Physical Exercise and Wet Cupping Therapy Stimulate Neural Stem Cells in Animal Model of Ischemic Stroke

Imam  Subadi; Nanda Aulya  Ramadhan; Albert  Setiawan; Nur  Sulastri; Wibi  Riawan; RA Meisy  Andriana; Martha Kurnia  Kusumawardani; Yudith Dian  Prawitri; Sintia Dewi  Septiani M.K

doi:10.18502/tim.v10i4.20727

Imam Subadi Department of Physical Medicine and Rehabilitation, Faculty of Medicine, Universitas Airlangga, Surabaya, Indonesia
Nanda Aulya Ramadhan Department of Physical Medicine and Rehabilitation, Faculty of Medicine, Universitas Airlangga, Surabaya, Indonesia
Albert Setiawan Department of Physical Medicine and Rehabilitation, Faculty of Medicine, Universitas Airlangga, Surabaya, Indonesia
Nur Sulastri Department of Physical Medicine and Rehabilitation, Faculty of Medicine, Universitas Airlangga, Surabaya, Indonesia
Wibi Riawan Department of Biomolecular Biochemistry, Faculty of Medicine, Brawijaya University, Malang, Indonesia
RA Meisy Andriana Department of Physical Medicine and Rehabilitation, Faculty of Medicine, Universitas Airlangga, Surabaya, Indonesia
Martha Kurnia Kusumawardani Department of Physical Medicine and Rehabilitation, Faculty of Medicine, Universitas Airlangga, Surabaya, Indonesia
Yudith Dian Prawitri Department of Physical Medicine and Rehabilitation, Faculty of Medicine, Universitas Airlangga, Surabaya, Indonesia
Sintia Dewi Septiani M.K Department of Physical Medicine and Rehabilitation, Faculty of Medicine, Universitas Airlangga, Surabaya, Indonesia

DOI: https://doi.org/10.18502/tim.v10i4.20727

Keywords: Exercise; Cupping therapy; SOX2 protein; Neural stem cells; Animal model; Ischemic stroke; Neuronal plasticity

Abstract

The process of neuroplasticity in stroke recovery remains poorly understood. SRY-related HMG-box 2 (SOX2), a protein that plays a role in controlling neural stem cell (NSC) proliferation and differentiation, is of particular interest. This research seeks to investigate how exercise and wet cupping therapy affect SOX2 expression in animal models of stroke, which are created using unilateral common carotid artery occlusion (UCCAO). The study utilized a control group design with a post-test evaluation. Thirty-six Wistar rats, aged 3 months, were randomly divided into six groups of equal size: control (n=6), stroke (n=6), cupping (n=6), exercise (n=6), stroke plus cupping (n=6), and stroke plus exercise (n=6). Wet cupping therapy was performed twice a week for three weeks. The exercise included a 20-minute swimming activity scheduled daily. This swimming exercise was performed three times a week for three weeks. Analysis of multiple comparisons among groups employing the ANOVA test proved that SOX2 expression in both the stroke plus exercise group and the stroke plus cupping group was significantly elevated. The stroke group was significantly lower than the control group. This study highlights the potential of physical exercise and wet cupping therapy to upregulate SOX2 expression in a UCCAO-induced brain injury model, supporting their role as promising alternative neuroregenerative interventions.