Leveraging passive exercise to support brain health

• Published in: British journal of sports medicine 2024-12, p.bjsports-2024-109129
• Main Authors: Tari, Benjamin, Heath, Matthew, Herold, Fabian, Cheval, Boris, Ronca, Flaminia, Etnier, Jennifer L, Costello, Joseph T, Logan, Nicole E, Cully, Megan, Zou, Liye
• Format: Article
• Language: English
• Subjects: Aerobics; Brain; Brain research; cognition; Cognition & reasoning; cognitive performance; Disease; Editorial; Executive function; Exercise; Flow velocity; Passive exercise; Physical fitness; physical health; Rehabilitation; Young adults
• ISSN: 0306-3674; 1473-0480; 1473-0480
• DOI: 10.1136/bjsports-2024-109129

What is passive exercise? the evidence for current use Regular active exercise (ie, volitional aerobic/resistance exercise) has numerous health benefits, including, but not limited to, improved functional abilities (eg, mobility), reduced risk of developing diseases, improved brain health and cognition, and facilitated recovery following a medical event (eg, acute injury).1 For example, active exercise can improve clinical recovery in individuals with a recent traumatic brain injury and reduce the risk of persistent post-concussive symptoms.2 For individuals who are unable to actively exercise (eg, unconscious, paralysed or sedated patients, stroke or spinal cord injury, Parkinson’s disease), passive exercise is usually prescribed in settings such as in hospitals, rehabilitation clinics or care homes.3 Passive exercise is completed independently of an individual’s volitional effort and relies entirely on an external force to move an individual’s limbs. [...]passive exercise looks to support increased cognitive (attentional) performance to support high-level EF demands. Furthermore, passive exercise using muscle stimulation—via lower calf muscle pump activation and whole-body vibration—reversed cognitive impairment and regulated blood pressure in hypotensive elderly adults and improved EF, including inhibitory control, in healthy young adults.10 11 It has been previously hypothesised that these benefits are related to a passive exercise-induced increase in cerebral blood flow related to the activation of mechanoreceptive muscle afferent feedback that stimulates the activity of primary and somatosensory cortices to increase stroke volume and cardiac output.5 However, other potential mechanisms should be investigated in future studies (figure 1). In prompting future research directions, we propose additional mechanistic studies, as well as the investigation of passive exercise in multilab ‘mega studies’.12 This will allow us to robustly identify effects and perform subgroup analyses to understand the influence of different moderators (eg, personal factors such as age, biological sex, disease types, socioeconomic status, and racial groups) and potential mediators (figure 1).