title: Defining Optimal Aerobic Exercise Parameters to Affect Complex Motor and Cognitive Outcomes after Stroke: A Systematic Review and Synthesis.
abstract: Although poststroke aerobic exercise (AE) increases markers of neuroplasticity and protects perilesional tissue, the degree to which it enhances complex motor or cognitive outcomes is unknown. Previous research suggests that timing and dosage of exercise may be important. We synthesized data from clinical and animal studies in order to determine optimal AE training parameters and recovery outcomes for future research. Using predefined criteria, we included clinical trials of stroke of any type or duration and animal studies employing any established models of stroke. Of the 5,259 titles returned, 52 articles met our criteria, measuring the effects of AE on balance, lower extremity coordination, upper limb motor skills, learning, processing speed, memory, and executive function. We found that early-initiated low-to-moderate intensity AE improved locomotor coordination in rodents. In clinical trials, AE improved balance and lower limb coordination irrespective of intervention modality or parameter. In contrast, fine upper limb recovery was relatively resistant to AE. In terms of cognitive outcomes, poststroke AE in animals improved memory and learning, except when training was too intense. However, in clinical trials, combined training protocols more consistently improved cognition. We noted a paucity of studies examining the benefits of AE on recovery beyond cessation of the intervention.
authors.affiliation: Recovery & Performance Laboratory, Faculty of Medicine, Memorial University, L.A. Miller Centre, Room 400, 100 Forest Road, St. John's, NL, Canada A1A 1E5.
authors.forename: S M Mahmudul
authors.initials: SM
authors.lastname: Hasan
authors.affiliation: Recovery & Performance Laboratory, Faculty of Medicine, Memorial University, L.A. Miller Centre, Room 400, 100 Forest Road, St. John's, NL, Canada A1A 1E5.
authors.forename: Samantha N
authors.initials: SN
authors.lastname: Rancourt
authors.affiliation: Recovery & Performance Laboratory, Faculty of Medicine, Memorial University, L.A. Miller Centre, Room 400, 100 Forest Road, St. John's, NL, Canada A1A 1E5.
authors.forename: Mark W
authors.initials: MW
authors.lastname: Austin
authors.affiliation: Recovery & Performance Laboratory, Faculty of Medicine, Memorial University, L.A. Miller Centre, Room 400, 100 Forest Road, St. John's, NL, Canada A1A 1E5.
authors.forename: Michelle
authors.initials: M
authors.lastname: Ploughman
mesh_terms: D000818:Animals; D003071:Cognition / Q000502:physiology; D003072:Cognition Disorders / Q000209:etiology / Q000523:psychology* / Q000534:rehabilitation*; D015444:Exercise / Q000502:physiology / Q000523:psychology*; D006801:Humans; D009048:Motor Skills / Q000502:physiology; D020127:Recovery of Function / Q000502:physiology; D020521:Stroke / Q000150:complications / Q000523:psychology*; D000071939:Stroke Rehabilitation