Exercise on a treadmill helps stroke survivors years later

Sep 2 2008

New research has found that exercising on a treadmill helped stroke survivors improve their mobility and physical conditioning.

The new study suggests the exercise helps by rewriting parts of the brain and is effective even years after the stroke occurred.

The study was conducted by researchers at the University of Maryland and Baltimore Veterans Affairs Medical Center and involved 71 people who had suffered a stroke an average four years earlier.

At the start of the study, half of the subjects could walk without assistance, while the rest used a cane, a walker or a wheelchair.

The researchers compared the brain and physical function of 37 people who had worked on a treadmill three times a week, with 34 people who were given traditional stretching exercises.

The participants were on average age 63, and they began the treadmill program around 50 months after the stroke.

Within six months the treadmill walkers improved their walking speed by 51 percent compared to 11 percent for the stretching group and scans detected increased activity in brain areas associated with controlling gait and walking, including the cerebellum and midbrain in the treadmill walkers.

Dr. Daniel Hanley, a neurology professor at Johns Hopkins University School of Medicine in Baltimore who helped lead the study, says some of the participants were wheelchair bound when they started, and many were using canes and walkers; one of the patients in the study had significant improvement 20 years after a stroke.

Dr. Hanley says after the treadmill use some were able to give up or lessen their dependence on the devices and this is important because stroke survivors' immobility can lead to cardiovascular disease and diabetes.

The patients with the most improvement in walking showed the strongest change in brain activity, though the researchers say it is unclear whether these brain changes were caused by more walking or whether participants walked better because brain activity in these key areas increased and this will be the focus of a future study.

The researchers say treadmill work should be part of standard treatment for every stroke survivor who has a walking habit and they believe exercise gives individuals a way to fight back against stroke disabilities.

Dr. Hanley says stroke patients are usually told to "learn to live with" their disabilities, unlike heart attack patients and others who are often prescribed lifestyle changes and exercise programs to help recover function.

Most stroke rehabilitation programs focus on short-term improvement, ending just a few months after a patient has had a stroke and as a result over the following years, patients' functional improvement plateaus and their fitness often wanes, which could increase the chance of a second stroke.

Dr. Hanley says the results are great news for stroke survivors because it clearly demonstrates that long-term stroke damage is not immutable and it is never too late for exercise to enable the brain and body to recover.

The research is published in the American Heart Association's journal Stroke.