Exercise-Induced Functional Recovery in Stroke and Traumatic Brain Injury: A 12-Week High-Intensity Prospective Study

BackgroundExercise-induced functional recovery in neurological disorders remains under-optimized despite known neuroplastic benefits. High-intensity, multimodal training may support functional improvements, but evidence from structured clinical programs remains limited. ObjectivesTo examine functional changes associated with a 12-week combined aerobic and resistance exercise program in adults with stroke or traumatic brain injury (TBI). MethodsIn this prospective, single-group, quasi-experimental study, 43 consecutive patients (mean age 54.3 +/-14.1 years; 80% stroke, 20% TBI) at a tertiary neurorehabilitation center completed a supervised exercise intervention (3 sessions/week, 60-75 min). Aerobic training targeted 60-80% heart rate reserve and resistance training targeted 70-80% 1-RM. The primary outcome was change in Barthel Index (BI). Secondary outcomes included Fugl-Meyer Assessment (FMA), Berg Balance Scale (BBS), and 10-Meter Walk Test (10MWT). Changes were analyzed using repeated-measures ANOVA; normality was checked with Shapiro-Wilk and paired t-tests were used as robustness checks. Effect sizes are reported as partial eta^2 and Cohens d. ResultsAll 43 participants completed the program (100% adherence) with no adverse events. BI increased from 41.0 +/-22.1 to 70.2 +/-19.5 (mean change +29.2 +/-13.8; F(1,42) = 178.4, p < 0.001, eta^2 = 0.81), with 79% exceeding the MCID. FMA rose by +15.9 +/-6.4 (F(1,42) = 152.6, p < 0.001, eta^2 = 0.78), BBS increased by +12.9 +/-11.1 (F(1,42) = 98.3, p < 0.001, eta^2 = 0.70), and 10MWT improved by +0.25 +/-0.10 m/s (F(1,42) = 124.7, p < 0.001, eta^2 = 0.75), with 86-93% of participants exceeding published MCIDs across measures. Paired t-tests confirmed these findings (all p < 0.001). Given the single-group design and early enrollment (median 6.2 weeks), observed gains should be interpreted as observational changes rather than definitive causal effects. ConclusionsA 12-week high-intensity combined aerobic and resistance program was safe, feasible, and associated with substantial improvements in functional independence, motor performance, balance, and gait. Randomized controlled trials are warranted to determine the interventions causal impact and long-term benefits.