Candidate: Frederick M. Ivey, Ph.D. is an Assistant Professor in the Division of Gerontology, School of Medicine at the University of Maryland, Baltimore. The long-term career goal of the candidate is to advance academically in a research environment focusing on stroke, exercise, insulin-glucose metabolism, and cardiovascular risk factor modification. Dr. Ivey has recently joined the faculty in the Division, making this the ideal time in his career for this RCA to provide advanced research training in clinical and laboratory investigation. The candidate's immediate goat is to examine the mechanisms by which exercise afibcts atherothrombotic risk in chronic hemiparetic stroke patients under the guidance of experienced mentors. Background: Stroke is the leading cause of disability and thkd leading cause of death in the United States. Physical inactivity following stroke increases the incidence of hyperinsulinemia and the insulin resistance syndrome, which increases risk for recurrent stroke and MI by impairing endogenous fibrinoiysis and vasomotor function. Current strategies for preventing recurrent stroke and M1 are limited. Although aerobic exercise (AEX) improves fibrinolysis, nitric oxide-related vasomotor reactivity (NO-VMR), and insulin sensitivity in the healthy elderly, no prior studies have addressed the effects of AEX therapy on vascular endothelial celt function and insulin-glucose metabolism in chronic hemiparetic stroke patients. Our preliminary data provides the first evidence of improved endogenous fibrinolysis and reduced hyperinsulinemia in chronic hemiparetic stroke patients with AEX training. Hypothesis: In the proposed RCA the candidate investigates the hypothesis that 6 months treadmill AEX improves endogenous fibrinolysis and nitric oxide-related VMR in chronic hemiparetic stroke patients, and that these changes are related to improved insulin mediated glucose metabolism on both the whole body and tissue levels.
The specific aims are to: 1) Determine the effects of 6 months AEX on a) fibrinolysis profiles and b) NO-VMR in the cerebral circulation. 2) Determine the effects of AEX on whole body insulin action, and whether alterations in fibrinolysis and NO-VMR are related to exercise-induced changes in insulin levels and action 3) Determine the effects of hemiparesis and AEX on insulin signaling proteins in stroke skeletal muscle. Environment: The Division of Gerontology has excellent resources for advanced research training in aging, stroke, exercise, metabolic, and vascular research. Additional training in molecular medicine is facilitated by Drs. Shuldiner and McLenithan, co-mentors on the revised proposal.

Agency
National Institute of Health (NIH)
Institute
National Institute on Aging (NIA)
Type
Research Scientist Development Award - Research & Training (K01)
Project #
5K01AG019242-04
Application #
7092140
Study Section
National Institute on Aging Initial Review Group (NIA)
Program Officer
Eldadah, Basil A
Project Start
2003-08-15
Project End
2008-07-31
Budget Start
2006-08-01
Budget End
2007-07-31
Support Year
4
Fiscal Year
2006
Total Cost
$129,330
Indirect Cost
Name
University of Maryland Baltimore
Department
Internal Medicine/Medicine
Type
Schools of Medicine
DUNS #
188435911
City
Baltimore
State
MD
Country
United States
Zip Code
21201
Ivey, Frederick M; Stookey, Alyssa D; Hafer-Macko, Charlene E et al. (2015) Higher Treadmill Training Intensity to Address Functional Aerobic Impairment after Stroke. J Stroke Cerebrovasc Dis 24:2539-46
Ivey, Frederick M; Ryan, Alice S (2014) Resistive training improves insulin sensitivity after stroke. J Stroke Cerebrovasc Dis 23:225-9
Ryan, Alice S; Buscemi, Andrew; Forrester, Larry et al. (2011) Atrophy and intramuscular fat in specific muscles of the thigh: associated weakness and hyperinsulinemia in stroke survivors. Neurorehabil Neural Repair 25:865-72
Ivey, Frederick M; Ryan, Alice S; Hafer-Macko, Charlene E et al. (2011) Improved cerebral vasomotor reactivity after exercise training in hemiparetic stroke survivors. Stroke 42:1994-2000
Ryan, Alice S; Ivey, Frederick M; Prior, Steven et al. (2011) Skeletal muscle hypertrophy and muscle myostatin reduction after resistive training in stroke survivors. Stroke 42:416-20
Ivey, Frederick M; Hafer-Macko, Charlene E; Ryan, Alice S et al. (2010) Impaired leg vasodilatory function after stroke: adaptations with treadmill exercise training. Stroke 41:2913-7
Ryan, Alice S; Macko, Richard F; Peters, Matthew N et al. (2009) Plasma adiponectin levels are associated with insulin sensitivity in stroke survivors. J Stroke Cerebrovasc Dis 18:214-20
Ivey, Frederick M; Hafer-Macko, Charlene E; Macko, Richard F (2008) Task-oriented treadmill exercise training in chronic hemiparetic stroke. J Rehabil Res Dev 45:249-59
Ivey, Frederick M; Ryan, Alice S; Hafer-Macko, Charlene E et al. (2007) Treadmill aerobic training improves glucose tolerance and indices of insulin sensitivity in disabled stroke survivors: a preliminary report. Stroke 38:2752-8
Patterson, Shawnna L; Forrester, Larry W; Rodgers, Mary M et al. (2007) Determinants of walking function after stroke: differences by deficit severity. Arch Phys Med Rehabil 88:115-9

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