Tejal Somvanshi
Stroke survivors face an increased risk of developing dementia, but new research offers hope through a simple intervention: exercise.
A Monash University-led study, published in JAMA Network Open and presented at the European Stroke Organisation Conference, found that aerobic exercise after an ischemic stroke is safe and may help preserve cognitive function.
The clinical trial involved 104 ischemic stroke survivors who began exercising about two months after their stroke. Participants were randomly assigned to either an eight-week aerobic exercise program or a balance and stretching program. Each participant completed three 60-minute sessions weekly.
“This study addressed a growing unmet need for stroke survivors who want to stop their brain from shrinking after stroke and avoid dementia,” said Professor Amy Brodtmann, who leads the Department of Neuroscience’s Cognitive Health Initiative at Monash University’s School of Translational Medicine.
The study was initially conducted in hospital gyms, but during the pandemic, most participants exercised at home through telehealth sessions with exercise professionals. This shift that home-based rehabilitation is both feasible and safe for stroke survivors.
Researchers tracked participants’ progress using brain imaging, cognitive tests, mood assessments, and fitness evaluations. They also collected blood and stool samples to investigate effects on inflammation, blood sugar, markers of brain degeneration, and gut bacteria.
The findings revealed that while aerobic exercise didn’t preserve hippocampal volume (a brain region crucial for memory) any better than balance and stretching exercises, it did show promising results for cognitive function. At the 12-month follow-up, participants in the aerobic exercise group demonstrated better executive and global cognitive performance compared to the balance and stretching group.
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Importantly, both exercise groups showed less brain volume loss than previously observed in studies where no intervention was offered. In fact, their brain volume changes were comparable to healthy individuals without stroke, suggesting that structured exercise of any kind may help protect the brain.
“Both the cardiorespiratory and balance and stretching control groups lost less brain volume than has been observed in prior studies where no intervention was offered,” Professor Brodtmann noted. “Indeed, their brain volume change was comparable to that seen in stroke-free healthy control participants, suggesting that both interventions may protect the brain.”
No serious exercise-related adverse events were reported during the study, confirming that these programs are safe for stroke survivors when properly supervised.
Professor Brodtmann highlighted that while exercise programs are commonly offered after major cardiac events, cancers, and lung disease, specific exercise prescriptions for stroke survivors have been lacking. This research helps fill that gap and may inform future rehabilitation guidelines.
The study was supported by an NHMRC Boosting Dementia Research grant, a Rapid Accelerated Research Translation grant, and Heart Foundation Fellowships for Professor Brodtmann.
For stroke survivors and healthcare providers, this research suggests that implementing structured exercise programs soon after a stroke could be a valuable strategy to maintain brain health and cognitive function.
