The Neurological Exercise Training (NExT) program: A pilot study of a community exercise program for survivors of stroke.

BACKGROUND: Many survivors of stroke face chronic disability and increased risk for recurrent stroke. Regular physical activity can reduce these risk factors and improve cardiovascular fitness. Most survivors of stroke face barriers to exercise, including lack of access to programs; as a result, most are sedentary. OBJECTIVE: Pilot the Neurological Exercise Training (NExT) program or survivors of stroke for attendance, safety, and effectiveness. METHODS: The NExT program was designed to promote self-directed exercise in a safe, accessible environment. Six participants attended as desired during open gym hours over two exercise periods per week totalling 19 weeks. After, participants were encouraged to continue exercise away from the gym for 20 weeks. Practicability of the program was assessed through safety, attendance, exercise intensity, and perception of the program. Pilot effectiveness measures were performed at five time points and effect sizes were generated. RESULTS: Attendance averaged 76% (SD12%) of possible sessions with an average duration of 62 (SD 11.3) minutes. Effectiveness measures had positive effect sizes after 19 weeks of the NExT program, but these benefits were lost after 20-weeks (cohen's d, mobility = 0.67 to -0.22, balance = 0.57 to -1.22, strength = 0.41 to -0.30, endurance = 0.09 to -0.19 and fatigue = 1.02 to -0.57). CONCLUSION: Results demonstrate that a community-based gym that is accessible for survivors of stroke will be well attended and perceived as beneficial. Pilot data suggests positive changes in multiple health domains regardless of the type of exercise self-selected by participants. Offering the gym on a continual basis may maintain gains.

Should we pay attention to eye movements? The impact of bilateral eye movements on behavioral and neural responses during the Attention Network Test.

Bilateral eye movements (EMs) have been associated with enhancements in episodic memory and creativity. We explored the influence of EMs on behavior and event related potential (ERP) responses during the Attention Network Test (ANT). Participants completed ANT trials after bilateral EMs or a center-fixation control manipulation. We examined condition (EM, control) and handedness (consistent, inconsistent) differences for overall task performance, as well as alerting, orienting, and executive attention networks. Behaviorally, there was a trend for inconsistent-handed participants to display faster RTs across cue types, and greater accuracy for no cue, double, and center cue trials when compared to consistent handers, yet consistent handers garnered greater improvements in behavior following altering and orienting cues than inconsistent handers. Although there were no behavioral differences between EM and control conditions, target-locked N100 and P200 ERPs were weaker in the EM than control condition for all cue types, except spatial cues for which there were no differences between groups. Because stronger N100 and P200 responses have been linked to increased selective attention, we speculate that ERP differences between EM and control conditions, in the absence of behavioral differences, may indicate that participants exposed to EMs required less selective attention to successfully complete the task.