Aerobic Exercise as an Adjuvant to Aphasia Therapy: Theory, Preliminary Findings, and Future Directions

• Type of Material: Article
• Authors: Stacy M. Harnish, Ohio State University; Amy Rodriguez, Emory University; Deena Schwen Blackett, Ohio State University; Christopher Gregory, Medical University of South Carolina; Lauren Seeds, Brooks Rehabilitation Center; Jeffrey Boatright, Emory University; Bruce Crosson, Emory University
• Language: English
• Date: 2018-01-01
• Publisher: Elsevier
• Publication Version: Author Accepted Manuscript (After Peer Review)
• Copyright Statement: © 2017 Elsevier Inc. All rights reserved.
• License: Creative Commons Attribution-NonCommercial-NoDerivs 4.0 International
• Final Published Version (URL): http://dx.doi.org/10.1016/j.clinthera.2017.12.002
• Title of Journal or Parent Work: Clinical Therapeutics
• Volume: 40
• Issue: 1
• Start Page: 35
• End Page: 48
• Grant/Funding Information: We are grateful for support provided by a Brooks Research Endowment (B.C.), NIH grants R01EY028859 (J.H.B.) and P30EY006360 (J.H.B.), the Atlanta Research and Educational Foundation, the Abraham J. & Phyllis Katz Foundation, and Research to Prevent Blindness, Inc.; This work was supported by the Veterans Affairs Rehabilitation Research & Development Service C7175M (S.M.H.), C2238P (A.D.R.), C1924P (J.H.B.), I21RX001924 (J.H.B.), B6364 (B.C.), C9246C (Atlanta VA Center of Excellence in Vision and Neurocognitive Rehabilitation).
• Keywords: therapy; Neurothropic factor; Chronic stroke; Plasticity; Anomia; Science & Technology; exercise; Cardiovascular fitness; Individuals; Adults; Working memory; Cognitive functions; Pharmacology & Pharmacy; Life Sciences & Biomedicine; aphasia; BDNF; Enhances explicit
• Research Categories: Health Sciences, Rehabilitation and Therapy; Biology, Neuroscience; Health Sciences, Speech Pathology

Abstract

Purpose This study investigated whether participation in aerobic exercise enhances the effects of aphasia therapy, and the degree to which basal serum brain-derived neurotropic factor (BDNF) concentrations fluctuate after the beginning of aerobic exercise or stretching activities in individuals with poststroke aphasia. Methods The study used a single-subject, multiple-baseline design. Seven individuals with chronic poststroke aphasia participated in 2 Blocks of aphasia therapy: aphasia therapy alone (Block 1), followed by aphasia therapy with the addition of aerobic activity via bicycle ergometer (n = 5) or stretching (n = 2) (Block 2). Serum BDNF concentrations from blood draws were analyzed in 4 participants who exercised and in 1 participant who stretched. Findings Three of the five exercise participants demonstrated larger Tau-U effects when aphasia therapy was paired with aerobic exercise, whereas 1 of the 2 stretching participants demonstrated a larger effect size when aphasia therapy was paired with stretching. Group-level comparisons revealed a greater overall increase in effect size in the aerobic exercise group, as indicated by differences in Tau-U weighted means. BDNF data showed that all 4 exercise participants demonstrated a decrease in BDNF concentrations during the first 6 weeks of exercise and an increase in BDNF levels near or at baseline during the last 6 weeks of exercise. The stretching participant did not show the same pattern. Implications Additional research is needed to understand the mechanism of effect and to identify the factors that mediate response to exercise interventions, specifically the optimal dose of exercise and timing of language intervention with exercise. ClinicalTrials.gov identifier: NCT01113879.