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Exercise and Executive Function in Individuals With Chronic Stroke: A Pilot Study

Kluding, Patricia M. PT, PhD; Tseng, Benjamin Y. PhD; Billinger, Sandra A. PT, PhD

Journal of Neurologic Physical Therapy: March 2011 - Volume 35 - Issue 1 - p 11–17
doi: 10.1097/NPT.0b013e318208ee6c
Research Articles

Background and Purpose: Emerging evidence suggests that exercise may improve cognitive function in older adults. The purpose of this pilot study was to describe changes in measures of cognition and executive function in individuals with chronic stroke following participation in aerobic and strengthening exercise.

Methods: A single-group, pretest-posttest design was used. Nine individuals with chronic stroke (mean age = 63.7 ± 9.1 years, mean time since stroke = 50.4 ± 37.9 months) completed a 12-week program of aerobic and strengthening exercise, 3 days per week. The primary outcome measures examined executive function (Digit Span Backwards and Flanker tests). Secondary measures examined various aspects of aerobic fitness (

O2peak and 6-minute walk distance) and function (Fugl-Meyer and 10-m walk speed).

Results: Following the intervention, significant improvements were found in the Digit Span Backwards test (mean change = 0.56 ± 0.9 digits; P = 0.05), Fugl-Meyer score (mean change = 3.6 ± 5.7; P = 0.05), and Stroke Impact Scale total score (mean change = 33.8 ± 38.5; P = 0.02). A significant correlation was found between improved aerobic capacity and improved performance on the Flanker test (r = 0.74; P = 0.02).

Discussion: The results of this study indicate that a 12-week aerobic and strengthening exercise program was associated with improvements in selected measures of executive function and functional capacity in people with stroke. Limitations of this study include the small sample size and lack of a comparison group.

Conclusions: This pilot study contributes to the emerging evidence that exercise improves cognition in people with stroke. These benefits indicate the need for future study with a larger group to have sufficient power to further explore these relationships.

Department of Physical Therapy and Rehabilitation Science, University of Kansas Medical Center, Kansas City.

Correspondence: Patricia M. Kluding, PT, PhD, 3901 Rainbow Blvd, Mailstop 3051, Kansas City, KS 66160 (

Funded by National Institute of Disability and Rehabilitation Research grant H133F05006 and supported, in part, by the University of Kansas Medical Center General Clinical Research Center grant M01 RR 02394, National Center for Research Resources/National Institute of Health. The authors have no financial conflict of interest to disclose.

A component of this project was presented in a platform at the World Conference of Physical Therapy Conference in Vancouver, British Columbia, Canada, in 2007.

© 2011 Neurology Section, APTA