Ride Your Way to Motor Improvement After Stroke

Forced aerobic exercise boosted motor improvement after stroke

/ Author:  / Reviewed by: Robert Carlson, M.D Beth Bolt, RPh

(RxWiki News) The last thing you want after a stroke is someone making you ride a bicycle at a fast pace, but that might be just what you need.

Repetitive task practice (RTP) is a common method used to re-teach certain motor functions after stroke. A recent study found that forced aerobic cycling combined with RTP boosted motor improvement. Through vigorous exercise, the brain may become primed to benefit from RTP.

"This study speaks to an important issue," said American Stroke Association spokesperson Pamela Duncan, PhD, a professor of Neurology and Director of Innovations and Transitional Outcomes for Wake Forest Baptist Health in West End, NC, in a press release. "By combining aerobic exercise with repetitive practice, you actually can improve motor performance after stroke."

A stroke occurs when part of the brain loses blood flow. Without oxygen, brain cells will die. Depending on which part of the brain is damaged, different problems can result.

If parts of the brain that control muscles are damaged, muscle weakness or paralysis can occur. Strength and movement can sometimes be recovered through RTP. By repeating tasks like holding a fork or buttoning a shirt, patients can relearn these basic motor skills.

This study looked at 17 patients who were six to 12 months post-stroke. They were split into three groups that performed RTP 24 times over eight weeks.

One group did extra RTP at each session. The second group did 45 minutes of cycling at a voluntary pace. The final group did 45 minutes of cycling at a forced pace that was 35 percent faster than the speed they would have chosen.

After eight weeks, all three groups had made gains in motor function. However, the group that cycled at a forced speed made the most gains (34 percent). The groups that did extra RTP and voluntary cycling made similar gains (17 and 16 percent, respectively).

Dr. Duncan suggested that "Forced aerobic exercise is better than a voluntary aerobic exercise and that is probably due to the fact that because of the significant motor impairments in stroke, they may not be able to optimize their aerobic capacity or be stressed enough."

In other words, the rapid pace was required for the patients to reach the optimal aerobic activity for brain "priming."

Also, the two exercising groups saw cardiovascular gains. But the voluntary cycling group made more cardiovascular gains than the forced-speed cycling group.

"Not only are we improving motor recovery with half the amount of task practice but we’re also improving cardiovascular health, and stroke patients often have cardiovascular co-morbidities," said lead study author Susan Linder, PT, DPT, NCS, a physical therapist at the Cleveland Clinic in Ohio, in a press release. "If we can improve motor recovery and cardiovascular health simultaneously, patients can regain lost motor function and improve their quality of life.”

Because this was a small study, Dr. Linder and team called for more research on this topic.

This study was presented at the American Stroke Association's International Stroke Conference 2015 in Nashville, TN. Research presented at conferences may not have been peer-reviewed.

The National Institute of Neurological Disorders and Stroke funded this research. Dr. Linder and team disclosed no conflicts of interest.

Review Date: 
February 10, 2015
Last Updated:
February 14, 2015