Does aerobic exercise affect memory, attention, working memory, and fatigue after acquired brain injury? A single-blinded, randomized controlled pilot study.
Clinical Snapshot
PICO Framework
| P — Population | Adults aged 16-65 years with moderate to severe acquired brain injury (stroke or traumatic brain injury), at least 3 months post-injury, enrolled in outpatient rehabilitation |
| I — Intervention | Aerobic exercise 30 minutes, 3-4 times per week for 8 weeks plus standard rehabilitation |
| C — Comparator | Routine physical therapy plus standard rehabilitation |
| O — Outcomes | Cognitive function (memory, attention, working memory), fatigue, neuroplasticity measured by fMRI, and endurance |
Bottom Line
This small pilot RCT (n=12) found no significant between-group differences in cognitive function, fatigue, or neuroplasticity when comparing aerobic exercise to routine physical therapy in adults with acquired brain injury. While the exercise group showed improvement in one executive processing measure (PASAT), the control group improved in visual attention speed. The study's major limitations include very small sample size, inadequate blinding, and limited statistical reporting. These preliminary findings are insufficient to support routine prescription of aerobic exercise for cognitive rehabilitation after brain injury. The results highlight the need for larger, adequately powered trials with robust methodology before clinical recommendations can be made. Clinicians should continue following established rehabilitation guidelines while awaiting stronger evidence.
Key Findings
P Value: PASAT improvement in exercise group: p=0.042; Visual search improvement in control group: p=0.027
Effect Size: Not reported
Primary Outcome: No significant between-group differences for cognitive variables, fatigue, or neuroplasticity
Nnt Or Sensitivity: Cannot be calculated from available data
Confidence Interval: Not reported
Clinical Application
Moderate - requires structured exercise program and rehabilitation facility resources Relevant to Australian stroke and TBI rehabilitation services. May align with RACGP guidelines for post-stroke care and could potentially be supported through Enhanced Primary Care plans or private health insurance Adults with moderate to severe acquired brain injury in outpatient rehabilitation phase (>3 months post-injury)
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.
References
- 1.Ingólfsdóttir, E., Bergfeldt, U., Berthold Lindstedt, M., Bergfeldt, L., Li, T. Q., Jonsson, T., & Möller, M. C. (2026). Does aerobic exercise affect memory, attention, working memory, and fatigue after acquired brain injury? A single-blinded, randomized controlled pilot study. Journal of Rehabilitation Medicine, 58, Article 44745. https://doi.org/10.2340/jrm.v58.44745
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