Jean-Francois Nepveu1,2, Alexander Thiel3,4, Ada Tang5, Joyce Fung6,2,7, Jesper Lundbye-Jensen8,9, Lara A Boyd10, Marc Roig1,2,7. 1. 1 Memory and Motor Rehabilitation Laboratory (MEMORY-LAB). 2. 3 Montreal Center for Interdisciplinary Research in Rehabilitation (CRIR), Montreal, Quebec, Canada. 3. 4 Jewish General Hospital Lady Davis Institute for Medical Research, Montreal, Quebec, Canada. 4. 5 McGill University, Montreal, Quebec, Canada. 5. 6 McMaster University, Hamilton, Ontario, Canada. 6. 2 Feil and Oberfeld Research Centre, Jewish Rehabilitation Hospital, Laval, Quebec, Canada. 7. 7 School of Physical and Occupational Therapy, McGill University, Montreal, Quebec, Canada. 8. 8 Department of Nutrition, Exercise & Sports, University of Copenhagen, Copenhagen, Denmark. 9. 9 Department of Neuroscience & Pharmacology, University of Copenhagen, Copenhagen, Denmark. 10. 10 University of British Columbia, Vancouver, British Columbia, Canada.
Abstract
BACKGROUND: One bout of high-intensity cardiovascular exercise performed immediately after practicing a motor skill promotes changes in the neuroplasticity of the motor cortex and facilitates motor learning in nondisabled individuals. OBJECTIVE: To determine if a bout of exercise performed at high intensity is sufficient to induce neuroplastic changes and improve motor skill retention in patients with chronic stroke. METHODS:Twenty-two patients with different levels of motor impairment were recruited. On the first session, the effects of a maximal graded exercise test on corticospinal and intracortical excitability were assessed from the affected and unaffected primary motor cortex representational area of a hand muscle with transcranial magnetic stimulation. On the second session, participants were randomly assigned to an exercise or a nonexercise control group. Immediately after practicing a motor task, the exercise group performed 15 minutes of high-intensity interval training while the control group rested. Twenty-four hours after motor practice all participants completed a test of the motor task to assess skill retention. RESULTS: The graded exercise test reduced interhemispheric imbalances in GABAA-mediated short-interval intracortical inhibition but changes in other markers of excitability were not statistically significant. The group that performed high-intensity interval training showed a better retention of the motor skill. CONCLUSIONS: The performance of a maximal graded exercise test triggers only modest neuroplastic changes in patients with chronic stroke. However, a single bout of high-intensity interval training performed immediately after motor practice improves skill retention, which could potentially accelerate motor recovery in these individuals.
RCT Entities:
BACKGROUND: One bout of high-intensity cardiovascular exercise performed immediately after practicing a motor skill promotes changes in the neuroplasticity of the motor cortex and facilitates motor learning in nondisabled individuals. OBJECTIVE: To determine if a bout of exercise performed at high intensity is sufficient to induce neuroplastic changes and improve motor skill retention in patients with chronic stroke. METHODS: Twenty-two patients with different levels of motor impairment were recruited. On the first session, the effects of a maximal graded exercise test on corticospinal and intracortical excitability were assessed from the affected and unaffected primary motor cortex representational area of a hand muscle with transcranial magnetic stimulation. On the second session, participants were randomly assigned to an exercise or a nonexercise control group. Immediately after practicing a motor task, the exercise group performed 15 minutes of high-intensity interval training while the control group rested. Twenty-four hours after motor practice all participants completed a test of the motor task to assess skill retention. RESULTS: The graded exercise test reduced interhemispheric imbalances in GABAA-mediated short-interval intracortical inhibition but changes in other markers of excitability were not statistically significant. The group that performed high-intensity interval training showed a better retention of the motor skill. CONCLUSIONS: The performance of a maximal graded exercise test triggers only modest neuroplastic changes in patients with chronic stroke. However, a single bout of high-intensity interval training performed immediately after motor practice improves skill retention, which could potentially accelerate motor recovery in these individuals.
Entities:
Keywords:
cardiovascular exercise; memory; motor skill learning; neuronal plasticity; rehabilitation; stroke; transcranial magnetic stimulation
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