Effects of an Acute High Intensity Exercise Bout on Retention of Explicit, Strategic Locomotor Learning in Individuals With Chronic Stroke

Abstract

Background Exercise priming, pairing high intensity exercise with a motor learning task, improves retention of upper extremity tasks in individuals after stroke, but has shown no benefit to locomotor learning. This difference may relate to the type of learning studied. Upper extremity studies used explicit, strategic tasks; locomotor studies used implicit sensorimotor adaptation (split-belt treadmill). Since walking is an important rehabilitation goal, it is crucial to understand under which circumstances exercise priming may improve retention of a newly learned walking pattern. Objective Determine the impact of exercise priming on explicit, strategic locomotor learning task retention in chronic stroke survivors. Methods Chronic stroke survivors (>6 months) performed 2 treadmill walking sessions. Visual feedback was used to train increased step length. Participants were assigned to control group (no exercise), continuous exercise (5 minutes high intensity), or long-interval exercise (15 minutes high/moderate intervals). After day 1 learning, participants either rested or performed exercise. On day 2, retention of the learned walking pattern was tested. Results All groups learned on day 1 ( P < .001). The 2 priming groups showed significant changes in blood lactate and heart rate after exercise priming, the resting control group did not ( P < .001). On day 2, there was no significant between-group difference in cued or un-cued task retention ( P = .963 and .287, respectively). Conclusions Exercise priming did not affect retention of an explicit locomotor task in chronic stroke survivors. Further work should explore subgroups of individuals for whom priming may have selective clinical benefit to locomotor learning. ClinicalTrials.gov Identifier: NCT03726047