title: Effects of Community Exercise Therapy on Metabolic, Brain, Physical, and Cognitive Function Following Stroke: A Randomized Controlled Pilot Trial.
abstract: BACKGROUND
  Exercise therapy could potentially modify metabolic risk factors and brain physiology alongside improving function post stroke.
  
  
  OBJECTIVE
  To explore the short-term metabolic, brain, cognitive, and functional effects of exercise following stroke.
  
  
  METHODS
  A total of 40 participants (>50 years, >6 months post stroke, independently mobile) were recruited to a single-blind, parallel, randomized controlled trial of community-based exercise (19 weeks, 3 times/wk, "exercise" group) or stretching ("control" group). Primary outcome measures were glucose control and cerebral blood flow. Secondary outcome measures were cardiorespiratory fitness, blood pressure, lipid profile, body composition, cerebral tissue atrophy and regional brain metabolism, and physical and cognitive function.
  
  
  RESULTS
  Exercise did not change glucose control (homeostasis model assessment 1·5 ± 0·8 to 1·5 ± 0·7 vs 1·6 ± 0·8 to 1·7 ± 0·7, P = .97; CI = -0·5 to 0·49). Medial temporal lobe tissue blood flow increased with exercise (38 ± 8 to 42 ± 10 mL/100 g/min; P < .05; CI = 9.0 to 0.1) without any change in gray matter tissue volume. There was no change in medial temporal lobe tissue blood flow in the control group (41 ± 8 to 40 ± 7 mL/100 g/min; P = .13; CI = -3.6 to 6.7) but significant gray matter atrophy. Cardiorespiratory fitness, diastolic blood pressure, high-density lipoprotein cholesterol, physical function, and cognition also improved with exercise.
  
  
  CONCLUSIONS
  Exercise therapy improves short-term metabolic, brain, physical, and cognitive function, without changes in glucose control following stroke. The long-term impact of exercise on stroke recurrence, cardiovascular health, and disability should now be explored.
authors.affiliation: Institute for Cellular Medicine, Newcastle University, Newcastle upon Tyne, UK Institute for Ageing and Health, Newcastle University, Newcastle upon Tyne, UK.
authors.forename: Sarah A
authors.initials: SA
authors.lastname: Moore
authors.affiliation: Institute for Cellular Medicine, Newcastle University, Newcastle upon Tyne, UK Institute for Ageing and Health, Newcastle University, Newcastle upon Tyne, UK.
authors.forename: Kate
authors.initials: K
authors.lastname: Hallsworth
authors.affiliation: Institute for Cellular Medicine, Newcastle University, Newcastle upon Tyne, UK Institute for Ageing and Health, Newcastle University, Newcastle upon Tyne, UK.
authors.forename: Djordje G
authors.initials: DG
authors.lastname: Jakovljevic
authors.affiliation: Institute for Cellular Medicine, Newcastle University, Newcastle upon Tyne, UK.
authors.forename: Andrew M
authors.initials: AM
authors.lastname: Blamire
authors.affiliation: Institute for Cellular Medicine, Newcastle University, Newcastle upon Tyne, UK.
authors.forename: Jiabao
authors.initials: J
authors.lastname: He
authors.affiliation: Institute for Ageing and Health, Newcastle University, Newcastle upon Tyne, UK.
authors.forename: Gary A
authors.initials: GA
authors.lastname: Ford
authors.affiliation: Institute for Ageing and Health, Newcastle University, Newcastle upon Tyne, UK.
authors.forename: Lynn
authors.initials: L
authors.lastname: Rochester
authors.affiliation: Institute for Cellular Medicine, Newcastle University, Newcastle upon Tyne, UK Institute for Ageing and Health, Newcastle University, Newcastle upon Tyne, UK michael.trenell@ncl.ac.uk.
authors.forename: Michael I
authors.initials: MI
authors.lastname: Trenell
mesh_terms: D000368:Aged; D001224:Aspartic Acid / Q000031:analogs & derivatives / Q000378:metabolism; D001823:Body Composition; D001921:Brain / Q000378:metabolism* / Q000473:pathology*; D003072:Cognition Disorders / Q000209:etiology* / Q000534:rehabilitation*; D005080:Exercise Test; D005081:Exercise Therapy / Q000379:methods*; D005260:Female; D006801:Humans; D050356:Lipid Metabolism; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests; D010865:Pilot Projects; D012111:Residence Characteristics; D016037:Single-Blind Method; D020521:Stroke / Q000150:complications; D000071939:Stroke Rehabilitation; D016896:Treatment Outcome; D064232:Visual Analog Scale
chemical_list: D001224:Aspartic Acid; C000179:N-acetylaspartate
keywords: cerebral blood flow; cognition; exercise; metabolic risk factors; physical function; stroke