Monday, January 18, 2010

Exercise. Because.

I was interviewed for this article on the Cleveland Clinic website. What I like most about it is that it also mentions one of my neuroscience heroes John Ratey. The fact that I'm mentioned before him- and more often- is just plain wrong.

The focus of this article is the impact of exercise on stroke recovery. But exercise per se does not necessarily drive the sort of cortical changes needed to recover. Of course, it is important to do both cardiovascular and strengthening exercises after stroke, if for no other reason than the fact that life poststroke takes so much energy for two reasons:
  • ~Typically everything a stroke survivor does takes twice as much energy. A good example of this is walking. A stroke survivor takes an average of twice as much energy to walk as someone who has not had a stroke.
  • ~Stroke survivors are in about half as good a shape as age matched couch potatoes.
  • ~Although it hasn't been measured, neuroplasticity takes energy. We're not sure how much. But when you consider that the brain gets 20% of total body oxygen consumption, while it only represents 2% of total body weight, you can imagine how much energy it takes to drive neuroplastic change.
So the bottom line is that stroke recovery needs energy. And exercise is good for banking energy.



Dean said...

Well Peter, I think something else is going on with tiredness/fatigue. If I am only using twice as much energy to move around I would be tired. But I am completely fatigued each and every day. My resting heart rate of 53 which at my age of 53 puts me in the athlete category. So my cardiovascular fitness is excellent. Even if I use 4 times as much energy each day to get around, that would just make me tired, not exhaust me.

Dean said...

Just finished reading the John Ratey book;Spark: The Revolutionary New Science of Exercise and the Brain. While it doesn't correlate directly with stroke rehabilitation, it gives me the same hope I had when I first learned about neuroplasticity.
Neurogenesis,I guess besides all the repetitions I need to exercise even more to bring my heart rate up to get all the abbreviations started.

Larry said...

Inspiring blog. I have always had so much empathy for how much energy it takes for stroke survivors to do things. This has driven me to find methods which rapidly re-educate the brain for the lost movements. This immediately makes exercise easier as the brain has returned to automatically coordinating muscles into more graceful movement. This contrasts with the "manual control" for each movement that makes stroke survivors so tired. The stroke traumatized the brain's ability to naturally move, but it can be restored. Thanks for caring about and supporting stroke survivors.

Peter said...

Dean, I'm a big fan of John Ratey, and I do think that his ideas intersect well with any kind of learning, including motor learning after stroke. I think what he's saying is, do cardio or weight training, then learn then do cardio or weight training and learn. Exercise primes the brain for any kind of learning.

Peter said...
This comment has been removed by the author.
Peter said...


Thanks for the kind words about the blog.

I think the key word in your statement is "rapidly." If it doesn't work soon, it's probably not going to work. Typically stroke survivors will try to get better by doing the same thing over and over. And when stroke survivors go back to therapy they end up doing essentially the same things that were used and failed to progress them beyond a previous perceived plateau. If something is going to work, you should see changes relatively soon. The changes should be measurable and they should be measured. You can make incremental change and not notice it because... it's incremental. So, if it does not work in the first 2-3 weeks, chuck it and move on. There are too many recovery fish in the sea to stick with ineffective stuff.

LSL said...

Hi Peter. I had two strokes during my pregnancy 3/13/99 & 3/16/99. It took until 9/04 for the doctor's to find out that I had a hole in my heart. The hole in my heart was fixed 10/04. Why I'm writing to you is because I've had too many TIA's to count since '99. When my stress level increases so do my TIA's. I don't know when, where, or why they continue. I'm on low dose aspirin, Lexapro & Xanax everyday. The Xanax helps keep the TIA's under control, but doesn't stop them from occuring. The doctor's did confirm 2 years ago that the white matter in my brain has been increasing. I just wondered if you knew any other treatments or studies done in this area. I appreciate any feedback that you can provide. Thank you. :)

陽台 said...
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Peter G Levine said...

LSL, email me at:


Tamara said...

I often wonder if fatigue isn't caused by depression (or in my case dysthymia). A few years ago I asked my physiatrist for antidepressants, but he advised me not to take them. Since I began recovering I am drawn to mind-body medicine. Movies like You can heal your life with Louise Hay and books by dr. David Hamilton and Bernie Siegel. They give me hope and inspire me.

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