title: Aerobic exercise effects on neuroprotection and brain repair following stroke: a systematic review and perspective.
abstract: Aerobic exercise (AE) enhances neuroplasticity and improves functional outcome in animal models of stroke, however the optimal parameters (days post-stroke, intensity, mode, and duration) to influence brain repair processes are not known. We searched PubMed, CINAHL, PsychInfo, the Cochrane Library, and the Central Register of Controlled Clinical Trials, using predefined criteria, including all years up to July 2013 (English language only). Clinical studies were included if participants had experienced an ischemic or hemorrhagic stroke. We included animal studies that utilized any method of global or focal ischemic stroke or intracerebral hemorrhage. Any intervention utilizing AE-based activity with the intention of improving cardiorespiratory fitness was included. Of the 4250 titles returned, 47 studies (all in animal models) met criteria and measured the effects of exercise on brain repair parameters (lesion volume, oxidative damage, inflammation and cell death, neurogenesis, angiogenesis and markers of stress). Our synthesized findings show that early-initiated (24-48h post-stroke) moderate forced exercise (10m/min, 5-7 days per week for about 30min) reduced lesion volume and protected perilesional tissue against oxidative damage and inflammation at least for the short term (4 weeks). The applicability and translation of experimental exercise paradigms to clinical trials are discussed.
authors.affiliation: Recovery and Performance Laboratory, Faculty of Medicine, Memorial University of Newfoundland, St. John's, NL, Canada.
authors.forename: Mark W
authors.initials: MW
authors.lastname: Austin
authors.affiliation: Recovery and Performance Laboratory, Faculty of Medicine, Memorial University of Newfoundland, St. John's, NL, Canada. Electronic address: michelle.ploughman@med.mun.ca.
authors.forename: Michelle
authors.initials: M
authors.lastname: Ploughman
authors.affiliation: Health Sciences Library, Faculty of Medicine, Memorial University of Newfoundland, St. John's, NL, Canada.
authors.forename: Lindsay
authors.initials: L
authors.lastname: Glynn
authors.affiliation: Canadian Partnership for Stroke Recovery and Department of Cellular and Molecular Medicine, University of Ottawa, Ottawa, Ontario, Canada.
authors.forename: Dale
authors.initials: D
authors.lastname: Corbett
mesh_terms: D000818:Animals; D017209:Apoptosis; D001921:Brain / Q000473:pathology* / Q000503:physiopathology*; D002545:Brain Ischemia / Q000534:rehabilitation*; D002318:Cardiovascular Diseases / Q000517:prevention & control; D002319:Cardiovascular System / Q000503:physiopathology; D004195:Disease Models, Animal; D005081:Exercise Therapy / Q000379:methods*; D005260:Female; D005849:Gerbillinae; D008297:Male; D051379:Mice; D055495:Neurogenesis; D009474:Neurons / Q000502:physiology; D018384:Oxidative Stress; D051381:Rats; D000071939:Stroke Rehabilitation; D013997:Time Factors
keywords: Cerebrovascular accident; Exercise; Inflammation; Ischemia; Neuroplasticity; Physical therapy; Rehabilitation