Treadmill exercise activates subcortical neural networks and improves walking after a stroke
BACKGROUND AND PURPOSE: Stroke often impairs gait thereby reducing mobility and fitness and promoting chronic disability. Gait is a complex sensorimotor function controlled by integrated cortical, subcortical, and spinal networks. The mechanisms of gait recovery after stroke are not well understood....
Main Authors: | , , , , , , , , , , |
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Format: | Article |
Language: | English |
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2008-12.
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Online Access: | Get fulltext Get fulltext |
LEADER | 02645 am a22002533u 4500 | ||
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001 | 358066 | ||
042 | |a dc | ||
100 | 1 | 0 | |a Luft, A.R. |e author |
700 | 1 | 0 | |a Macko, R.F. |e author |
700 | 1 | 0 | |a Forrester, L.W. |e author |
700 | 1 | 0 | |a Villagra, F. |e author |
700 | 1 | 0 | |a Ivey, F. |e author |
700 | 1 | 0 | |a Sorkin, J.D. |e author |
700 | 1 | 0 | |a Whitall, Jill |e author |
700 | 1 | 0 | |a McCombe-Waller, S. |e author |
700 | 1 | 0 | |a Katzel, L. |e author |
700 | 1 | 0 | |a Goldberg, A.P. |e author |
700 | 1 | 0 | |a Hanley, D.F. |e author |
245 | 0 | 0 | |a Treadmill exercise activates subcortical neural networks and improves walking after a stroke |
260 | |c 2008-12. | ||
856 | |z Get fulltext |u https://eprints.soton.ac.uk/358066/1/treadmill%2520exercise%2520activates%2520subcortical%2520neural%2520networks%2520and%2520improves%2520walking%2520after%2520a%2520stroke.pdf | ||
856 | |z Get fulltext |u https://eprints.soton.ac.uk/358066/2/358066WHITALL3.pdf | ||
520 | |a BACKGROUND AND PURPOSE: Stroke often impairs gait thereby reducing mobility and fitness and promoting chronic disability. Gait is a complex sensorimotor function controlled by integrated cortical, subcortical, and spinal networks. The mechanisms of gait recovery after stroke are not well understood. This study examines the hypothesis that progressive task-repetitive treadmill exercise (T-EX) improves fitness and gait function in subjects with chronic hemiparetic stroke by inducing adaptations in the brain (plasticity). METHODS: A randomized controlled trial determined the effects of 6-month T-EX (n=37) versus comparable duration stretching (CON, n=34) on walking, aerobic fitness and in a subset (n=15/17) on brain activation measured by functional MRI. RESULTS: T-EX significantly improved treadmill-walking velocity by 51% and cardiovascular fitness by 18% (11% and -3% for CON, respectively; P<0.05). T-EX but not CON affected brain activation during paretic, but not during nonparetic limb movement, showing 72% increased activation in posterior cerebellar lobe and 18% in midbrain (P<0.005). Exercise-mediated improvements in walking velocity correlated with increased activation in cerebellum and midbrain. CONCLUSIONS: T-EX improves walking, fitness and recruits cerebellum-midbrain circuits, likely reflecting neural network plasticity. This neural recruitment is associated with better walking. These findings demonstrate the effectiveness of T-EX rehabilitation in promoting gait recovery of stroke survivors with long-term mobility impairment and provide evidence of neuroplastic mechanisms that could lead to further refinements in these paradigms to improve functional outcomes. | ||
655 | 7 | |a Article |