Oral Presentation Smart Strokes Annual Scientific Meeting 2024

Moderate intensity cycling may enhance neuroplasticity after stroke - findings of a randomised controlled pilot study. (106923)

Gabrielle Hill 1 , Finn Johnson 2 , Jeric Uy 2 , Ines Serrada 2 , Benyamin Beben 3 4 , Maayken van den Berg 1 , Brenton Hordacre 2
  1. Clinical Rehabilitation, College of Nursing and Health Sciences, Flinders University , Adelaide, SA, Australia
  2. Innovation, IMPlementation and Clinical Translation (IIMPACT) in Health, University of South Australia, Adelaide, SA, Australia
  3. Australian Centre for Precision Health, Allied Health and Human Performance, University of South Australia, Adelaide , SA, Australia
  4. South Australian Health and Medical Research Institute, Adelaide, SA, Australia

Introduction: A key question in stroke recovery is whether it is possible to re-open, or prolong, the spontaneous period of enhanced neuroplasticity evident after stroke. Ability to do so may lead to greater functional recovery. One intervention that is associated with neuroplasticity upregulation is aerobic exercise, a relatively safe and simple intervention. This study aimed to determine whether a single bout of moderate-intensity exercise can enhance neuroplasticity in stroke survivors.

 

Methods: Participants were randomly assigned to 20-minutes of moderate-intensity exercise (intervention) or remained sedentary (control). Transcranial magnetic stimulation measured corticospinal excitability of the contralesional hemisphere by recording motor evoked potentials (MEPs). Intermittent theta burst stimulation (iTBS) was used to repeatedly activate synapses in the contralesional primary motor cortex, initiating the early stages of neuroplasticity. It was surmised that if exercise increased neuroplasticity, there would be a greater facilitation of MEPs following iTBS.

 

Results: Thirty-three people with stroke participated in this study (aged 63.87 ± 10.30 years, 20 male, 6.13 ± 4.33 years since stroke). Participants allocated to aerobic exercise had a stronger increase in MEP amplitude following iTBS. A non-significant trend indicated time since stroke might moderate this interaction (P = 0.055). Exploratory analysis suggested participants who were 2–7.5 years post stroke had a strong MEP facilitation following iTBS (P < 0.001). There was no effect of age, sex, resting motor threshold, self-reported physical activity levels, lesion volume or weighted lesion load (all P > 0.208).

 

Conclusion: Our results suggest that moderate intensity cardiovascular exercise may enhance neuroplasticity.

 

Relevance to clinical practice or patient experience: The ability to upregulate neuroplasticity following stroke may enhance recovery and reduce likelihood of long-term disability. Given relative safety and simplicity of performing moderate intensity exercise, we suggest this approach is clinically feasible and holds promise as a therapy adjuvant in stroke rehabilitation.