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Aerobic exercise shows limited cognitive benefit in brain injury rehabilitation pilot studyEarly study finds mixed results on exercise for brain injury recovery

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Key Takeaway
Consider that this pilot study found no significant benefit of aerobic exercise on primary cognitive outcomes in brain injury rehabilitation.

This randomized controlled pilot study enrolled 12 participants (10 men, 2 women; aged 16-65 years) with moderate to severe stroke or traumatic brain injury at least 3 months post-injury in an outpatient rehabilitation program. The intervention was 30 minutes of aerobic exercise 3-4 times per week for 8 weeks, compared to routine physical therapy.

The primary outcomes were cognitive function, fatigue, and neuroplasticity. No significant difference between the groups was reported for cognitive variables, fatigue, or neuroplasticity. For secondary outcomes, working memory/executive demanding processing speed improved significantly in the aerobic exercise group (p = 0.042). Trends of improvements were noted in several other executive tests in the aerobic group. Automatic visual search speed improved in the control group (p = 0.027).

Safety and tolerability were not reported. The study is limited by its pilot nature and preliminary findings. The practice relevance is that experiences from this study might facilitate the design of future studies on this topic. The question of whether aerobic exercise promotes cognition and fatigue after brain injury remains unanswered.

Twelve adults with moderate to severe acquired brain injuries participated in this outpatient rehabilitation study. They were divided into two groups: one received 30 minutes of aerobic exercise three to four times a week for eight weeks, while the other group received only routine physical therapy.

The researchers measured changes in cognitive function, fatigue, and neuroplasticity. They found that the group doing aerobic exercise showed significant improvement in working memory and executive processing speed compared to the control group. However, there were no significant differences between the groups regarding fatigue levels or measures of neuroplasticity.

Interestingly, the control group receiving only routine therapy actually showed improvement in automatic visual search speed. No safety concerns or adverse events were reported during the study. Since this was a pilot study with a very small number of participants, the findings are considered preliminary. Readers should understand that these early results do not yet change medical practice or prove that aerobic exercise is a proven treatment for brain injury recovery.

What this means for you:
Small early study shows mixed results on exercise benefits for brain injury recovery.

Study Details

Study typeRct
EvidenceLevel 2
Follow-up780.0 mo
PublishedApr 2026
View Original Abstract ↓
OBJECTIVE: To explore potential effects of aerobic exercise on cognitive function, fatigue, and neuroplasticity after stroke or traumatic brain injury. DESIGN: A randomized controlled pilot study. SUBJECTS/PATIENTS: Twelve participants, 10 men and 2 women aged 16-65 years diagnosed with acquired brain injury (moderate to severe stroke or traumatic brain injury), enrolled in an outpatient rehabilitation programme at least 3 months post-injury. METHODS: The intervention group (n = 6) participated in 30 min of aerobic exercise 3-4 times/week for 8 weeks during their outpatient rehabilitation. The control group (n = 6) received routine physical therapy. In addition, both groups received rehabilitation according to their rehabilitation plan. Neuropsychological and endurance testing was performed before and after the intervention and at a 3-month follow-up. Functional magnetic resonance imaging was performed before and after the intervention. RESULTS: Preliminary findings show no significant difference between the groups regarding cognitive variables, fatigue, or neuroplasticity. However, working memory/executive demanding processing speed, measured with the Paced Auditory Serial Addition Test, improved significantly (p = 0.042) in the aerobic exercise group and there were trends of improvements on several other executive tests in the aerobic exercise group. Automatic visual search speed improved in the control group (p = 0.027). CONCLUSION: The question of whether aerobic exercise promotes cognition and fatigue after brain injury remains unanswered. This randomized controlled pilot study and its preliminary findings indicate greater improvements in executive processing speed in the aerobic exercise group, while more automatized attention speed improved more in the control group. The experiences from this study might facilitate the design of future studies on this intriguing topic. TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT07429526.
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