub.com/doi/full/10.1089/acm.2015.0066

    J Altern Complement Med. 2016 Jan;22(1):33-7.

    The Effects of Acupuncture on Cerebral Blood Flow in Post-Stroke Patients: A Randomized Controlled Trial.

    BACKGROUND/OBJECTIVE: Stroke is a major cause of disability and death in the Western world. Studies have shown a direct relationship between specific mental and motor activity and changes in cerebral blood flow. Acupuncture is often used in post-stroke patients, but there is a lack of sham-controlled studies evaluating the effects of acupuncture on cerebral blood flow following a stroke. This pilot concept-assessment study sought to evaluate the effects of true acupuncture on cerebral blood flow velocity compared with sham acupuncture and lay a foundation for future work in this field.

    METHODS: Seventeen inpatients (age range, 44-79 years) 1-3 months post-stroke were allocated to acupuncture at true acupuncture (TA) points or at sham acupuncture (SA) points. The treatment was 20 minutes long. Transcranial Doppler ultrasonography was used to measure mean flow velocity (MFV) and peak flow velocity (PFV) at both healthy and damaged hemispheres before (T0), in the middle of (T15), and 5 minutes after (T25) treatment. Blood pressure was measured at T0 and T25.

    RESULTS: A statistically significant (p < 0.04) MFV increase in both hemispheres was found during and after TA; this increase was higher than that seen with SA (p < 0.035). Acupuncture had no significant effect on PFV. Systolic blood pressure significantly decreased after acupuncture (p < 0.005) in a similar manner for both TA and SA. National Institutes of Health Stroke Scale score was negatively correlated with MFV at T15 (r = -0.825; p < 0.05).

    CONCLUSION: This pilot study showed a significant influence on cerebral blood flow velocity by TA. This study lays a foundation for larger-scale studies that may prove acupuncture to be a useful tool for cerebral blood flow enhancement during post-stroke rehabilitation.

    Be well!

    JP

  8. JP Says:

    Updated 06/26/16:

    http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4908235/

    Evid Based Complement Alternat Med. 2016;2016:2795915.

    Effectiveness of Gotu Kola Extract 750 mg and 1000 mg Compared with Folic Acid 3 mg in Improving Vascular Cognitive Impairment after Stroke.

    This study aimed to determine the effectiveness of gotu kola (Centella asiatica) in improving cognitive function in patients with vascular cognitive impairment (VCI). This study uses a quasi-experimental design. Subjects in this study were patients with poststroke cognitive impairment who were treated at two hospitals in Yogyakarta, Indonesia. The number of subjects was 48: 17 subjects were treated with 1000 mg/day of gotu kola extract, 17 subjects treated with 750 mg/day of gotu kola extract, and 14 subjects treated with 3 mg/day of folic acid for 6 weeks. A Montreal Cognitive Assessment-Indonesian version (MoCA-Ina) was conducted at the beginning of treatment and after 6 weeks of therapy. It was found that all trials effectively improved poststroke VCI based on MoCA-Ina scores over the course of the study. There is no significant difference in ΔMoCA-Ina (score at the 6th week of treatment – score at the beginning) mean score among the three groups, indicating that gotu kola is as effective as folic acid in improving poststroke VCI. Gotu kola was shown to be more effective than folic acid in improving memory domain. This study suggested that gotu kola extract is effective in improving cognitive function after stroke.

    Be well!

    JP

  9. JP Says:

    Updated 06/29/16:

    http://www.ncbi.nlm.nih.gov/pubmed/27351560

    J Altern Complement Med. 2016 Jun 28. [Epub ahead of print]

    Effect of Underwater Exercise on Lower-Extremity Function and Quality of Life in Post-Stroke Patients: A Pilot Controlled Clinical Trial.

    OBJECTIVES: To date, controlled clinical trials evaluating the efficacy of underwater exercise in improving the lower-extremity function and quality of life (QOL) in post-stroke patients have yet to be conducted. The purpose of the present study was to determine whether repeated underwater exercise enhances the therapeutic effect of conventional therapy for post-stroke patients.

    DESIGN: This was a pilot controlled clinical trial.

    SETTING: The study took place in a research facility attached to a rehabilitation hospital.

    PATIENTS: This prospective trial included 120 consecutive post-stroke inpatients with hemiplegic lower limbs (Brunnstrom stage 3-6). Patients were assigned to either an experimental or a control group. Patients in the experimental group received both repeated underwater exercise and conventional rehabilitation therapy.

    INTERVENTIONS: The underwater exercise consisted of 30-min training sessions in a pool with a water temperature of 30-31°C in which patients followed the directions and movements of trained staff. Training sessions were conducted once a day on 2 days of the week for a total of 24 times. Patients in the control group received only the conventional therapy.

    OUTCOME MEASURES: The 10-Minute Walk Test (10MWT), the Modified Ashworth Scale, and the 36-Item Short Form Health Survey were the outcome measures used. Lower-extremity function and QOL were assessed before and upon completion of the 12-week program.

    RESULTS: Improvements in 10MWT results and spasticity parameters were greater in the experimental group than they were in the control group (p < 0.01). Significant differences between the groups were observed in magnitudes of changes of all QOL parameters (p < 0.01).

    CONCLUSIONS: Combining conventional therapy with repeated underwater exercise may improve both lower-extremity function and QOL in post-stroke patients.

    Be well!

    JP

  10. JP Says:

    Updated 09/17/16:

    http://bmccomplementalternmed.biomedcentral.com/articles/10.1186/s12906-016-1337-0

    BMC Complement Altern Med. 2016 Sep 13;16:361.

    Efficacy and safety assessment of acupuncture and nimodipine to treat mild cognitive impairment after cerebral infarction: a randomized controlled trial.

    BACKGROUND: Cerebral infarction frequently leads to mild cognitive impairment (MCI). Prompt management of MCI can prevent vascular dementia and improve patient outcome. This single center randomized controlled trial aims to investigate the efficacy and safety of acupuncture and nimodipine to treat post-cerebral infarction MCI.

    METHODS: A total of 126 Chinese patients with post-cerebral infarction MCI recruited from the First Teaching Hospital of Tianjin University of Traditional Chinese Medicine between April 2013 and June 2014 were randomized at 1:1: 1 ratio into nimodipine alone (30 mg/time and 3 times daily), acupuncture alone (30 min/time, 6 times/week), and nimodipine + acupuncture groups. The treatments were 3 months. Cognitive function was evaluated using Montreal Cognitive Assessment (MoCA) scale at enrollment interview, at the end of 3-month therapy, and at the post-treatment 3-month follow-up.

    RESULTS: The per-protocol set included 39, 40, and 40 patients from nimodipine alone, acupuncture alone, and the combination group, respectively, was analyzed. Intra-group comparison revealed that MoCA score at the follow-up improved significantly by 15.8 ± 10.9, 20.9 ± 13.8 %, and 30.2 ± 19.7 % compared with the baseline MoCA for nimodipine alone, acupuncture alone, and the combination group, respectively. Inter-group comparison demonstrated that the combination therapy improved MoCA score (5.5 ± 2.2) at significantly higher extent than nimodipine alone (3.1 ± 1.8) and acupuncture alone (4.3 ± 2.3) at the follow-up (All P < 0.05), and significantly higher proportion of patients in acupuncture alone group (80 %) and the combination therapy group (90 %) than in nimodipine alone group (56.4 %) showed ≥12 % MoCA score improvement compared with the baseline MoCA (All P < 0.05). No adverse event was reported during the study.

    CONCLUSION: Acupuncture may be used as an additional therapy to conventional pharmacological treatment to further improve the clinical outcomes of patients with post-cerebral infarction MCI.

    Be well!

    JP

  11. JP Says:

    Updated 12/10/16:

    https://www.ncbi.nlm.nih.gov/pubmed/27932540

    Clin Rehabil. 2016 Dec 8.

    Twelve month follow-up on a randomised controlled trial of relaxation training for post-stroke anxiety.

    OBJECTIVE: To follow up participants in a randomised controlled trial of relaxation training for anxiety after stroke at 12 months.

    DESIGN: Twelve month follow-up to a randomised controlled trial, in which the control group also received treatment.

    SETTING: Community.

    PARTICIPANTS: Fifteen of twenty one original participants with post-stroke anxiety participated in a one year follow-up study.

    INTERVENTIONS: A self-help autogenic relaxation CD listened to five times a week for one month, immediately in the intervention group and after three months in the control group.

    MAIN MEASURES: Hospital Anxiety and Depression Scale-Anxiety subscale and the Telephone Interview of Cognitive Status for inclusion. Hospital Anxiety and Depression Scale-Anxiety subscale for outcome. All measures were administered by phone.

    RESULTS: Anxiety ratings reduced significantly between pre and post-intervention, and between pre-intervention and one year follow-up (χ2(2) = 22.29, p < 0.001).

    CONCLUSIONS: Reductions in anxiety in stroke survivors who received a self-help autogenic relaxation CD appear to be maintained after one year.

    Be well!

    JP

  12. JP Says:

    Updated 06/13/17:

    https://www.ncbi.nlm.nih.gov/pubmed/28603381

    J Phys Ther Sci. 2017 May;29(5):959-963.

    The effects of Pilates exercise on cardiopulmonary function in the chronic stroke patients: a randomized controlled trials.

    [Purpose] The purpose of this study was to examine the effect of modified Pilates exercise on cardiopulmonary function in chronic stroke patients. [Subjects and Methods] Twenty participants (age, 62.7 ± 7.3 years; height, 163.3 ± 8.5 cm; weight, 68.8 ± 10.3 kg) were recruited for this study, and randomly allocated to the modified Pilates exercise group (n=10) or the control group (n=10). Graded submaximal treadmill exercise test was used to examine the status of patients’ cardiopulmonary function, based on maximal oxygen intake, at the end of a patient’s exercise tolerance limit. [Results] The resting heart rates, maximal oxygen intake, and maximal oxygen intake per kilogram were significantly different after 8 weeks of modified Pilates exercise. In addition, these variables were also significantly different between the Pilates and control groups after 8 weeks. [Conclusion] This study has demonstrated that 8 weeks of modified Pilates exercise program can have a positive influence on patients with chronic stroke, potentially by enhancing the cardiopulmonary function, which may have positive implications for increasing their functional ability.

    Be well!

    JP

  13. JP Says:

    Updated 09/08/17:

    https://www.ncbi.nlm.nih.gov/pubmed/28878450

    J Phys Ther Sci. 2017 Aug;29(8):1292-1296.

    The effects of aroma massage and foot bath on psychophysiological response in stroke patients.

    [Purpose] This research aimed to examine the effects of back massage and foot bath with blended essential oil on psychophysiological response in stroke patients.

    [Subjects and Methods] The subjects were 14 adult stroke patients randomly divided into the experimental group (7 patients) and the control group (7 patients). Physical and psychological stress, mood state and sleep satisfaction was measured using evaluation instruments and body temperature was measured with infrared thermography (T-1000).

    [Results] Measurements included physical and psychological stress, and mood state of the experiment group became significantly lower than that of the control group. The body temperature and sleeping satisfaction of the experimental group became significantly higher than that of the control group.

    [Conclusion] The present study suggested that aroma therapy and foot bath that can be used as alternative physical therapy that offers an overall beneficial effect on psychophysiological response such as reduced stress, mood state and increased body temperature, sleeping satisfaction of stroke patients.

    Be well!

    JP

  14. JP Says:

    Updated 09/14/17:

    https://www.ncbi.nlm.nih.gov/pubmed/28900454

    J Res Med Sci. 2017 Aug 16;22:98.

    The effect of alpha-lipoic acid supplementation on anthropometric indices and food intake in patients who experienced stroke: A randomized, double-blind, placebo-controlled clinical trial.

    BACKGROUND: Stroke as a devastating condition is a major cause of death worldwide. It is accountable for long-term disability with high personal and social cost in adults. Alpha-lipoic acid (ALA) is an eight-carbon, sulfur-containing compound with antioxidant properties which reduces body weight, changes other anthropometric indices, and regulates food intake by suppressing appetite and increasing metabolism This study was designed to evaluate the possible effects of ALA supplementation on anthropometric indices and dietary intake in patients with stroke.

    MATERIALS AND METHODS: In this randomized, double-blind, placebo-controlled clinical trial, 67 patients with stroke were randomly allocated to two groups (taking a 600 mg ALA supplement or placebo daily for 12 weeks). Weight, waist circumference, energy, carbohydrate, protein, and fat intake were measured, and body mass index (BMI) was calculated before and after intervention. Dietary intake and statistical analyses were carried out using Nutritionist IV and SPSS (version 16; SPSS Inc., Chicago, IL, USA) software, respectively.

    RESULTS: Primary features were similar in the intervention and placebo groups (P > 0.05). Waist circumference (P < 0.001), energy, carbohydrate, protein, and fat intake (P < 0.001) decreased significantly, after the intervention period, in ALA group compared with placebo. While no significant change was observed in weight (P = 0.26) and BMI (P = 0.56) in ALA supplementation group compared with placebo.

    CONCLUSION: Results of this trial indicated that 12-week supplementation with 600 mg ALA can decrease waist circumference and food intake (energy, carbohydrate, protein, and fat) in patients with stroke.

    Be well!

    JP

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