NEW YORK (Reuters Health) – Treadmill exercise increases activity in the cerebellum and midbrain and is associated with improved walking in stroke patients, according to a report in the August 28th issue of Stroke: Journal of the American Heart Association.

“This is great news for stroke survivors because results clearly demonstrate that long-term stroke damage is not immutable and that with exercise it’s never too late for the brain and body to recover,” senior author Dr. Daniel F. Hanley, from Johns Hopkins University School of Medicine in Baltimore, said in a statement.

Cortical, subcortical, and spinal networks are all thought to play a role in controlling gait. In the present study, the researchers sought to determine if treadmill exercise, three times a week for up to 40 minutes, could improve gait in patients with hemiparetic stroke by inducing changes in brain activity.

The study involved 37 patients who were randomized to treadmill exercise and 34 who underwent a stretching intervention of comparable duration. Functional MRI was used to evaluate brain activation in a subset of patients.

Treadmill exercise was associated with significant improvements in both treadmill-walking velocity and cardiovascular fitness. Stretching, by contrast, had little effect on walking velocity and slightly worsened cardiovascular fitness.

During paretic limb movement, treadmill exercise, but not stretching, increased brain activation, specifically in the posterior cerebellar lobe and midbrain. No effect of either intervention was seen during nonparetic limb movement.

“Many stroke survivors believe there’s nothing to be gained from further rehabilitation, but our results suggest that health and functional benefits from walking on a treadmill can occur even decades out from stroke,” co-author Dr. Richard F. Macko, from the University of Maryland in Baltimore, noted in a statement.

Stroke 2008.

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