A Systematic Review on the Effects of Acute Aerobic Exercise on Neurophysiological, Molecular, and Behavioral Measures in Chronic Stroke

Abstract

Background A single bout of aerobic exercise (AE) can produce changes in neurophysiological and behavioral measures in healthy individuals and those with stroke. However, the effects of AE-priming effects on neuroplasticity markers and behavioral measures are unclear. Objectives This systematic review aimed to examine the effects of AE on neuroplasticity measures, such as corticomotor excitability (CME), molecular markers, cortical activation, motor learning, and performance in stroke. Methods A literature search was performed in MEDLINE, CINAHL, Scopus, and PsycINFO databases. Randomized and non-randomized studies incorporating acute AE in stroke were selected. Two reviewers independently assessed the risk of bias and methodological rigor of the studies and extracted data on participant characteristics, exercise interventions, and neuroplasticity related outcomes. The quality of transcranial magnetic stimulation reported methods was assessed using a standardized checklist. Results A total of 16 studies were found suitable for inclusion. Our findings suggest mixed evidence for the effects of AE on CME, limited to no effects on intracortical inhibition and facilitation and some evidence for modulating brain derived neurotrophic factor levels, motor learning, and cortical activation. Exercise intensities in the moderate to vigorous range showed a trend towards better effects on neuroplasticity measures. Conclusion It appears that choosing a moderate to vigorous exercise paradigm for at least 20 to 30 minutes may induce changes in some neuroplasticity parameters in stroke. However, these findings necessitate prudent consideration as the studies were diverse and had moderate methodological quality. There is a need for a consensus on an exercise priming paradigm and for good-quality, larger controlled studies.

Ausdauertraining nach Schlaganfall

“…Mehrere Studien zeigen, dass Training wie z. B. hochintensives Ausdauertraining 26 , wenn es unmittelbar vor oder in Bezug zu einer motorischen Aufgabe durchgeführt wird, die Leistung von motorischen Aufgaben und das motorische Lernen verbessert 17 26 .…”

“…Es gibt Hinweise darauf, dass eine einzige Sitzung mit HIIT die kortikale Exzitabilität, das motorische Lernen und die Konzentration von zirkulierendem BDNF erhöhen kann 17 . Längerfristiges Training scheint möglicherweise vorteilhafter für nachhaltige Effekte auf kortikale Mechanismen, BDNF-Spiegel und damit verbundene Leistungen zu sein.…”

“…Studien zeigten, dass ein Ausdauertraining die Konzentra tion von zirkulierenden Neurotrophinen wie dem neurotro phen Faktor (BrainDerived Neurotrophic Factor, BDNF) [22] insulinähnlicher Wachstumsfaktor (Insulinlike Growth Fac tor, IGF1) [23] und vaskulärer endothelialer Wachstums faktor (Vascular Endothelial Growth Factor, VEGF) verbes sert [17,24].…”

“…jüngerer Zeit hat sich das Wissen um die Sekretion von BDNF als Antwort auf Aktivität oder Bewegung als ent scheidende Komponente für die Regulierung des motori sches Lernens und die Bildung von motorischen Langzeit veränderungen etabliert[17,25]. Mehrere Studien zeigen, dass Training wie z.…”

Mechanisms and benefits of cardiac rehabilitation in individuals with stroke: emerging role of its impact on improving cardiovascular and neurovascular health

“…Similarly, aerobic exercise significantly increases levels of BDNF and its primary receptor, tropomyosin receptor kinase B (TrkB), involved in neuroprotective effects during conditions like cerebral ischemia and neurotoxicity, as well as synaptotagmin, a synaptic protein crucial for learning and memory ( 65 – 69 ). Importantly, clinical studies have demonstrated the impact of aerobic exercise training on cortical excitability and alterations in neural circuits in individuals with stroke ( 70 – 74 ). Preclinical studies have unveiled additional mechanistic insights into the effects of aerobic exercise, including regulation of neuro-inflammation and mitochondrial biogenesis, as well as the repair of the blood-brain barrier ( 75 – 77 ).…”