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Research Highlights
Treadmill gains seen even decades after stroke
October 23, 2008
In a recent Baltimore-based study, people who walked on a treadmill even years
after suffering stroke damage achieved major gains in fitness and mobility,
reflecting actual "rewiring" of their brains. The study appeared online in the journal
Stroke on Aug. 28 and will appear in the print edition in January 2009.
"Many stroke survivors believe there’s nothing to be gained from further
rehabilitation, but our results suggest that health and functional benefits from
walking on a treadmill can occur even decades out from stroke. We believe exercise
gives individuals a way to fight back against stroke disabilities," says Richard
Macko, MD, of VA and the University of Maryland, lead investigator on the study.
He noted that one of the patients in the study had significant improvement 20 years
after a stroke.
Senior study author Daniel Hanley, MD, a professor of neurology at Johns
Hopkins School of Medicine, added, "This is great news for stroke survivors because
results clearly demonstrate that long-term stroke damage is not immutable and that
with exercise it’s never too late for the brain and body to recover."
The study involved 71 older men and women who had suffered a stroke an
average of four years earlier. All the participants were tested for mobility and aerobic
capacity, and a subgroup underwent functional magnetic resonance imaging (fMRI)
to track brain activity linked to walking.
One group then took part in a treadmill-based exercise program, while the other
group mainly did stretching, guided by therapists. After six months, walking speed
for the treadmill group had increased 51 percent, compared with only about 11
percent for those in the stretching group. The treadmill exercisers were also more aerobically fit at the end of the study, whereas aerobic capacity had
declined slightly in the stretching group.
Moreover, the investigators took new brain scans and found
increased activity in brain areas associated with walking among all
the treadmill exercisers. Brain scans of patients in the stretching
group showed no such changes. "This suggests that the brain is
responsible for the improvement we saw in patients' walking
ability. It seems to be recruiting other regions [of the brain] to take
on the job of areas damaged by stroke," said Andreas Luft, MD, a
visiting researcher from Germany who helped lead the study.
Those patients with the most improvement in walking showed
the strongest change in brain activity, though the researchers don’t
yet know whether these brain changes were caused by more
walking or whether participants walked better because brain
activity in these key areas increased. This question will be the
focus of future research.
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