Aerobic exercise effects on neuroprotection and brain repair following stroke: A systematic review and perspective

• Published in: Neuroscience research 2014-10, Vol.87, p.8-15
• Main Authors: Austin, Mark W., Ploughman, Michelle, Glynn, Lindsay, Corbett, Dale
• Format: Article
• Language: English
• Subjects: Animals; Apoptosis; Brain - pathology; Brain - physiopathology; Brain Ischemia - rehabilitation; Cardiovascular Diseases - prevention & control; Cardiovascular System - physiopathology; Cerebrovascular accident; Disease Models, Animal; Exercise; Exercise Therapy - methods; Female; Gerbillinae; Inflammation; Ischemia; Male; Mice; Neurogenesis; Neurons - physiology; Neuroplasticity; Oxidative Stress; Physical therapy; Rats; Rehabilitation; Stroke Rehabilitation; Time Factors
• ISSN: 0168-0102; 1872-8111
• DOI: 10.1016/j.neures.2014.06.007

•Exercise 24–48h post-stroke reduced lesion volume more than later onset exercise.•Post-stroke exercise effects on the older brain and in the long term are not known.•Moderate intensity is most effective in reducing lesion volume.•Moderate intensity exercise decreases inflammation and increases neurogenesis.•Higher intensity exercise increases angiogenesis in perilesional area and striatum. Aerobic exercise (AE) enhances neuroplasticity and improves functional outcome in animal models of stroke, however the optimal parameters (days post-stroke, intensity, mode, and duration) to influence brain repair processes are not known. We searched PubMed, CINAHL, PsychInfo, the Cochrane Library, and the Central Register of Controlled Clinical Trials, using predefined criteria, including all years up to July 2013 (English language only). Clinical studies were included if participants had experienced an ischemic or hemorrhagic stroke. We included animal studies that utilized any method of global or focal ischemic stroke or intracerebral hemorrhage. Any intervention utilizing AE-based activity with the intention of improving cardiorespiratory fitness was included. Of the 4250 titles returned, 47 studies (all in animal models) met criteria and measured the effects of exercise on brain repair parameters (lesion volume, oxidative damage, inflammation and cell death, neurogenesis, angiogenesis and markers of stress). Our synthesized findings show that early-initiated (24–48h post-stroke) moderate forced exercise (10m/min, 5–7 days per week for about 30min) reduced lesion volume and protected perilesional tissue against oxidative damage and inflammation at least for the short term (4 weeks). The applicability and translation of experimental exercise paradigms to clinical trials are discussed.