Post Ischaemic Stroke Cardiovascular Exercise Study (PISCES)

Ischemic stroke (i.e., the temporary reduction in blood flow to a part of the brain leading to brain injury) and dementia (i.e., the progressive reduction in thinking skills, behaviour, mood, and the ability to live independently, due to brain volume loss) are the two leading causes of death, disability, and reduced quality of life in our society, and research suggests that the former is a major risk factor for the latter.

Aims

The aim of this project is to determine whether aerobic exercise after stroke can help to preserve brain volume and function, as well as general physical and psychological well-being.

We hypothesise that participants who undertake prescribed aerobic exercise (i.e., tailored exercise that increases heart rate and breathing) after stroke will have preserved brain volume and neurocognitive performance, higher mood levels, and better end-organ disease state (i.e., fewer recurrent strokes, improved blood pressure, reduced cardiovascular disease) compared to participants who do not undertake aerobic exercise.

For this reason, it is important to understand how to protect the brain after ischaemic stroke.

Exercise is a simple, yet effective, method of improving cardiovascular health. We will examine if exercise after stroke can protect against brain atrophy and cognitive decline.

Results from this study will provide information on the relationship between stroke, physical activity, brain health, and dementia. Our findings will establish whether exercise after stroke can prevent brain atrophy, cognitive impairment, and general cardiovascular disease, or at the very least, minimise their occurrence. A prescribed and tailored exercise programme could offer a simple and economically viable solution to patient care.

The investigators involved in this study have both the research and clinical experience in the fields of stroke, dementia, neuroimaging, neuropsychology, and prescribed exercise to ensure both scientific rigor and participant safety.

Methods:

This is a pilot study where we will recruit ischaemic stroke participants within two months of their events.

At two months post-stroke, participants will be randomly allocated to one of two exercise groups:

Very low intensity activity, or aerobic activity.

Both exercise programmes will follow an eight week course.

In total, there will be three assessment time points:

Two months post-stroke: The baseline assessment before exercise intervention;

Four months post-stroke: Immediately after exercise intervention; and 12 months post-stroke.

We will measure the following at each time-point: brain volume, using the latest neuroimaging techniques, cognitive function, cardiovascular state, mood levels, general body fitness, and select blood biomarkers.

Progress:

The project has received ethics approval and is about to start participant recruitment.