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Exercise Effects on Word Learning

Acute Exercise Effects on Word Learning in Aging and Stroke-induced Aphasia

Status
Completed
Phases
NA
Study type
Interventional
Source
ClinicalTrials.gov
Registry ID
NCT03370471
Enrollment
28
Registered
2017-12-12
Start date
2016-12-09
Completion date
2019-08-16
Last updated
2021-09-05

For informational purposes only — not medical advice. Sourced from public registries and may not reflect the latest updates. Terms

Conditions

Aging, Aphasia

Keywords

aerobic exercise, learning, language, cognition

Brief summary

The aging Veteran population will substantially increase over the next 10 years, as the 24.9% of Veterans who are currently between 55-64 years of age join the 38.5% who are already over age 65. The risk of stroke more than doubles each decade after age 55, which places Veterans at an ever-increasing risk of suffering stroke-related language impairment (i.e., aphasia). Difficulty retrieving words, which negatively impacts psychosocial well-being and quality of life, is the most common complaint in healthy aging and aphasia. Word retrieval interventions to maintain or restore communicative function are needed. Studies have shown that physical exercise can improve word learning in young adults. This study will investigate the effects of exercise on word learning in aging and aphasia. The results will help the us understand how exercise may be used to optimize word retrieval interventions for our aging Veterans.

Detailed description

Difficulty retrieving the right word to communicate a message is the most common complaint in healthy older adults and individuals with stroke-induced language impairment (i.e., aphasia). Novel word learning paradigms have been used to investigate a variety of behavioral and neuromodulatory approaches to improve word retrieval deficits. Previous novel word learning studies have shown that physical exercise can improve long term recall in healthy young adults and that increased levels of dopamine may be responsible for this effect; however, no studies have investigated the effects of exercise on novel word learning in older adults and individuals with aphasia, and very little is known about the mechanisms that support exercise-enhanced word learning in these populations. The aims of this study are to: 1\) to identify the novel word learning paradigm that facilitates immediate and long-term word recall 2a) to investigate how acute, moderate-intensity exercise alters levels of serum brain-derived neurotrophic factor (BDNF) and plasma dopamine 2b) to describe and quantify the association between novel word learning and any observed changes in serum BDNF and plasma dopamine. This research will provide a platform for future investigations of immediate exercise effects on word learning, which are essential for achieving our long-term goal of developing exercise-based word retrieval interventions for healthy older Veterans and Veterans with aphasia. A within subjects crossover design will be used to address Aims 1, 2a and 2b. Subjects will complete aerobic exercise or stretching (training) before engaging in Study Only or Retrieval Practice (learning). Subjects will be counterbalanced within and across conditions. Sixteen healthy older adults (65-89 years) and 16 individuals with aphasia (35-89 years), will be recruited. The study will comprise 18 sessions over 12 weeks. In Week 1, subjects will undergo baseline blood draws, a physical assessment, cognitive and language assessments, and a practice word learning task. In Weeks 2-12, subjects will complete the four conditions. Each condition will last two weeks, with a one-week break between conditions. In each condition, training and learning sessions will take place on Monday, Wednesday and Friday. Training: Subjects will engage in 30 minutes of moderate-intensity cycling or gentle upper and lower limb stretching (control) prior to engaging in a novel word learning task. Learning: Familiar objects (e.g., cup) will be paired with nonwords (e.g., flark). In the Study Only paradigm, object/nonword pairs will be presented three times across three days (Monday, Wednesday, Friday). In the Retrieval Practice paradigm, object/nonword pairs will be presented during the first session (Monday). In subsequent sessions (Wednesday, Friday), subjects will be asked to recall the nonword name of presented objects. Corrective feedback will be provided on each trial. Testing: Recognition and recall testing without corrective feedback will be administered immediately after learning (short-term memory), before training in the second and third learning session (overnight consolidation) and one week after learning (long-term memory). Blood Draws: Three blood samples will be taken at baseline (rest, 30 minutes, 60 minutes). In each of the four conditions, blood samples will be taking during the first and third learning session (at rest, after training, after learning, and 15 minutes after learning). Whole blood will be collected in plain tubes and in anticoagulant-treated tubes for subsequent serum BDNF and plasma dopamine analysis by ELISA. Samples will be analyzed in triplicate to increase reliability.

Interventions

BEHAVIORALRetrieval Practice + Moderate Intensity Exercise

Subjects will engage in 30 minutes of moderate-intensity cycling prior to word learning using Retrieval Practice (active retrieval during learning)

BEHAVIORALRetrieval Practice + Gentle Stretching

Subject will engage in 30 minutes of gentle upper- and lower- limb stretching prior to word learning using Retrieval Practice (active retrieval during learning)

BEHAVIORALStudy Only + Moderate Intensity Exercise

Subjects will engage in 30 minutes of gentle stretching prior to word learning using Study Only (no active retrieval during learning)

BEHAVIORALStudy Only + Gentle Stretching

Subjects will engage in 30 minutes of gentle stretching prior to word learning using Study Only (no active retrieval during learning)

Sponsors

VA Office of Research and Development
Lead SponsorFED

Study design

Allocation
RANDOMIZED
Intervention model
CROSSOVER
Primary purpose
OTHER
Masking
NONE

Intervention model description

2x2 crossover design comparing two learning paradigms (Study Only vs. Retrieval Practice) and two training conditions (Moderate Intensity Exercise vs. Gentle Stretching)

Eligibility

Sex/Gender
ALL
Age
35 Years to 89 Years
Healthy volunteers
Yes

Inclusion criteria

* monolingual English speakers * low physical activity on the International Physical Activity Questionnaire * physician's written approval for participation in moderate-intensity exercise

Exclusion criteria

* VO2 max \>26 (men) and 22 (women) * inability to cycle for 3 minutes at 50 revolutions/minute with no resistance * any comorbid condition with exercise contraindications * use of hormone replacement therapy * dopaminergic * anti-depressant * anti-psychotic * or illicit drugs * consumption of \>14 alcoholic drinks/week or \> 1pack of cigarettes/day * uncorrected hearing or vision impairments that interfere with study procedures * inability to read or repeat nonwords (e.g., flark) * inability to learn one novel word during a practice learning task * below cut-off on the Montreal Cognitive Assessment or the Comprehensive Aphasia Test Cognitive Screen * and/or \>10 on the Beck Depression Inventory

Design outcomes

Primary

MeasureTime frameDescription
Study-Specific Word Recall TaskAssessment occurs over a two-week period for each of the 4 intervention/arms: Week 1: Monday, Wednesday, Friday, Week 2: FridayStudy-specific word recall task comprising trained items. Participant is shown each trained item and types the name. Acquisition: immediately after exercise or stretching on Monday, Wednesday and Friday. Consolidation: immediately before exercise or stretching on Wednesday and Friday, one week after training (Friday)

Secondary

MeasureTime frameDescription
Serum BDNF Concentration Levels (pg/mL)Assessment occurs on Monday, Wednesday and Friday of Week 1 for each of the 4 intervention/armsBlood samples collected to measure serum BDNF concentration levels (pg/mL), as follows: 1. Before moderate intensity exercise or gentle stretching 2. Immediately after moderate intensity exercise or gentle stretching 3. Immediately after word learning 4. 15 minutes after word learning
Plasma DopamineAssessment occurs on Monday, Wednesday and Friday of Week 1 for each of the 4 intervention/armsThe investigators will collect blood samples to detect changes in plasma dopamine in the training conditions on Monday and Friday sessions, as follows:. 1. Before exercise or stretching 2. Immediately after exercise or stretching 3. Immediately after word learning 4. 15 minutes after word learning

Countries

United States

Participant flow

Participants by arm

ArmCount
Healthy Older Adults
Participants complete all four study interventions Retrieval Practice + Moderate Intensity Exercise: Subjects will engage in 30 minutes of moderate-intensity cycling prior to word learning using Retrieval Practice (active retrieval during learning) Retrieval Practice + Gentle Stretching: Subject will engage in 30 minutes of gentle upper- and lower- limb stretching prior to word learning using Retrieval Practice (active retrieval during learning) Study Only + Moderate Intensity Exercise: Subjects will engage in 30 minutes of gentle stretching prior to word learning using Study Only (no active retrieval during learning) Study Only + Gentle Stretching: Subjects will engage in 30 minutes of gentle stretching prior to word learning using Study Only (no active retrieval during learning)
16
Individuals With Aphasia
Participants complete all four study interventions Retrieval Practice + Moderate Intensity Exercise: Subjects will engage in 30 minutes of moderate-intensity cycling prior to word learning using Retrieval Practice (active retrieval during learning) Retrieval Practice + Gentle Stretching: Subject will engage in 30 minutes of gentle upper- and lower- limb stretching prior to word learning using Retrieval Practice (active retrieval during learning) Study Only + Moderate Intensity Exercise: Subjects will engage in 30 minutes of gentle stretching prior to word learning using Study Only (no active retrieval during learning) Study Only + Gentle Stretching: Subjects will engage in 30 minutes of gentle stretching prior to word learning using Study Only (no active retrieval during learning)
3
Total19

Withdrawals & dropouts

PeriodReasonFG000FG001
Overall StudyScreen fail10
Overall StudyUnable to access veins for blood draw01
Overall StudyWithdrawal by Subject61

Baseline characteristics

CharacteristicHealthy Older AdultsTotalIndividuals With Aphasia
Age, Continuous74.1 years
STANDARD_DEVIATION 5.1
71.5 years
STANDARD_DEVIATION 10.4
57.7 years
STANDARD_DEVIATION 21.1
Ethnicity (NIH/OMB)
Hispanic or Latino
0 Participants0 Participants0 Participants
Ethnicity (NIH/OMB)
Not Hispanic or Latino
16 Participants19 Participants3 Participants
Ethnicity (NIH/OMB)
Unknown or Not Reported
0 Participants0 Participants0 Participants
Race (NIH/OMB)
American Indian or Alaska Native
0 Participants0 Participants0 Participants
Race (NIH/OMB)
Asian
0 Participants0 Participants0 Participants
Race (NIH/OMB)
Black or African American
4 Participants5 Participants1 Participants
Race (NIH/OMB)
More than one race
1 Participants1 Participants0 Participants
Race (NIH/OMB)
Native Hawaiian or Other Pacific Islander
0 Participants0 Participants0 Participants
Race (NIH/OMB)
Unknown or Not Reported
0 Participants0 Participants0 Participants
Race (NIH/OMB)
White
11 Participants13 Participants2 Participants
Region of Enrollment
United States
16 Participants19 Participants3 Participants
Sex: Female, Male
Female
7 Participants9 Participants2 Participants
Sex: Female, Male
Male
9 Participants10 Participants1 Participants

Adverse events

Event typeEG000
affected / at risk
EG001
affected / at risk
deaths
Total, all-cause mortality
0 / 230 / 5
other
Total, other adverse events
1 / 231 / 5
serious
Total, serious adverse events
0 / 230 / 5

Outcome results

Primary

Study-Specific Word Recall Task

Study-specific word recall task comprising trained items. Participant is shown each trained item and types the name. Acquisition: immediately after exercise or stretching on Monday, Wednesday and Friday. Consolidation: immediately before exercise or stretching on Wednesday and Friday, one week after training (Friday)

Time frame: Assessment occurs over a two-week period for each of the 4 intervention/arms: Week 1: Monday, Wednesday, Friday, Week 2: Friday

ArmMeasureGroupValue (MEAN)Dispersion
Healthy Older AdultsStudy-Specific Word Recall TaskConsolidation- Retrieval Practice + Moderate Intensity Exercise4.6 number of words gainedStandard Deviation 4.1
Healthy Older AdultsStudy-Specific Word Recall TaskConsolidation- Study Only + Moderate Intensity Exercise3.6 number of words gainedStandard Deviation 3.2
Healthy Older AdultsStudy-Specific Word Recall TaskConsolidation- Retrieval Practice + Gentle Stretching4.6 number of words gainedStandard Deviation 4.5
Healthy Older AdultsStudy-Specific Word Recall TaskAcquisition- Study Only + Gentle Stretching5.4 number of words gainedStandard Deviation 2.7
Healthy Older AdultsStudy-Specific Word Recall TaskAcquisition- Retrieval Practice + Gentle Stretching4.8 number of words gainedStandard Deviation 3.8
Healthy Older AdultsStudy-Specific Word Recall TaskConsolidation- Study Only + Gentle Stretching3.5 number of words gainedStandard Deviation 3.6
Healthy Older AdultsStudy-Specific Word Recall TaskAcquisition- Study Only + Moderate Intensity Exercise4.8 number of words gainedStandard Deviation 3.6
Healthy Older AdultsStudy-Specific Word Recall TaskAcquisition- Retrieval Practice + Moderate Intensity Exercise6.4 number of words gainedStandard Deviation 3.6
Individuals With AphasiaStudy-Specific Word Recall TaskAcquisition- Study Only + Moderate Intensity Exercise1.7 number of words gainedStandard Deviation 3.8
Individuals With AphasiaStudy-Specific Word Recall TaskConsolidation- Retrieval Practice + Moderate Intensity Exercise1.5 number of words gainedStandard Deviation 2.1
Individuals With AphasiaStudy-Specific Word Recall TaskAcquisition- Retrieval Practice + Gentle Stretching1.7 number of words gainedStandard Deviation 2.5
Individuals With AphasiaStudy-Specific Word Recall TaskConsolidation- Retrieval Practice + Gentle Stretching0.7 number of words gainedStandard Deviation 2.1
Individuals With AphasiaStudy-Specific Word Recall TaskAcquisition- Retrieval Practice + Moderate Intensity Exercise1.7 number of words gainedStandard Deviation 2.1
Individuals With AphasiaStudy-Specific Word Recall TaskConsolidation- Study Only + Moderate Intensity Exercise1.3 number of words gainedStandard Deviation 2.3
Individuals With AphasiaStudy-Specific Word Recall TaskAcquisition- Study Only + Gentle Stretching2.7 number of words gainedStandard Deviation 2.9
Individuals With AphasiaStudy-Specific Word Recall TaskConsolidation- Study Only + Gentle Stretching1.3 number of words gainedStandard Deviation 2.3
Secondary

Plasma Dopamine

The investigators will collect blood samples to detect changes in plasma dopamine in the training conditions on Monday and Friday sessions, as follows:. 1. Before exercise or stretching 2. Immediately after exercise or stretching 3. Immediately after word learning 4. 15 minutes after word learning

Time frame: Assessment occurs on Monday, Wednesday and Friday of Week 1 for each of the 4 intervention/arms

Population: We were not able to obtain reliable measurements of dopamine for analysis.

Secondary

Serum BDNF Concentration Levels (pg/mL)

Blood samples collected to measure serum BDNF concentration levels (pg/mL), as follows: 1. Before moderate intensity exercise or gentle stretching 2. Immediately after moderate intensity exercise or gentle stretching 3. Immediately after word learning 4. 15 minutes after word learning

Time frame: Assessment occurs on Monday, Wednesday and Friday of Week 1 for each of the 4 intervention/arms

ArmMeasureGroupValue (MEAN)Dispersion
Healthy Older AdultsSerum BDNF Concentration Levels (pg/mL)Moderate Intensity Exercise- Before Exercise195.50 serum BDNF concentration levels (pg/mL)Standard Deviation 36
Healthy Older AdultsSerum BDNF Concentration Levels (pg/mL)Moderate Intensity Exercise- Immediately After Exercise218.98 serum BDNF concentration levels (pg/mL)Standard Deviation 79.39
Healthy Older AdultsSerum BDNF Concentration Levels (pg/mL)Moderate Intensity Exercise- Immediately After Learning209.95 serum BDNF concentration levels (pg/mL)Standard Deviation 75.7
Healthy Older AdultsSerum BDNF Concentration Levels (pg/mL)Moderate Intensity Exercise- 15 Minutes After Learning204.17 serum BDNF concentration levels (pg/mL)Standard Deviation 57.36
Healthy Older AdultsSerum BDNF Concentration Levels (pg/mL)Gentle Stretching- Before Stretching199.92 serum BDNF concentration levels (pg/mL)Standard Deviation 48.72
Healthy Older AdultsSerum BDNF Concentration Levels (pg/mL)Gentle Stretching- Immediately After Stretching217.14 serum BDNF concentration levels (pg/mL)Standard Deviation 49.33
Healthy Older AdultsSerum BDNF Concentration Levels (pg/mL)Gentle Stretching- Immediately After Learning222.03 serum BDNF concentration levels (pg/mL)Standard Deviation 58.78
Healthy Older AdultsSerum BDNF Concentration Levels (pg/mL)Gentle Stretching- 15 Minutes After Learning218.00 serum BDNF concentration levels (pg/mL)Standard Deviation 60
Individuals With AphasiaSerum BDNF Concentration Levels (pg/mL)Gentle Stretching- 15 Minutes After Learning117.76 serum BDNF concentration levels (pg/mL)Standard Deviation 40.87
Individuals With AphasiaSerum BDNF Concentration Levels (pg/mL)Moderate Intensity Exercise- Before Exercise137.83 serum BDNF concentration levels (pg/mL)Standard Deviation 51.88
Individuals With AphasiaSerum BDNF Concentration Levels (pg/mL)Gentle Stretching- Before Stretching180.25 serum BDNF concentration levels (pg/mL)Standard Deviation 42.48
Individuals With AphasiaSerum BDNF Concentration Levels (pg/mL)Moderate Intensity Exercise- Immediately After Exercise156.01 serum BDNF concentration levels (pg/mL)Standard Deviation 70.25
Individuals With AphasiaSerum BDNF Concentration Levels (pg/mL)Gentle Stretching- Immediately After Learning140.85 serum BDNF concentration levels (pg/mL)Standard Deviation 23.66
Individuals With AphasiaSerum BDNF Concentration Levels (pg/mL)Moderate Intensity Exercise- Immediately After Learning153.70 serum BDNF concentration levels (pg/mL)Standard Deviation 28.94
Individuals With AphasiaSerum BDNF Concentration Levels (pg/mL)Gentle Stretching- Immediately After Stretching201.19 serum BDNF concentration levels (pg/mL)Standard Deviation 93.51
Individuals With AphasiaSerum BDNF Concentration Levels (pg/mL)Moderate Intensity Exercise- 15 Minutes After Learning129.34 serum BDNF concentration levels (pg/mL)Standard Deviation 12.9
Post Hoc

Word Recognition

Participants complete word recognition task on trained items. Acquisition: immediately after exercise or stretching on Monday, Wednesday, and Friday Consolidation: immediately before exercise or stretching on Monday and Wednesday, and one week after learning (Friday)

Time frame: Assessment occurs over a two-week period for each of the 4 intervention/arms: Week 1: Monday, Wednesday, Friday, Week 2: Friday

ArmMeasureGroupValue (MEAN)Dispersion
Healthy Older AdultsWord RecognitionAcquisition- Retrieval Practice + Moderate Intensity Exercise3.1 number of words gainedStandard Deviation 2.3
Healthy Older AdultsWord RecognitionConsolidation- Retrieval Practice + Moderate Intensity Exercise3.0 number of words gainedStandard Deviation 3
Healthy Older AdultsWord RecognitionAcquisition- Retrieval Practice + Gentle Stretching3.1 number of words gainedStandard Deviation 2
Healthy Older AdultsWord RecognitionConsolidation- Retrieval Practice + Gentle Stretching2.9 number of words gainedStandard Deviation 2.6
Healthy Older AdultsWord RecognitionAcquisition- Study Only + Moderate Intensity Exercise2.7 number of words gainedStandard Deviation 2.2
Healthy Older AdultsWord RecognitionConsolidation- Study Only + Moderate Intensity Exercise1.8 number of words gainedStandard Deviation 2.4
Healthy Older AdultsWord RecognitionAcquisition- Study Only + Gentle Stretching1.9 number of words gainedStandard Deviation 2.2
Healthy Older AdultsWord RecognitionConsolidation- Study Only + Gentle Stretching3.2 number of words gainedStandard Deviation 2.8
Individuals With AphasiaWord RecognitionConsolidation- Study Only + Gentle Stretching1.7 number of words gainedStandard Deviation 0.5
Individuals With AphasiaWord RecognitionAcquisition- Retrieval Practice + Moderate Intensity Exercise4.0 number of words gainedStandard Deviation 1.7
Individuals With AphasiaWord RecognitionAcquisition- Study Only + Moderate Intensity Exercise2.3 number of words gainedStandard Deviation 1.5
Individuals With AphasiaWord RecognitionConsolidation- Retrieval Practice + Moderate Intensity Exercise3.5 number of words gainedStandard Deviation 0.07
Individuals With AphasiaWord RecognitionAcquisition- Study Only + Gentle Stretching2.7 number of words gainedStandard Deviation 3.1
Individuals With AphasiaWord RecognitionAcquisition- Retrieval Practice + Gentle Stretching3.0 number of words gainedStandard Deviation 3.5
Individuals With AphasiaWord RecognitionConsolidation- Study Only + Moderate Intensity Exercise0.3 number of words gainedStandard Deviation 2.1
Individuals With AphasiaWord RecognitionConsolidation- Retrieval Practice + Gentle Stretching-1.7 number of words gainedStandard Deviation 1.5

Source: ClinicalTrials.gov · Data processed: Feb 4, 2026