The Influence of Exercise on Neuroplasticity and Motor Learning After Stroke "EX-ML3"

Recruiting

Phase N/A Results N/A

Trial Description

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).

Conditions

Interventions

  • Exercise Other
    Intervention Desc: Each experimental day participants will complete an acute bout of exercise on a recumbent bike.
    ARM 1: Kind: Experimental
    Label: Exercise + practice
    Description: Individuals will complete 20 minutes of exercise on a recumbent bicycle before practicing a novel motor task.
  • Practice Behavioral
    Intervention Desc: Each experimental day participants will complete a session of skilled motor practice.
    ARM 1: Kind: Experimental
    Label: Exercise + practice
    Description: Individuals will complete 20 minutes of exercise on a recumbent bicycle before practicing a novel motor task.
    ARM 2: Kind: Experimental
    Label: Rest + practice
    Description: Individuals will rest for 20 minutes before practicing a novel motor task. Attention will be controlled during this time.

Outcomes

Type Measure Time Frame Safety Issue
Primary Change response time during a novel motor task. Baseline, After Intervention (2 weeks), 30-day follow-up
Primary Wolf Motor Function Task Rate Baseline, After Intervention (2 weeks), 30-day follow-up
Secondary Transcallosal Inhibition Baseline, After Intervention (2 weeks), 30-day follow-up
Secondary Arm Use Ratio Baseline, After Intervention (2 weeks), 30-day follow-up
Secondary Functional magnetic resonance imaging (fMRI) Baseline, After Intervention (2 weeks), 30-day follow-up
Secondary Structural magnetic resonance imaging - myelin Baseline, After Intervention (2 weeks), 30-day follow-up
Secondary Structural magnetic resonance imaging - diffusion Baseline, After Intervention (2 weeks), 30-day follow-up

Sponsors