Therapeutic Importance of Exercise in Neuroplasticity in Adults with Neurological Pathology: Systematic Review.

Neuroplasticity is an essential mechanism by which the nervous system shapes and adapts according to functional requirements. Evidence suggests that physical exercise induces a cascade of cellular processes that favours brain plasticity. The Brain Derived Neurotrophic Factor (BDNF) is a neurotrophin closely linked to neuroplasticity that can be increased due to exercise. To verify the effects of therapeutic exercise on neuroplasticity and/or peripheral BDNF levels in neurological conditions in adults, such as stroke, Parkinson's and Alzheimer's diseases and mild cognitive impairment and address its clinical relevance in the treatment of neurological dysfunctions. A systematic review was carried using PUBMED, Web of Science and Scopus databases. Inclusion criteria were: randomized controlled trials or pilot studies; humans with age > 18 yrs with neurological condition; English language; score ≥ 6 in PEDro Scale (moderate to high quality). Reviews, meta-analyses and other articles that did not meet the criteria were excluded. The PRISMA methodology was applied for studies' selection. A total of 9 studies were selected for a systematic and comprehensive analysis. According to these studies, moderate to high intensity aerobic exercise (AE), increases the level of peripheral BDNF and positively influences functional gains in neurological conditions. Larger outcomes are observed in protocols with minimum session duration of 30 minutes, frequency of 3 times/week and intervention duration of 4 weeks. Current evidence shows that moderate to high intensity AE induces neuroplasticity in neurological patients, thus being a fundamental therapeutic strategy to include in interventions aiming to repair/delay neurological dysfunctions.