Clinical trial NCT02980796: The Influence of Exercise on Neuroplasticity and Motor Learning After Stroke
Official title: The Influence of Acute Bouts of Aerobic Exercise on Neuroplasticity and Motor Learning After Stroke
Study type: INTERVENTIONAL
Overall status: UNKNOWN
Phase: NA
Conditions: Stroke
Exercise
Rest
Keywords: Brain
MRI
Exercise
Rehabilitation
TMS
Lead sponsor: University of British Columbia
Sponsor class: OTHER
First posted: 2016-12-02
Enrollment: 104
Sex: ALL
Minimum age (years): 40
Maximum age (years): 85
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: yes
Allocation: RANDOMIZED
Intervention model: PARALLEL
Primary purpose: BASIC_SCIENCE

Brief summary: Participants will complete 11 sessions. These include screening, 5 sessions where exercise or rest (according to group assignment) are paired with practice of a motor task, MRI and Transcranial Magnetic Stimulation (TMS) before and after the intervention will be used to assess neuroplasticity (ability for the brain to reorganize and create new connections).

Detailed description: All participants will complete baseline sessions: 1) sub-maximal exercise test to ensure safe participation in aerobic exercise (testing session \[s\] 1); and 2) magnetic resonance imaging (MRI) to assess brain structure and function, and 3) clinical assessments of motor function and activity. The MRI and clinical tests will be completed on s2. Between the exercise test and MRI sessions individuals will wear accelerometers for 3 days to index usual activity levels. A custom computer program will then assign participants quasi-randomly to either the rest or exercise groups stratified on age, sex, and baseline motor function. Cortical excitability will be assessed before and after either a single session of priming aerobic exercise, or rest, by group (s3). Next, priming exercise will be paired with skilled motor practice for 5 sessions (s4-8). Practice sessions will be separated by 48 hours. Importantly motor learning will be assessed via delayed, no-exercise retention tests 24-hours (s9) and 30-days (s11) after the last practice session. Activity levels (3 day accelerometry), TMS and MRI measures will be re-assessed after the second retention test (s10).

Eligibility criteria: Inclusion Criteria:

* Between the ages of 40 - 85
* Had a stroke at least 12 months ago
* OR are a healthy adult who does not have a history of neurodegenerative disorders
* Have the ability to understand English

Exclusion Criteria:

* Contraindication to brain stimulation (such as a history of seizure or epilepsy)
* Contraindication to MRI (such as a pacemaker, metal in the eyes / brain or fear of enclosed spaces)
* Neurodegenerative disorder ( such as Parkinson disease, Alzheimers disease or Multiple Sclerosis)
* Contraindications to exercise

Primary outcomes:
measure: Change response time during a novel motor task.
timeFrame: Baseline, After Intervention (2 weeks), 30-day follow-up
measure: Wolf Motor Function Task Rate
timeFrame: Baseline, After Intervention (2 weeks), 30-day follow-up
Secondary outcomes:
measure: Transcallosal Inhibition
timeFrame: Baseline, After Intervention (2 weeks), 30-day follow-up
measure: Arm Use Ratio
timeFrame: Baseline, After Intervention (2 weeks), 30-day follow-up
measure: Functional magnetic resonance imaging (fMRI)
timeFrame: Baseline, After Intervention (2 weeks), 30-day follow-up
measure: Structural magnetic resonance imaging - myelin
timeFrame: Baseline, After Intervention (2 weeks), 30-day follow-up
measure: Structural magnetic resonance imaging - diffusion
timeFrame: Baseline, After Intervention (2 weeks), 30-day follow-up
Other outcomes:
Locations:
city: Vancouver
country: Canada
facility: University of British Columbia
state: British Columbia
Study officials:
affiliation: Univeristy of British Columbia
name: Lara Boyd, Pt, PhD
role: PRINCIPAL_INVESTIGATOR
References:
citation: Clark B, Whitall J, Kwakkel G, Mehrholz J, Ewings S, Burridge J. The effect of time spent in rehabilitation on activity limitation and impairment after stroke. Cochrane Database Syst Rev. 2021 Oct 25;10(10):CD012612. doi: 10.1002/14651858.CD012612.pub2.