Eighty-five-year-old Les scans the New York Times crossword puzzle, considers one of the clues and, with practiced care, writes in the answer. It’s a daily ritual that wouldn’t have been possible a few years ago.

“I still have difficulty with my arm some days, but nothing like it was,” recalls the retired school teacher and musician.

When he was in his mid-seventies, Les suffered a stroke that paralyzed his right arm and hand.

“I lost all feeling. I was unable to cut my own food or play the fiddle anymore,” he says.

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About stroke

Stroke — the third leading cause of death in Canada — occurs when blood vessels in the brain become narrowed or blocked, preventing the brain from getting the oxygen and nutrients it needs.

Within a matter of minutes, if blood flow isn’t restored, brain cells begin to die, causing temporary or, in severe cases of stroke, more permanent loss of muscle movement and control, as well as cognitive impairments, ranging from mild memory loss to dementia-like symptoms.

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Eager to regain his strength and motor control, Les quickly turned his attention to rehabilitation. He signed up as a participant in a six-month UBC study examining the benefits of exercise for stroke survivors. Several times a week Les pushed himself, taking part in everything from aerobic to resistance training. Over time, he built his strength and slowly regained the motor control he had lost.

But, as UBC researchers have revealed, the healing power of exercise for stroke survivors like Les goes beyond the physical.

“We now know that exercise also improves cognitive function after stroke,” says Dr. Teresa Liu-Ambrose, a professor in the Department of Physical Therapy and Tier 1 Canada Research Chair in Healthy Aging.

“Whether it’s brain fog or more extreme memory loss, cognitive impairments are a common consequence of stroke and can profoundly impact a person’s quality of life and independence. It also puts them at increased risk of dementia,” she says.

“Through our research, we’ve demonstrated that exercise is essential to brain recovery and plays a key role when it comes to improving cognitive function after stroke,” Dr. Liu-Ambrose says.

Together with UBC’s Dr. Janice Eng, a professor in the Department of Physical Therapy and Tier 1 Canada Research Chair in Neurological Rehabilitation, Dr. Liu-Ambrose ran the world’s longest study examining the effect of exercise on cognitive function among people with chronic stroke.

They found that chronic stroke survivors who participated in the six-month exercise training program — which involved 60-minute classes of strength, aerobic, agility and balance exercises, twice weekly — experienced significant and unexpected cognitive gains. Meanwhile, those who participated in cognitive or social activities, or were assigned to the stretching and toning control group, experienced no change in cognitive function.

“The incredible thing about the brain is that it constantly continues to change, so every time you take an extra step or do a hand exercise, you’re helping the brain make new connections.”

– Dr. Janice Eng

The study findings hold great promise for chronic stroke survivors, defined in the study as those 12 months past their initial symptom: “While the most rapid recovery typically occurs within the first three months after stroke — a period during which the brain enters a heightened state of neuroplasticity — this study shows that improvements are still possible well beyond that initial mark,” Dr. Eng says.

As director of the neurorehabilitation research program at UBC, Dr. Eng has been a strong proponent of exercise as part of the recovery journey for stroke survivors. 

“The incredible thing about the brain is that it constantly continues to change, so every time you take an extra step or do a hand exercise, you’re helping the brain make new connections,” she says.

Dr. Liu-Ambrose and Dr. Eng’s findings are particularly important because cognitive function has been largely overlooked in post-stroke care. Exercise, as a tool to improve cognitive function in older adults with chronic stroke, has also been shown to be cost-effective.

Dr. Eng and her research team have developed a number of stroke rehabilitation exercise programs — including a group exercise program known as FAME (Fitness and Mobility Exercise Program), which recently received federal funding to support its expansion to communities across the province. They have also developed an arm-and-hand exercise program which is now offered in hospitals and health centres around the world, from India and Australia to Kuwait.

Today, Dr. Eng and Dr. Liu-Ambrose are continuing to expand their work, with the hopes of shedding new light on ways to promote brain health and make a difference in the lives of stroke survivors.

For Les, staying physically and mentally active remains an important part of his life.

 “If exercise can help me live a longer, healthier life, and — most importantly — keep me ‘ticking between the ears,’ then I’m all for it,” he says with a smile.