The Influence of Exercise on Neuroplasticity and Motor Learning After Stroke

Not Applicable

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).

Recruitment & Eligibility

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

Arm && Interventions

Group	Intervention	Description
Exercise + practice	Exercise	Individuals will complete 20 minutes of exercise on a recumbent bicycle before practicing a novel motor task.
Rest + practice	Practice	Individuals will rest for 20 minutes before practicing a novel motor task. Attention will be controlled during this time.
Exercise + practice	Practice	Individuals will complete 20 minutes of exercise on a recumbent bicycle before practicing a novel motor task.

Primary Outcome Measures

Name	Time	Method
Change response time during a novel motor task.	Baseline, After Intervention (2 weeks), 30-day follow-up	Serial targeting task
Wolf Motor Function Task Rate	Baseline, After Intervention (2 weeks), 30-day follow-up	Standardized test of arm motor function

Secondary Outcome Measures

Name	Time	Method
Transcallosal Inhibition	Baseline, After Intervention (2 weeks), 30-day follow-up	Ipsilateral silent period
Arm Use Ratio	Baseline, After Intervention (2 weeks), 30-day follow-up	Accelerometry
Functional magnetic resonance imaging (fMRI)	Baseline, After Intervention (2 weeks), 30-day follow-up	Resting state fMRI
Structural magnetic resonance imaging - myelin	Baseline, After Intervention (2 weeks), 30-day follow-up	Myelin water fraction
Structural magnetic resonance imaging - diffusion	Baseline, After Intervention (2 weeks), 30-day follow-up	Diffusion weighted fractional anisotrophy

Locations (1): University of British Columbia
🇨🇦
Vancouver, British Columbia, Canada

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