The Healing Power of Movement: Exercise in Recovery from Acquired Brain Injury and Stroke

What Is an Acquired Brain Injury (ABI)?

An Acquired Brain Injury (ABI) refers to any damage to the brain that occurs after birth. There are several reasons why an ABI can occur, with the most common causes including physical trauma (such as falls or accidents), infections, tumours, strokes, and lack of oxygen (asphyxiation). Symptoms can manifest physically, cognitively, and emotionally. Physical symptoms may include weakness, nausea, migraines, and seizures. Cognitive symptoms can consist of memory loss/alterations, slower processing, impaired judgement, attention issues, executive dysfunction and much more. Emotional symptoms are directly influenced by cognitive issues, resulting in emotional dysregulation that can lead to increased outbursts, irritability, anxiety, and depression (Healthdirect, Exercise is Medicine Australia). 

What is a Stroke

A stroke is the result of interrupted blood flow to the brain, which can happen either due to a blocked artery (ischemic stroke) or a ruptured blood vessel (haemorrhagic stroke). Without the oxygen-rich blood that is vital for brain function, neurons begin to die quickly. The extent of impairment resulting from a stroke varies depending on the specific regions of the brain that are affected.

Why Exercise Matters in ABI and Stroke Recovery

Exercise programs improve both functional capacity and quality of life (QoL) in individuals with ABI. Exercise rehabilitation and therapy is a crucial component in managing ABI symptoms. The best benefits are acquired through continuous personalised exercise plans, which can be created with exercise physiologists (like us!). Exercises that are beneficial include strength training, balance re-training, aerobic training, cardio, functional training, and much more. A major benefit from exercise plans is that it is highly adaptable, and can have its strenuous levels decreased or increased to meet the needs of the individual.

In stroke-specific populations, aerobic exercise has been found to be effective in improving cognitive recovery post-stroke (Frontiers).

Physical & Functional Advantages

  • Gait, mobility, and endurance: Using physical training exercises such as treadmill walking with body-weight support, aerobic workouts, and strength exercises can significantly improve walking speed, balance, and overall endurance in chronic stroke survivors. Another common exercise for stroke patients is aquatic-based exercises. This is quite popular due to its ability to decrease joint pains while building on mobility.

  • Neuroprotective benefits: Exercise enhances angiogenesis, supports brain blood flow via nitric oxide pathways, and stimulates neurotrophic factors like BDNF and VEGF—helping protect and repair neurons post-stroke (ScienceDirect).

  • Functional recovery across ABIs: TBI and other ABIs also respond positively to structured exercise, with notable gains in cognition and daily functioning (ScienceDirect).

Cognitive & Emotional Benefits

  • Regular physical activity boosts neuroplasticity, (the brains ability to create new neuron pathways and modify pathways as needed).

  • Studies with chronic stroke survivors engaging in 6-month, twice-weekly exercise programs have shown significant cognitive gains—compared to those doing only cognitive or social activities (Pathways Issue 8).

  • Short bursts of intense exercise (HIIT style) have been shown to double fitness gains (VO₂ max) compared to moderate workouts, and are well tolerated by stroke survivors (Business Insider).

  • Larger-scale epidemiological studies emphasize that pre-stroke physical activity is a stronger predictor of post-stroke functional independence than body fat or BMI (TIME).

  • Exercise also promotes healthy social activity. Joining a group class dedicated to ABI and stroke survivors can be a great way to receive both physical and emotional support. Working out alongside others also increases feelings of motivation and accountability towards sustained exercising.

Best-Practice Guidance in Australia

In Australia, the BRIDGES guidelines (“BRain Injury: Developing GuidElineS”) provide national, evidence-informed recommendations for exercise rehabilitation post-brain injury. These are supported by key bodies like the National Health and Medical Research Council, Australian Physiotherapy Association, Exercise & Sports Science Australia, and the Rehabilitation Medicine Society of Australia & New Zealand (IMHConnectivity).

Key Takeaways

  • Exercise is a cornerstone of brain injury rehabilitation—promoting physical, cognitive, and emotional recovery.

  • Early, tailored, and varied exercise interventions, including aerobic, strength, aquatic, and mind–body options, yield the best long-term outcomes.

  • Strategies to sustain long-term adherence, such as social engagement and tailoring activity to emotional well-being, are vital.

  • For a trusted, local resource, Stroke Foundation Australia remains an excellent portal for people seeking information on stroke support and rehabilitation.