High-intensity exercise paired with motor practice benefits cognitive performance in stroke and older adults

IntroductionStroke is a leading cause of long-term disability resulting in cognitive and motor impairments. Exercise may improve cognition and motor function. We paired multiple bouts of high-intensity interval training (HIIT) exercise with motor practice to positively affect cognitive and motor function after stroke and age-matched controls. MethodsUsing a randomized controlled parallel group design, 31 individuals with chronic stroke and 41 older adult controls were randomized to either 23 minutes of HIIT exercise or rest prior to completing motor task practice using their paretic/non-dominant arm across five days. Primary outcomes were reaction time and motor function. Assessors were blinded to the intervention group. Trail Making Test-A and B (TMT-A, TMT-B), and object hit and avoid (OHA) were used to assess processing speed and inhibitory control. ResultsAll participants showed evidence of motor learning; HIIT exercise did not confer an additional benefit. For stroke participants, motor function (p = .047), but not motor impairment, improved. The stroke exercise group displayed significant reductions in TMT-A completion time (p = .026). Exercise with motor practice also led to a reduced number of distractors hit (p = .035) in the OHA task for both participant groups. There were no adverse events. ConclusionsFive days of HIIT exercise paired with motor practice led to improved processing speed for individuals with stroke. Both participant, exercise groups showed improved visuospatial skills and inhibitory control. Together, HIIT exercise paired with motor practice appears to be a safe and effective means of enhancing cognitive-motor skills after stroke and in older adults. Trial RegistryClinicalTrials.gov, ID: NCT02980796 Trial registry nameThe Influence of Exercise on Neuroplasticity and Motor Learning After Stroke (EX-ML3)