The Link Between Exercise and Neuroprotection (Podcast)

The benefits of exercise for cardiovascular health are clear, but what about its effect on neurological conditions? Researchers at Cleveland Clinic have been investigating the role of exercise in combating neurodegeneration and providing neuroprotection, beginning with studies on tandem cycling for patients with Parkinson’s disease.

“The study that really put us on the map in terms of lower extremity exercise showed that it can promote improvements in the upper extremity despite the fact that patients weren’t doing anything with their hands,” says Jay Alberts, PhD, Vice Chair of innovation in Cleveland Clinic’s Neurological Institute and a researcher in the Department of Biomedical Engineering. “And we showed improvements or changes in brain function that looked very similar to what you get when you administer antiparkinsonian medication.”

Dr. Alberts and his colleagues, including Susan Linder, DPT, Director of Research in the Department of Physical Medicine and Rehabilitation, have expanded their investigations to include stroke and other neurological conditions. In the latest episode of Cleveland Clinic’s Neuro Pathways podcast, Dr. Alberts and Dr. Linder share details on:

• The effects of exercise using tandem and motorized stationary bicycles on Parkinson’s disease
• The intensity and duration of exercise shown to achieve results
• The use of aerobic exercise to improve motor recovery in people who have had strokes
• Study results on the benefits of high-intensity exercise for individuals with Alzheimer’s disease and multiple sclerosis
• The potential role of other modes of exercise, including treadmill walking and rowing

Click the podcast player above to listen to the episode now, or read on for a short edited excerpt. Check out more Neuro Pathways episodes at clevelandclinic.org/neuropodcast or wherever you get your podcasts.

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Excerpt from the episode

Podcast host Glen Stevens, DO, PhD: Have you seen any improvements in areas of stroke rehabilitation that you wouldn’t think would get improved with exercise?

Dr. Linder: Yes. In fact, what we’re looking at now is changes in walking capacity and gait. Previously it was thought that stroke patients needed task specificity to elicit improvements in other functions. For example, in order for walking to improve, you have to practice walking. So, cycling and walking aren’t the same, but they have similar enough characteristics that we’re seeing a carryover from intensive cycling interventions to improvements in walking. And we’ve seen improvements in gait velocity, walking capacity. And importantly, patients are not demonstrating worsening compensatory strategies in order to walk faster. We’re seeing that their biomechanics of gait are actually improving as a result of the cycling intervention.

We’re finding that the old adage of killing two birds with one stone is absolutely happening here. We’re seeing improvements in cardiovascular function — which was already known from previous studies — and improvements in motor recovery of the arm. Again, this is with a lower extremity aerobic exercise intervention and improvements in walking capacity. So, we feel that this intervention can potentially reduce disability.

One of the things we’re looking at now is the cost-effectiveness of this intervention because aerobic exercise is not typically covered by insurance for patients who have stroke, yet we see a lot of benefits to it. If we can show that we’re reducing disability and improving community reintegration, all at a lower cost, then we’re hoping insurance companies will start to cover this intervention and this approach.