How Aerobic Exercise Aids Adult Brain Injury Recovery

People know that young brains and aging brains are different, which is why the idiom says, “you can't teach old dogs new tricks”. Parents of preschool-aged kids believe that children’s brain can be optimized by multiple stimulation, which is the reasons why enrichment classes are popular. Many studies also conclude that sufficient aerobic exercises not only promote growth and health but also improve cognitive function and executive function – making kids smarter and preparing them to receive academic training. On the other hand, more evolving evidence also shows that both aging brains and injured brains have similar capacity to react to aerobic exercise.  

Aerobic exercise refers to the exercise that repetitively use large skeletal muscle groups, such as brisk walking, jogging, and swimming. The type, intensity, frequency, and duration of exercise are also the parameters that affect its training outcomes. For the aging population or persons with brain injury, there may have barriers to access aerobic exercise, such as cardiac status, cognitive/perceptual deficits, fatigue, lack of support or time. Therefore, selecting appropriate aerobic exercise is crucial. In a clinical setting, a physiotherapist can prescribe a tailored exercise regime, assessing cardiopulmonary, musculoskeletal and neurologic condition before the training. During aerobic training, a physiotherapist monitors target heart rate, exertion level, and performance to ensure the goal are met safely.

To optimize brain recovery from injury, then we must consider neuroplasticity – the brain’s ability to constantly change, form new connections and reshape itself through learning, behaviour and memory. It is a concept that a young brain possesses in abundance, but aging brains and injured brains have the potential for it too. Brain-derived neurotrophic factor (BDNF), a key protein promoting neuroregeneration, has been shown to increase with aerobic exercise. In other words, aerobic exercise equips the brain to accept new learning and new challenging tasks.  

Stroke is the leading cause of disability worldwide. Stroke survivors often present with one-sided weakness, difficulty walking, problem with self-care, loss of work ability, and may even need a caretaker. The affected arm and leg become weak and uncoordinated, requiring constant motor training to improve the performance. While the principles of motor training is established, evolving studies are targeted on methods to enhance skill acquisition. Research mentioned that because aerobic exercise increase the level of BDNF, it is recommended to engage in aerobic exercise before motor training. In other words, aerobic exercise improves the learning and maintenance of motor skills in post-stroke rehabilitation.

Parkinson’s disease (PD) is notorious for its degenerative progression, causing by the loss of nerve cell that release dopamine. Even with adequate medication, people with PD may eventually experience a decline in motor function and cognition. Given its neuroprotective and neuroregenerative characteristics, BDNF can promote the survival of dopaminergic neurons and may be a promising therapeutic agent. A study gathered sixteen studies, including 370 patients with PD, and conducted a meta-analysis comparing BDNF level between exercise and control groups. The results show the greater exercise intensity, the higher the BDNF level. In conclusion, exercise for people with PD acts another medicine that directly influences the brain.  

Aerobic exercise not only increase the levels of BDNF but also boots neurotransmitter such as dopamine and serotonin. These molecules are associated with feeling of pleasure and reward. On the other hand, aerobic exercise improves cardiorespiratory and muscular fitness, leading to better cerebral blood flow and decrease systemic and central nervous system inflammation. To sum up, aerobic exercise directly and indirectly improves the overall brain health, resulting better mood, greater arousal, and slower neurodegeneration.

In conclusion, aerobic exercise is beneficial young brains, aging brains, and injured brains. People with stroke or PD, their brain have the potential to regenerate connections and slow the degeneration process with adequate physical training. Last but not least, whenever you face problems in getting an optimal exercise regime, consult a nearby physiotherapist for advice.

References:

Zang W, Zhu J, Xiao N, Fang M, Li D, Li H, Yan J, Jing H, Wang S. Effects of aerobic exercise on children's executive function and academic performance: A systematic review and meta-analysis. Heliyon. 2024 Mar 27;10(7):e28633. doi: 10.1016/j.heliyon.2024.e28633. PMID: 38586404; PMCID: PMC10998207.

Mang CS, Campbell KL, Ross CJ, Boyd LA. Promoting neuroplasticity for motor rehabilitation after stroke: considering the effects of aerobic exercise and genetic variation on brain-derived neurotrophic factor. Phys Ther. 2013;93(12):1707-1716. doi:10.2522/ptj.20130053

Paterno A, Polsinelli G, Federico B. Changes of brain-derived neurotrophic factor (BDNF) levels after different exercise protocols: a systematic review of clinical studies in Parkinson's disease. Front Physiol. 2024 Feb 20;15:1352305. doi: 10.3389/fphys.2024.1352305. PMID: 38444767; PMCID: PMC10912511.


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