Protecting the Brain From Post-Stroke Cognitive Impairment and Dementia With Multimodal Exercise Training
McGill University
126 participants
Jan 1, 2026
INTERVENTIONAL
Conditions
Summary
The rates of cognitive decline and dementia after stroke are disproportionately high. Strategies that can protect the brain early after the stroke event could reduce the future risk of cognitive decline and dementia in these patients. Although physical exercise is usually recommended after stroke, there is very little information about the protective effect of exercise implemented in early stages of recovery as a potential protective measure against cognitive decline and dementia risk in these patients. This study will investigate the effect of a multimodal exercise intervention implemented early after the stroke event on cognition and on a selected group of markers that can predict cognitive decline and dementia risk.
Eligibility
Inclusion Criteria2
- have had a first-ever ischemic/hemorrhagic stroke confirmed by MRI/CT 0-6 months prior to participation.
- Able to independently walk at least 10 meters (assistive devices permitted) and capable of following instructions will be required.
Exclusion Criteria6
- Diagnosed with dementia
- Absolute contraindications to exercise or MRI scanning
- Significant disability (modified Rankin score >3)
- Severe untreated depression (Beck Depression Inventory II score >28)
- Participants will be excluded if they have been engaged in a structured exercise training program outside their regular in/out-patient hospital rehabilitation since suffering the stroke.
- Co-morbidities that preclude exercise participation, pain worsened with exercise, and communication (e.g., severe aphasia) or behavioral issues limiting safe participation will also be reasons for exclusion.
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Interventions
Training sessions, which will include resistance training followed by cardiovascular training, will start with 3 minutes of warm-up and end with 2 minutes of cool down. Resistance training (20 minutes) will involve one day of upper limb, one day of lower limb and one day of full body exercises involving major muscle groups. Workloads will be increased from moderate (50-69% 1-RM; RPE=12-13) to vigorous intensities (70-85% 1-RM; RPE=14-17) by adding movement modifications and/or increasing resistance to ensure progressive overload and maximize adaptations. The first 4 weeks of cardiovascular training will involve 20 minutes of continuous exercise at moderate intensities (40-60% HRR; RPE=12-13). The following 4 weeks, will involve 3x4 minutes (long) high intensity interval training (HIIT) at moderate to vigorous intensity (60-80% HRR; RPE=14-16). The last 4 weeks will involve 10 blocks of 1x1 minutes (short) HIIT at vigorous to maximal intensities (80-100% HRR; RPE=17-20).
Sessions will be performed at light intensity (\<40% HRR) and finalize with a 5-minute cool-down. During the 40- minute main session, exercises involving balance, toning and stretching will be performed. Participants will progress through increasingly challenging exercises (e.g., reduce base of support in balance exercises), but they will aim to maintain a HRR \<40%.
Locations(2)
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NCT07445841