None listed
Conditions
Brief summary
The aim of this pilot study is to investigate whether moderate intensity exercise could increase neuroplasticity in people with chronic stroke. We specifically investigated people with chronic stroke to avoid the initial, brief, spontaneous period of enhanced neuroplasticity that emerges early after stroke. To evaluate capacity for neuroplasticity, we used a repetitive stimulation protocol, known as intermittent theta-burst stimulation (iTBS) which has been shown to modulate the efficiency of synapses within the cortex. Physiologically, this can be quantified as a change in cortical excitability. Therefore, the hypothesis was that if moderate intensity exercise increases capacity for neuroplasticity, then the physiological response to iTBS would be greater compared to people who do not undertake exercise. If moderate intensity exercise does increase neuroplasticity in people with stroke, then it might provide one method to explore as a technique to re-open a period of enhanced neuroplasticity. Future trials could use exercise as a brain priming therapy to increase responsiveness to rehabilitation.
Interventions
Participants allocated to the intervention (exercise) group will complete a single session of 20 minutes of moderate intensity continuous aerobic exercise on a recumbent exercise bike. Participants were monitored to ensure they stay within 60-80% of maximum heart rate which will calculated using the formula: 208-(0.7 x age).
Sessions will be supervised by physiotherapists and delivered one-on-one. Adherence will be monitored by continuous supervision by research staff.
Following exercise or co
Participants allocated to the intervention (exercise) group will complete a single session of 20 minutes of moderate intensity continuous aerobic exercise on a recumbent exercise bike. Participants were monitored to ensure they stay within 60-80% of maximum heart rate which will calculated using the formula: 208-(0.7 x age). Sessions will be supervised by physiotherapists and delivered one-on-one. Adherence will be monitored by continuous supervision by research staff. Following exercise or control, all participants will receive intermittent theta burst stimulation (iTBS) to the non-lesioned hemisphere. The standard 600 pulses iTBS paradigm was used, consisting of three low intensity, high frequency pulses (50Hz), applied every 200ms for two seconds, then repeated every 10 seconds for a total of 190 seconds. The intensity of stimulation was set at 70% of RMT. Participants were asked to relax and avoid contraction of the upper limb muscles during delivery and following iTBS. Coil position was consistently monitored to maintain correct positioning. timulation was delivered using a Neuro-MS/D rTMS device (Neurosoft Ltd. Ivanova, Russia) that was connected to an oil cooled figure eight coil (wing diameter 70mm).
Sponsors
University of South Australia
Study design
Allocation
Randomised controlled trial
Intervention model
Parallel
Primary purpose
Treatment
Masking
Blinded (masking used) (Investigator, Outcomes Assessor)
Eligibility
Sex/Gender
All
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
People who had experienced stroke at least three months prior, were community ambulators, medically stable and over the age of 18 years will be invited to participate. Participants must be deemed safe for non-invasive brain stimulation using international guidelines
Exclusion criteria
Exclusion criteria were previous diagnosis of another neurological disease, recent craniotomy or neurosurgical intervention, any concurrent medication known to modify seizure threshold, presence of contraindications to TMS (such as metallic implants in the skull, history of seizures or implanted permanent pacemaker) or were unable to use an exercise bike.
Outcome results
None listed