{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T15:34:49Z","timestamp":1791300889283,"version":"4.1.0"},"reference-count":35,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"12","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Stroke"],"published-print":{"date-parts":[[2008,12]]},"abstract":"<jats:p>\n            <jats:bold>\n              <jats:italic>Background and Purpose\u2014<\/jats:italic>\n            <\/jats:bold>\n            Stroke often impairs gait thereby reducing mobility and fitness and promoting chronic disability. Gait is a complex sensorimotor function controlled by integrated cortical, subcortical, and spinal networks. The mechanisms of gait recovery after stroke are not well understood. This study examines the hypothesis that progressive task-repetitive treadmill exercise (T-EX) improves fitness and gait function in subjects with chronic hemiparetic stroke by inducing adaptations in the brain (plasticity).\n          <\/jats:p>\n          <jats:p>\n            <jats:bold>\n              <jats:italic>Methods\u2014<\/jats:italic>\n            <\/jats:bold>\n            A randomized controlled trial determined the effects of 6-month T-EX (n=37) versus comparable duration stretching (CON, n=34) on walking, aerobic fitness and in a subset (n=15\/17) on brain activation measured by functional MRI.\n          <\/jats:p>\n          <jats:p>\n            <jats:bold>\n              <jats:italic>Results\u2014<\/jats:italic>\n            <\/jats:bold>\n            T-EX significantly improved treadmill-walking velocity by 51% and cardiovascular fitness by 18% (11% and \u22123% for CON, respectively;\n            <jats:italic>P<\/jats:italic>\n            &lt;0.05). T-EX but not CON affected brain activation during paretic, but not during nonparetic limb movement, showing 72% increased activation in posterior cerebellar lobe and 18% in midbrain (\n            <jats:italic>P<\/jats:italic>\n            &lt;0.005). Exercise-mediated improvements in walking velocity correlated with increased activation in cerebellum and midbrain.\n          <\/jats:p>\n          <jats:p>\n            <jats:bold>\n              <jats:italic>Conclusions\u2014<\/jats:italic>\n            <\/jats:bold>\n            T-EX improves walking, fitness and recruits cerebellum-midbrain circuits, likely reflecting neural network plasticity. This neural recruitment is associated with better walking. These findings demonstrate the effectiveness of T-EX rehabilitation in promoting gait recovery of stroke survivors with long-term mobility impairment and provide evidence of neuroplastic mechanisms that could lead to further refinements in these paradigms to improve functional outcomes.\n          <\/jats:p>","DOI":"10.1161\/strokeaha.108.527531","type":"journal-article","created":{"date-parts":[[2008,8,29]],"date-time":"2008-08-29T01:50:13Z","timestamp":1219974613000},"page":"3341-3350","update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":240,"title":["Treadmill Exercise Activates Subcortical Neural Networks and Improves Walking After Stroke"],"prefix":"10.1161","volume":"39","author":[{"given":"Andreas R.","family":"Luft","sequence":"first","affiliation":[{"name":"From the Department of Neurology (A.R.L., R.F.M., F.I., D.F.H.), University of Maryland, School of Medicine, Baltimore, Md; the Department of Medicine, Division of Gerontology (R.F.M., L.W.F., F.I., J.D.S., L.K., A.P.G., D.F.H.), University of Maryland, School of Medicine, Baltimore, Md; the Division of Brain Injury Outcomes, Department of Neurology (A.R.L., D.F.H.), Johns Hopkins University, Baltimore, Md; the Department of Neurology (A.R.L.), University of Zurich, Switzerland; the Department of..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Richard F.","family":"Macko","sequence":"additional","affiliation":[{"name":"From the Department of Neurology (A.R.L., R.F.M., F.I., D.F.H.), University of Maryland, School of Medicine, Baltimore, Md; the Department of Medicine, Division of Gerontology (R.F.M., L.W.F., F.I., J.D.S., L.K., A.P.G., D.F.H.), University of Maryland, School of Medicine, Baltimore, Md; the Division of Brain Injury Outcomes, Department of Neurology (A.R.L., D.F.H.), Johns Hopkins University, Baltimore, Md; the Department of Neurology (A.R.L.), University of Zurich, Switzerland; the Department of..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Larry W.","family":"Forrester","sequence":"additional","affiliation":[{"name":"From the Department of Neurology (A.R.L., R.F.M., F.I., D.F.H.), University of Maryland, School of Medicine, Baltimore, Md; the Department of Medicine, Division of Gerontology (R.F.M., L.W.F., F.I., J.D.S., L.K., A.P.G., D.F.H.), University of Maryland, School of Medicine, Baltimore, Md; the Division of Brain Injury Outcomes, Department of Neurology (A.R.L., D.F.H.), Johns Hopkins University, Baltimore, Md; the Department of Neurology (A.R.L.), University of Zurich, Switzerland; the Department of..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Federico","family":"Villagra","sequence":"additional","affiliation":[{"name":"From the Department of Neurology (A.R.L., R.F.M., F.I., D.F.H.), University of Maryland, School of Medicine, Baltimore, Md; the Department of Medicine, Division of Gerontology (R.F.M., L.W.F., F.I., J.D.S., L.K., A.P.G., D.F.H.), University of Maryland, School of Medicine, Baltimore, Md; the Division of Brain Injury Outcomes, Department of Neurology (A.R.L., D.F.H.), Johns Hopkins University, Baltimore, Md; the Department of Neurology (A.R.L.), University of Zurich, Switzerland; the Department of..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fred","family":"Ivey","sequence":"additional","affiliation":[{"name":"From the Department of Neurology (A.R.L., R.F.M., F.I., D.F.H.), University of Maryland, School of Medicine, Baltimore, Md; the Department of Medicine, Division of Gerontology (R.F.M., L.W.F., F.I., J.D.S., L.K., A.P.G., D.F.H.), University of Maryland, School of Medicine, Baltimore, Md; the Division of Brain Injury Outcomes, Department of Neurology (A.R.L., D.F.H.), Johns Hopkins University, Baltimore, Md; the Department of Neurology (A.R.L.), University of Zurich, Switzerland; the Department of..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John D.","family":"Sorkin","sequence":"additional","affiliation":[{"name":"From the Department of Neurology (A.R.L., R.F.M., F.I., D.F.H.), University of Maryland, School of Medicine, Baltimore, Md; the Department of Medicine, Division of Gerontology (R.F.M., L.W.F., F.I., J.D.S., L.K., A.P.G., D.F.H.), University of Maryland, School of Medicine, Baltimore, Md; the Division of Brain Injury Outcomes, Department of Neurology (A.R.L., D.F.H.), Johns Hopkins University, Baltimore, Md; the Department of Neurology (A.R.L.), University of Zurich, Switzerland; the Department of..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jill","family":"Whitall","sequence":"additional","affiliation":[{"name":"From the Department of Neurology (A.R.L., R.F.M., F.I., D.F.H.), University of Maryland, School of Medicine, Baltimore, Md; the Department of Medicine, Division of Gerontology (R.F.M., L.W.F., F.I., J.D.S., L.K., A.P.G., D.F.H.), University of Maryland, School of Medicine, Baltimore, Md; the Division of Brain Injury Outcomes, Department of Neurology (A.R.L., D.F.H.), Johns Hopkins University, Baltimore, Md; the Department of Neurology (A.R.L.), University of Zurich, Switzerland; the Department of..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sandy","family":"McCombe-Waller","sequence":"additional","affiliation":[{"name":"From the Department of Neurology (A.R.L., R.F.M., F.I., D.F.H.), University of Maryland, School of Medicine, Baltimore, Md; the Department of Medicine, Division of Gerontology (R.F.M., L.W.F., F.I., J.D.S., L.K., A.P.G., D.F.H.), University of Maryland, School of Medicine, Baltimore, Md; the Division of Brain Injury Outcomes, Department of Neurology (A.R.L., D.F.H.), Johns Hopkins University, Baltimore, Md; the Department of Neurology (A.R.L.), University of Zurich, Switzerland; the Department of..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Leslie","family":"Katzel","sequence":"additional","affiliation":[{"name":"From the Department of Neurology (A.R.L., R.F.M., F.I., D.F.H.), University of Maryland, School of Medicine, Baltimore, Md; the Department of Medicine, Division of Gerontology (R.F.M., L.W.F., F.I., J.D.S., L.K., A.P.G., D.F.H.), University of Maryland, School of Medicine, Baltimore, Md; the Division of Brain Injury Outcomes, Department of Neurology (A.R.L., D.F.H.), Johns Hopkins University, Baltimore, Md; the Department of Neurology (A.R.L.), University of Zurich, Switzerland; 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