Exercise helps the brain to recover movements after a stroke. Here is how it happens!

Exercise stimulates the brain to create new neurons and new connections.

This is exciting news; this is how it happens, according to the researchers.

First, exercise stimulates neurons to release a special protein; the ” Brain-Derived Neurotrophic Factor” (in short, BDNF)1. This protein appears in the blood only as a response to exercise. Keep in mind researchers have shown its presence as a response to aerobic exercise1; however, they believe resistance type of exercise too may also stimulate neurons to release this protein.

Exercise matters to regain movements after a stroke; more the better.

What does this protein (BDNF) do?

Second, this protein triggers a series of changes in many areas of the brain. It includes the sprouting of new dendrites and synapses1 (see Figure 1). With these structural changes, repair work begins. This is a sort of remodelling. These new neurons and connections are essential to take over the jobs earlier carried out by dead neurons.

(This remarkable ability of the brain to undergo structural changes to face changing realities is commonly called “neuroplasticity”).

Aerobic exercise triggers the growth of new neurons and new connections (synapses) among neurons.

Mang et al. 2013; Physical therapy and Rehab. journal

However, there is a catch!

The exercise intensity level should cross a minimum threshold to release this protein.

The BDNF protein does not appear if the exercise attempts do not reach the required intensity threshold level. We have another important fact to remember: The intensity level and the BDNF level go hand-in-hand – the higher the intensity level more the release of BDNF level!

The exercise intensity should receive a certain threshold to release this BNF protein.

What is the minimum threshold?

It should be moderate-to-high intensity.

What is that?

Treadmill high-intensity interval training resulted in significantly high blood levels of BDNF at least 20 minutes when compared to treadmill moderate-intensity continuous exercise; that is what researchers have found out2.

What is the minimum threshold?

Other benefits of exercise

Mang et al. (2013)1 describe other types of assistance aerobic exercises provide to the brain’s recovery attempts.

Releasing messenger proteins

Researchers have uncovered that exercises stimulate neighbouring neurons to release messenger proteins such as dopamine and serotonin. Neurons require these proteins to communicate with each other fast and efficiently.

These are urgent requirements! Because the brain has to adapt to face new challenges after the stroke attack.

How do we know this?

New technologies such as Functional MRI (fMRI) help researchers to view the changes while someone is carrying out activities or exercises.

Increasing the brain’s blood flow

Exercises increase the blood flow to the brain; This is necessary because the neurons require food and more oxygen for their extra-duty work at present.

Increasing muscle strength

This is again really necessary to restart activities of daily living as early as possible. More importantly, muscle non-use results in irreversible muscle wasting.

Types of exercises and activities we should promote?

Certain rules apply here in promoting post-stroke exercises and activities; this post outlines what those rules are; Following posts discuss what those rules are;


  1. Cameron S. Mang, Kristin L. Campbell, Colin J.D. Ross, Lara A. Boyd, Promoting Neuroplasticity for Motor Rehabilitation After Stroke: Considering the Effects of Aerobic Exercise and Genetic Variation on Brain-Derived Neurotrophic Factor, Physical Therapy, Volume 93, Issue 12, 1 December 2013, Pages 1707–1716, https://doi.org/10.2522/ptj.20130053
  2. Boyne, P., Meyrose, C., Westover, J., Whitesel, D., Hatter, K., Reisman, D. S., Cunningham, D., Carl, D., Jansen, C., Khoury, J. C., Gerson, M., Kissela, B., & Dunning, K. (2019). Exercise intensity affects acute neurotrophic and neurophysiological responses poststroke. Journal of applied physiology (Bethesda, Md. : 1985)126(2), 431–443. https://doi.org/10.1152/japplphysiol.00594.2018

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