Publication: The biomarkers’ changes after conventional rehabilitation therapy in ischemic and hemorrhagic stroke patients in Hospital Universiti Sains Malaysia
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Date
2022-03
Authors
Hadjer, Khiati
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Abstract
Introduction: Stroke is a heterogeneous disease with multiple causes and risk factors and a major cause of death globally. The pathophysiology of stroke is a complex process that leads to the release of different blood markers into blood circulation, such as Creatine kinase (CK) enzyme, Cardiac Troponin T (cTnT) and pro-inflammatory Interleukins-6 (IL-6). A conventional rehabilitation therapy aimed to balance the release of these biomarkers in patients with stroke by increasing the activity of the heart and muscles. Rehabilitation therapy also helps individuals to improve their quality of life, dependency and facilitate social reintegration. Aim: This study evaluated the changes in the serum concentration level of plasma CK, cTnT, IL-6 biomarkers and Modified Barthel Index (MBI) scores after six weeks of the conventional rehabilitation therapy in ischemic and hemorrhagic stroke patients in Hospital Universiti Sains Malaysia (HUSM). Method: This was a prospective study with 19 participants (Males= 12, Females= 7, Age M= 52.79; Ischemic= 9, Hemorrhagic= 10) who underwent conventional physiotherapy sessions over a period of six weeks. The sessions were based on conventional rehabilitation therapy conducted by similar sets of physiotherapists. A fully automated analyser, was used to measure the concentration level of serum CK (The Architect c8000), Serum cTnT (Cobas e411) serum IL-6 (Cobas e601), and MBI was used to measure the biological and functional outcomes before the intervention and after the six weeks intervention. Results: There were no statistically significant changes in CK, cTnT, IL-6 and MBI scores before and after six weeks of conventional rehabilitation in ischemic and hemorrhagic stroke groups. Comparison between the ischemic and hemorrhagic stroke groups showed no significant difference p > 0.05 (= 0.05 significant level) in all biomarkers’ levels after six weeks of conventional rehabilitation therapy. However, there was a significant difference in MBI scores between ischemic and hemorrhagic stroke types after six weeks of therapy (p=.006). Discussion: The findings suggest that the changes in CK and cTnT, IL-6 are likely to be regulated by different mechanisms and influenced by different factors related to the severity of the stroke. Better functional recovery in stroke patients is related to the initial nervous system severity and dysfunction. Functional recovery outcome has been more positive, which was measured and self-reported by the patients using MBI. Conclusion: From our findings, this study suggested that conventional rehabilitation therapy positively affects functional outcomes in stroke patients. However, the changes in the concentration level of blood biomarkers (CK, cTnT, IL-6) and MBI in this study were limited due to the small sample size. Larger sample size is recommended for future studies to confirm the influence of conventional rehabilitation on physiological changes in ischemic and hemorrhagic stroke patients