The Aphasia Physical EXercise (APEX) study: feasibility of a new high-intensity functional interval training for stroke survivors with aphasia.
Maria V Ivanova, Michelle Gravier, Christian Thompson and 5 others
PMID 42769467WHAT IT FOUND
High-intensity interval training was safe and well attended by 6 stroke survivors with aphasia, but language and cognitive changes did not reach significance; aerobic endurance improved.
Key findings
01No adverse events were documented, one participant withdrew after the 11th class for an unrelated musculoskeletal injury, and attendance among completers was 97.9%.
02Letter fluency improved by an average of 4.3 words, and sentence comprehension and category fluency showed positive change, but these language changes did not reach statistical significance.
03Aerobic endurance improved from an average of 91 to 111 steps on the 2-minute step test, and all 6 participants improved; greater aerobic gains were associated with greater letter fluency and sentence comprehension gains.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for SLPs
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What it does not show
Only 7 participants were recruited and 6 were analysed, so the study cannot show whether the exercise works for aphasia. There was no control group, so changes could reflect practice effects, time, or spontaneous recovery. Participants had mild-to-moderate aphasia and could walk independently, so results do not apply to more severe aphasia or greater mobility restrictions. Language and cognitive improvements were exploratory and did not reach statistical significance; minimal clinically important change thresholds are not established for most measures. Individual speech-language therapy was stopped during the study, and no psychosocial outcomes or neuroimaging or biomarker measures were collected.
The easy way to misread this
Do not read the letter fluency gain of 4.3 words or the 2-minute step test rise from 91 to 111 steps as proof that this exercise improves aphasia. The language and cognitive changes were not statistically significant, the study had no control group, and only 6 participants were analysed.