CC..png    

16plus.png

Legal and postal addresses of the founder and publisher: Northern (Arctic) Federal University named after M.V. Lomonosov, Naberezhnaya Severnoy Dviny, 17, Arkhangelsk, 163002, Russian Federation

Editorial office address: Journal of Medical and Biological Research, 56 ul. Uritskogo, Arkhangelsk

Phone: (8182) 21-61-00, ext.18-20

E-mail: vestnik_med@narfu.ru
https://vestnikmed.ru/en/

ABOUT JOURNAL

Hematological and Non-Hematological Mechanisms of Adaptation to Intermittent Hypoxia in Post-Stroke Patients During Rehabilitation. P. 19–32

Версия для печати

Section: Biological sciences

Download (pdf, 0.6MB )

UDC

616-003.96+616.831-005

Authors

Oleg S. Glazachev1, Elena N. Dudnik2, Malachi Nyamukondiwa3*, Anna I. Medvedeva4, Elizaveta S. Koneva5, Andrey L. Pokhachevskiy6

1–3, 5, 6I.M. Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia

4People’s Friendship University of Russia named after Patrice Lumumba (RUDN University), Moscow, Russia

5Joint Stock Company Medsi Group, Moscow, Russia

1glazachev@mail.ru, https://orcid.org/0000-0001-9960-6608

2dudnik_e_n@staff.sechenov.ru, https://orcid.org/0000-0003-4571-1781

3nyamukondiva_m@student.sechenov.ru*, https://orcid.org/0000-0002-9834-2505

4smimula1@yandex.ru, https://orcid.org/0009-0000-0115-1305

5elizaveta.coneva@yandex.ru, https://orcid.org/0000-0002-9859-194X

6pokhachevskiy_a_l@staff.sechenov.ru, https://orcid.org/0000-0001-6610-007X

Abstract

The rationale for and development of hypoxic conditioning techniques is an actively developing area in physiology and medical rehabilitation. The purpose of the study is to investigate the hematological and non-hematological mechanisms of adaptation to intermittent hypoxia-hyperoxia exposures (IHHE) in post-stroke patients to enhance the effectiveness of comprehensive neurorehabilitation. Materials and methods. A prospective randomized controlled trial was conducted involving 34 patients (males and females aged 46–73) with residual effects after a stroke. The patients were divided into a study group (19 subjects, standard rehabilitation + IHHE course) and a control group (15 subjects, standard rehabilitation only). The IHHE course consisted of 12 procedures administered using the ReOxy® device in an individualized mode. Clinical and functional indicators (using the 6-minute walk test (6MWT), the Barthel Index, psychometric scales, short-term memory and attention span tests) and hematological parameters were assessed before and after the course. Results. The patients in the study group demonstrated a significant and more pronounced improvement compared to the controls in exercise tolerance, as well as an increased self-care ability. Moreover, a more pronounced reduction in symptoms of asthenia (MFI-21) and daytime sleepiness, as well as better recovery of cognitive functions were observed. By the end of the rehabilitation course, signs of erythropoiesis activation were detected in the blood of the study group subjects: moderate increases in hemoglobin levels, reticulocyte concentration, and reticulocyte hemoglobin content, while the erythropoiesis stimulation index (OFF-Score) was statistically significantly higher than control values. Thus, incorporating IHHE into the standard rehabilitation program for post-stroke patients leads to significant functional and cognitive improvements, which is likely due to the synergy of hematological and non-hematological adaptive mechanisms. The IHHE method demonstrates high clinical potential as an adjuvant non-pharmacological technique for neurorehabilitation.

Funding. This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.

For citation: Glazachev O.S., Dudnik E.N., Nyamukondiwa M., Medvedeva A.I., Koneva E.S., Pokhachevskiy A.L. Hematological and Non-Hematological Mechanisms of Adaptation to Intermittent Hypoxia in Post-Stroke Patients During Rehabilitation. Journal of Medical and Biological Research, 2026, vol. 14, no. 3, pp. 19–32. https://doi.org/10.37482/2687-1491-Z293

Keywords

intermittent hypoxia, intermittent hypoxia-hyperoxia exposures, neurorehabilitation, post-stroke rehabilitation, hematological adaptation, non-hematological adaptation, reticulocytes, OFF-Score

References

1. Burtscher J., Glazachev O.S., Kopp M., Burtscher M. Effects of Intermittent Hypoxia Exposures and Interval Hypoxic Training on Exercise Tolerance (Narrative Review). Sports Med. Res. Pract., 2024, vol. 14, no. 2, pp. 16–23. https://doi.org/10.47529/2223-2524.2024.2.5

2. Randy H., Perrin T.P, Ghaith A., Kohlbrenner D., Flore P., Champigneulle B., Guinot M., Doutreleau S., Brugniaux J., Verges S. et al. Moderate Intermittent Hypoxic Conditioning to Enhance Vascular Function and Cardiorespiratory Fitness in the Elderly: A Randomised Controlled Trial. Physiol. Rep., 2025, vol. 13, no. 19. Art. no. e70432. https://doi.org/10.1152/ajpregu.00160.2025

3. Zhang Q., Zhao W., Li S., Ding Yu., Wang Yu., Ji X. Intermittent Hypoxia Conditioning: A Potential Multi-Organ Protective Therapeutic Strategy. Int. J. Med. Sci., 2023, vol. 20, no. 12, pp. 1551–1561. https://doi.org/10.7150/ijms.86622

4. Aderinto N., Olatunji G., Kokori E., Ukoaka B., Babalola A.E., Ogieuhi I.J., Moradeyo A., Yusuf I.A., Oluwatomisin A.O., Oluwakorede A.T. et al. Understanding the Biological Effects of Hypoxia in Ischemic Stroke: Implications for Rehabilitation and Recovery. Discov. Med., 2024, vol. 1, no. 1. Art. no. 130. https://doi.org/10.1007/s44337-024-00161-0

5. Yuan H., Liu J., Gu Y., Ji X., Nan G. Intermittent Hypoxia Conditioning as a Potential Prevention and Treatment Strategy for Ischemic Stroke: Current Evidence and Future Directions. Front. Neurosci., 2022, vol. 16. Art. no. 1067411. https://doi.org/10.3389/fnins.2022.1067411

6. Bondarenko N.N., Khomutov E.V., Ryapolova T.L., Kishenya M.S., Ignatenko T.S., Tolstoy V.A., Evtushenko I.S., Tumanova S.V. Molecular and Cellular Mechanisms of Hypoxic Response. Ulyanovsk Med. Biol. J., 2023, no. 2, pp. 6–29 (in Russ.). https://doi.org/10.34014/2227-1848-2023-2-6-29

7. Semenov D.G., Belyakov A.V. Hypoxic Conditioning as a Stimulus for the Formation of Hypoxic Tolerance of the Brain. Prog. Physiol. Sci., 2023, vol. 54, no. 2, pp. 3–19 (in Russ.). https://doi.org/10.31857/S0301179823020066

8. Behrendt T., Bielitzki R., Behrens M., Herold M., Schega L. Effects of Intermittent Hypoxia–Hyperoxia on Performance- and Health-Related Outcomes in Humans: A Systematic Review. Sports Med. Open, 2022, vol. 8, no. 1. Art. no. 70. https://doi.org/10.1186/s40798-022-00450-x

9. Burtscher J., Mallet R.T., Pialoux V., Millet G.P., Burtscher M. Adaptive Responses to Hypoxia and/or Hyperoxia in Humans. Antioxid. Redox Signal., 2022, vol. 37, no. 13–15, pp. 887–912. https://doi.org/10.1089/ars.2021.0280

10. Bestavashvili A.A., Glazachev O.S., Bestavashvili A.A., Dhif I., Suvorov A.Yu., Vorontsov N.V., Tuter D.S., Gognieva D.G., Zhang Y., Pavlov Ch.S. et al. The Effects of Intermittent Hypoxic–Hyperoxic Exposures on Lipid Profile and Inflammation in Patients with Metabolic Syndrome. Front. Cardiovasc. Med., 2021, vol. 8. Art. no. 700826. https://doi.org/10.3389/fcvm.2021.700826

11. Bushkova J.V., Suvorov A.U., Ivanova G.Е., Nyrkov G.V., Tulupov D.O. Normobaric Interval Hypoxia- Hyperoxic Therapy (IHHT) in the Process of Medical Rehabilitation of Patients after Stroke. Bull. Rehabil. Med., 2018, no. 3, pp. 115–122 (in Russ.).

12. Kuriakose D., Xiao Z. Pathophysiology and Treatment of Stroke: Present Status and Future Perspectives. Int. J. Mol. Sci., 2020, vol. 21, no. 20. Art. no. 7609. https://doi.org/10.3390/ijms21207609

13. Täger T., Hanholz W., Cebola R., Fröhlich H., Franke J., Doesch A., Katus H.A., Wians F.H. Jr., Frankenstein L. Minimal Important Difference for 6-Minute Walk Test Distances among Patients with Chronic Heart Failure. Int. J. Cardiol., 2014, vol. 176, no. 1, pp. 94–98. https://doi.org/10.1016/j.ijcard.2014.06.035

14. Tobin B., Costalat G., Renshaw G.M.C. Intermittent not Continuous Hypoxia Provoked Haematological Adaptations in Healthy Seniors: Hypoxic Pattern May Hold the Key. Eur. J. Appl. Physiol., 2020, vol. 120, no. 3, pp. 707–718. https://doi.org/10.1007/s00421-020-04310-y

15. Afari M.E., Bhat T. Neutrophil to Lymphocyte Ratio (NLR) and Cardiovascular Diseases: An Update. Expert Rev. Cardiovasc. Ther., 2016, vol. 14, no. 5, pp. 573–577. https://doi.org/10.1586/14779072.2016.1154788

16. Wojan F., Stray-Gundersen S., Nagel M.J., Lalande S. Short Exposure to Intermittent Hypoxia Increases Erythropoietin Levels in Healthy Individuals. J. Appl. Physiol. (1985), 2021, vol. 130, no. 6, pp. 1955–1960. https://doi.org/10.1152/japplphysiol.00941.2020

17. Duderstadt Y., Schreiber S., Burtscher J., Schega L., Müller N.G., Brigadski T., Braun-Dullaeus R.C., Leßmann V., Müller P. Controlled Hypoxia Acutely Prevents Physical Inactivity-Induced Peripheral BDNF Decline. Int. J. Mol. Sci., 2024, vol. 25, no. 14. Art. no. 7536. https://doi.org/10.3390/ijms25147536

18. Guan Y., Gu Y., Shao H., Ma W., Li G., Guo M., Shao Q., Li Y., Liu Y., Wang C. et al. Intermittent Hypoxia Protects against Hypoxic-Ischemic Brain Damage by Inducing Functional Angiogenesis. J. Cereb. Blood Flow Metab., 2023, vol. 43, no. 10, pp. 1656–1671. https://doi.org/10.1177/0271678X231185507

19. Wang R., Li J., Duan Y., Tao Z., Zhao H., Luo Y. Effects of Erythropoietin on Gliogenesis During Cerebral Ischemic/ Reperfusion Recovery in Adult Mice. Ageing Dis., 2017, vol. 8, no. 4, pp. 410–419. https://doi.org/10.14336/AD.2016.1209

20. Iwamoto E., Hanson B.E., Bock J.M., Casey D.P. Intermittent Hypoxia Enhances Shear-Mediated Dilation of the Internal Carotid Artery in Young Adults. J. Appl. Physiol. (1985), 2020, vol. 129, no. 3, pp. 603–611. https://doi.org/10.1152/japplphysiol.00274.2020

21. Stray-Gundersen S., Massoudian S.D., Wojan F., Tanaka H., Lalande S. Hypoxic Preconditioning Reduces Endothelial Ischemia-Reperfusion Injury in Older Adults. Am. J. Physiol. Regul. Integr. Comp. Physiol., 2022, vol. 323, no. 5, pp. R832–R838. https://doi.org/10.1152/ajpregu.00200.2022

22. Hornby T.G., Plawecki A., Lotter J.K., Shoger L.H., Voigtmann C.J., Inks E., Henderson C.E. Acute Intermittent Hypoxia with High-Intensity Gait Training in Chronic Stroke: A Phase II Randomised Crossover Trial. Stroke, 2024, vol. 55, no. 7, pp. 1748–1757. https://doi.org/10.1161/STROKEAHA.124.047261




Make a Submission


INDEXED IN: 

bel_spis.png

DOAJ_logo-colour.png

Elibrary.ru

logotype.png

infobaseindex

Логотип.png




Лань

OTHER NArFU JOURNALS: 

Vestnik of NArFU.
Series "Humanitarian and Social Sciences"

Forest Journal 
obl_les2023.jpg 

Arctic and North  

AiS.jpg

Продолжая просмотр сайта, я соглашаюсь с использованием файлов cookie владельцем сайта в соответствии с Политикой в отношении файлов cookie, в том числе на передачу данных, указанных в Политике, третьим лицам (статистическим службам сети Интернет).