Neuroplasticity is the ability of the brain to physiologically change due to our experiences. There is accumulating evidence for the benefits of a single session of aerobic exercise to enhance motor learning and neuroplasticity in young adults. Stationary cycling exercise performed immediately before or after skilled motor practice enhances motor learning that involves movements of the nonexercised upper limb. Also, several studies have shown increased neuroplasticity in the brain’s motor system (i.e., the motor cortex) following acute aerobic exercise. This increase in capacity for neuroplasticity in the motor system is thought to support previously observed exercise-induced enhancements to motor learning.

One way that we can measure neuroplasticity in humans is by using transcranial magnetic stimulation to assess changes in the excitability of the motor cortex before and after an intervention. In young adults, acute aerobic exercise of various intensities and types (e.g., continuous, interval) can enhance the excitability of the nonexercised upper limbs (e.g., hand and wrist representation in the brain). However, it was not known if healthy older adults respond similarly.

Typical aging is accompanied by decreases in motor cortex excitability, which have been associated with poorer coordination, fine motor control and motor learning. Therefore, it is important to understand whether acute aerobic exercise might be used to ameliorate these age-related decreases in motor cortex excitability.

In our study, published in the April 2022 issue of Medicine & Science in Sport & Exercise_®, we investigated the neuroplasticity that occurs following a high-intensity interval training (HIIT) exercise session in healthy older adults. We studied 42 healthy older individuals (average age = 66 years) who completed a 23-minute bout of HIIT (alternating three-minute bouts of high- and low-intensity) or seated rest. We measured motor cortex excitability using transcranial magnetic stimulation before, immediately after and 30 minutes after HIIT or rest.

Contrary to our hypothesis, we discovered that corticospinal excitability (the summation of cortical excitability sent out from the motor cortex to the body to contract our muscles) increased following HIIT, when compared to rest, 30 minutes post exercise. Unlike previous findings we observed in young healthy individuals, there were no changes in cortical inhibition or facilitation (circuits that impact the output of corticospinal excitability). These findings indicate that acute HIIT increases neuroplasticity as measured by an increased corticospinal output to the nonexercised arm muscles in older adults.

We think the increased corticospinal excitability may have resulted from older adults having lower baseline excitability compared to younger adults. In turn, a lower baseline may have created the potential for increased excitability after HIIT exercise. Also, our participants showed high levels of daily physical activity (greater than that currently recommended by the American College of Sports Medicine_® [ACSM]). Previous work in young adults showed that acute aerobic exercise increased corticospinal excitability in those who were categorized as regularly physically active. Future studies should investigate the role of daily physical activity and cardiorespiratory fitness on baseline and exercise-induced increases in corticospinal excitability in older adults.

Our results suggest that acute aerobic exercise promotes neuroplasticity in distinct ways across the lifespan. Thus, the current findings are important to consider for the prescription of acute bouts of exercise in aging populations and rehabilitation contexts.

Jason Neva, Ph.D., is a neuroscientist and kinesiologist. Dr. Neva an assistant professor in the School of Kinesiology and Physical Activity Sciences at the University of Montreal in Canada, as well as a research and laboratory director at the Research Centre of the Montreal Geriatrics Institute (CRIUGM, French acronym). His research focuses on the neuroplasticity mechanisms that support motor learning, change in response to exercise and improve motor function in aging-related neurological conditions (i.e., stroke, Parkinson’s disease). Dr. Neva uses transcranial magnetic stimulation and other neuroimaging techniques in his work.

Lara Boyd, P.T., Ph.D., is a Wall Scholar and professor in the Department of Physical Therapy at the University of British Columbia. She directs the Brain Behaviour Lab and is a member of the Djavad Mowafaghian Centre for Brain Health. Dr. Boyd is an expert in the neurobiology of learning and uses advanced brain imaging approaches (MRI and transcranial magnetic stimulation) to look into the brain. Dr. Boyd’s research is centered on understanding how behavior shapes learning, unlearning and relearning.

Viewpoints presented in SMB commentaries reflect opinions of the authors and do not necessarily represent ACSM positions or policies. Active Voice authors who have received financial or other considerations from a commercial entity associated with their topic must disclose such relationships at the time they accept an invitation to write for SMB.

From a physiological perspective, long-distance running performance is determined by the interaction of three factors: maximal oxygen uptake, the highest oxygen uptake that can be sustained (at steady-state) and running economy (the amount of oxygen required to transport the body mass over a given distance). While each one of these factors is important to performance, running economy can be improved in the time taken to change a pair of shoes.

Highly cushioned running shoes, which have been shown to considerably improve running economy, have gained the title of “super shoes” and are used by runners around the world.

However, research examining their potential performance-enhancing effects has been performed with the athlete in a well-rested state, which is not typical. For example, during running, the body is subjected to substantial vertical loading (equivalent to approximately 2-3 times body weight). During the course of a marathon, in which a runner may strike the ground >35,000 times, the accumulative impact load may cause microscopic damage to skeletal muscle, altering its structure. Similarly, muscle damage may be observed during the course of a normal endurance-training program where tissue strain supersedes tissue tolerance — think plyometrics, strength training, downhill running or even high weekly mileage. This change to the microscopic structure of the muscle is known to impair running economy. Given the importance of running economy to long-distance running performance, an intervention that improves running economy in the absence and presence of muscle damage would be highly advantageous.

In our study, published in the April 2022 issue of Medicine & Science in Sport & Exercise_®, we examined the influence of highly cushioned shoes on running performance and economy. We did this in both the absence and presence of appreciable muscle damage caused by an extreme downhill run. We found that when exercising in a well-rested state, highly cushioned shoes improved running performance. This coincided with improved running economy, such that there was an increase in the speed corresponding to a blood lactate concentration of 3 mM. We also observed improvement in running economy during exercise in the presence of muscle damage. Based on the observed improvements in running economy, we would expect marathon running speed to increase by ~0.35 km·h^-1. If we assume this effect is maintained over the entire marathon, it could translate to a whopping nine-minute improvement in race time. Thus, the potency of chosen footwear to overcome the detriments elicited by muscle damage is not to be underestimated.

Highly cushioned shoes may enable the absorption of greater training loads for the same perceived effort and may have contributed to the improved race performances observed since the advent of super shoes. We did observe considerable differences between participants in the improvement in running economy afforded by the highly cushioned shoes that was not related to sex, body mass or maximal oxygen uptake. The beneficial effects of highly cushioned shoes will vary. Thus, individuals will need to evaluate differences to determine which model shoe is optimal for them. Further research is needed to better understand, and optimize, the participant-shoe interaction during training and competition.

Matthew I. Black, Ph.D., is a postdoctoral research fellow in the Applied Physiology, Nutrition and Metabolism research group with the School of Sport and Health Sciences at the University of Exeter, UK. Dr. Black’s research expertise spans the two broad areas of this group, focusing on (1) skeletal muscle bioenergetics and oxygen delivery and utilization as modulators of exercise (in)tolerance in health and disease and (2) therapeutic and ergogenic applications of manipulating nitric oxide bioavailability via dietary interventions.

Andrew M. Jones Ph.D., FACSM, is a professor of applied physiology at the University of Exeter, UK. Dr. Jones conducts research in muscle oxidative metabolism, the causes of exercise-related fatigue, the kinetics of pulmonary gas exchange, and sports performance physiology and nutrition. Dr. Jones has published >300 peer-reviewed scientific articles, and his work has received >33,000 citations. As a former international-level runner, Dr. Jones has a keen interest in the translation of his research to elite sports performance, and he has served as a consultant to UK Athletics, the English Institute of Sport and Nike, Inc.

Viewpoints presented in SMB commentaries reflect opinions of the authors and do not necessarily represent ACSM positions or policies. Active Voice authors who have received financial or other considerations from a commercial entity associated with their topic must disclose such relationships at the time they accept an invitation to write for SMB.

“My child is no longer involved in occupational therapy or physical therapy, so he’s not moving as much. What should I do … ?”

This is a conversation I have had many times over the last 18 years. Parents call my organization, Exercise Connection, in their search to find a logical next step. What they are surprised to learn is that the benefits of exercise go beyond health for someone on the autism spectrum.

Occupational therapy (OT) and physical therapy (PT) are part of the early intervention plan when a child is diagnosed with autism, and these services typically continue as the child progresses through school. While OT and PT focus on a variety of functional skills and are therapies that involve gross-motor movement, they don’t meet the child’s daily physical activity requirements. Even though physical education is mandated in schools in the United States (which many parents aren’t aware of, BTW), many children with disabilities are not receiving it. These services end when their child achieves their goal or ages out of school, leaving parents wondering what’s next.

Many parents conclude that it’s exercise. As fitness professionals, we have an opportunity to fill this gap for the autism community and simultaneously expand our customer base. If you embark on this mission, you will not only get tremendous satisfaction but will gain an audience that really needs in-person training. Autism is the world’s fastest growing developmental disability and can no longer be ignored. Inclusion is a worldwide topic and should include fitness centers and gyms. When those with autism come into your gym, you need to be prepared to teach them. To do so, you’ll also need to understand their parents.

Sales approach vs. sales empathy

Before I found my mission (or the mission found me) of teaching exercise to persons with autism, I spent time in a big box gym as a personal trainer. They hired me for my experience in working with children. I went through their sales training because my boss wanted to show me “how it’s done.” He was using the same sales approach as if he was talking to a middle-aged, overweight man who was wavering on committing to 10 personal training sessions. As you might have guessed, it was a complete disconnect for the parents. As a result, the gym wasn’t “closing the sale,” but rather closing the door on children who were almost there.

Engaging with this community requires a different understanding. Parents of those with autism have been sold false hope and “snake oil” for years. Most are frustrated, exhausted and just trying to get through the day. Fancy exercise physiology language won’t impress them. Instead, focus your eyes and attention on their child, asking questions to him/her (whether they can talk or not). Educate the parents about the benefits of exercise, and have the research on hand. Give them time (both the parent[s] and the child) to process the information, tour the facility and not be rushed. When done right, you will give parents hope that their child can reach their fullest potential. And they will sign up.

Be respectful — sell one session, not ten. The parent will appreciate the fact that your goal is to have their son or daughter want to return for their second session. If you do that, you will be building a foundation to have a client for life. That is the win.

Related content: 
CEC Course | Autism Exercise Specialist
Blog | 3 Key Elements to Successfully Training Children with Autism
Video | Overview of Autism Webinar 1

David S. Geslak, BS, ACSM-EP, the founder of Exercise Connection, has pioneered exercise tools and programs to engage and improve the lives of those with autism. David also created the Autism Exercise Specialist Certificate (AESC) in partnership with ACSM. He has trained professionals around the world on the AESC. His commitment and methodology to bringing exercise to persons with autism has been enthusiastically embraced by professionals, higher education, and the autism community.

The Annual Meeting is BACK and this year we will be in-person in San Diego, CA! I am excited to share with you the interdisciplinary content that will be presented each day of the 2022 ACSM Annual Meeting in the Biomechanics and Neural Control of Movement topical area.

The Biomechanics and Neural Control of Movement content will kick off on Wednesday, June 1, 9:30 AM – 11:30 AM with a thematic poster session on Running Injury. Our other free communication sessions include: a rapid-fire podium session titled, “Gait Markers of Physical Activity and Health Status” (Thursday, June 2, 9:30 AM – 11:00 AM); a thematic poster session titled, “ACL Injury: Prevention & Rehabilitation Strategies” (Friday, June 3, 9:30 AM – 11:30 AM); a podium session titled, “Aging Interventions” (Friday, June 3, 3:45 PM – 5:45 PM); and 159 posters including poster sessions dedicated to concussions, biomechanics of military health, measuring biomechanics in the wild, sports medicine biomechanics and running performance, among other great topics.

Our showcase highlighted symposium this year will be “Extending Human Movement Research from the Lab into the Field,” on Wednesday, June 1, 1:00 – 3:00 PM. Presenters include Clare Milner, Ph.D., FACSM; Robin Queen, Ph.D., FACSM; Emily Matijevich, Ph.D.; and Kellee Hanigan, Ph.D., PT; chaired by Allison Gruber, Ph.D., FACSM. Technological developments in wearable technology have allowed gait biomechanics to be measured in more natural and ecological environments than the laboratory. However, concerns regarding data accuracy often outweigh the potential benefits of using wearables to measure free living gait for clinical and research purposes. This symposium will address these pitfalls by highlighting the technical and practical considerations of using wearable technology to measure gait out-of-the-lab with in-lab quality, validity and precision. Discussion topics also include differences in gait performed in- versus out-of-lab, considerations for data collection and management, estimating internal musculoskeletal loads from externally worn sensors and accounting for missing data. This session is unopposed by other biomechanics and neural control of movement offerings to give everyone the opportunity to attend.

The other symposia and tutorial sessions for the Biomechanics and Neural Control of Movement topical area include sessions presented across other ACSM topical areas and interest groups:

Thursday, June 2, 2:40 – 3:30 PM: “Epidemic of UCL Injuries in Adult and Youth Baseball Pitchers - Causes and Prevention Strategies,” presented by Rafael F. Escamilla, Ph.D., and Arnel Aguinaldo, Ph.D. This colloquium will evaluate elbow biomechanics during pitching as well as UCL rehabilitation and training strategies to decrease UCL injury risk in adult and youth baseball pitchers.

Friday, June 3, 9:30 – 11:30 AM: “Measuring and Modeling Load Carriage,” presented by Anne Silverman, Ph.D.; Kari L. McKenzie, Ph.D.; Jennifer Neugebauer-Sperlein, Ph.D.; and Karen R. Kelly Ph.D.; chaired by Pinata Sessoms, Ph.D. The amount of load carried is only one of many factors that influences musculoskeletal injury risk and physiological performance. Changes in how load is carried or training programs for service members could reduce injury risk. This symposium will present different approaches being used to analyze load carriage related to injury prevention and the unique information each provides with regards to injury prevention and performance.

Saturday, June 4, 8:00 – 8:50 AM: “Treating the Mechanistic Determinants of Muscles Weakness after ACL Injury: Translating the Science into the Clinic,” presented by Lindsey Lepley, Ph.D., ATC, and Riann Palmieri-Smith, Ph.D. ATC. This session will present the mechanisms by which muscle strength is lost after ACL injury and evidence in support of alternative exercise interventions to optimize muscle recovery after injury.

Saturday, June 4, 9:00 – 9:50 AM: “Tai Chi for Fall Prevention - Application and Critical Factors for Success,” presented by Li Li, Ph.D., FACSM. This tutorial lecture will present the scientific basis and the benefits of integrating Tai Chi practice into a fall prevention program for people among a wide spectrum of different groups.

There are several other sessions that will be of interest to biomechanists and motor controlists that are being presented under other topical areas. Two of these great sessions include: “Preventing Bone Stress Injuries in Athletes: What do we Know and What are the Knowledge Gaps?” (Wednesday, June 1, 3:15 PM – 5:15 PM) presented by Stuart Warden, Ph.D, FACSM; Vanessa Yingling, Ph.D., FACSM; Eimear Dolan, Ph.D.; and Craig Sale, Ph.D. (chair); and “Using an Evolutionary Approach in the Prevention of Running Injuries” (Friday, June 3, 3:45 PM – 5:45 PM) presented by Daniel Lieberman, Ph.D.; Adam S. Tenforde, M.D., FACSM; Irene S. Davis, Ph.D., PT, FACSM; and Jacob Hofer, Ph.D (chaired by William O. Roberts, M.D., MS, FACSM).

The Biomechanics Interest Group (BIG) will be hosting their meeting on site, Thursday, June 2. Stay tuned to their website and Twitter for details about the event as they become available. The BIG meeting will include a social event, awards ceremony and a talk by the 2022 ACSM-BIG Career Achievement Award Winner.

Allison H. Gruber, Ph.D., FACSM, is an Associate Professor of Kinesiology in the Indiana University School of Public Health – Bloomington. She is the Topical Representative for Biomechanics and Neural Control of Movement and a previous chairperson of the ACSM Biomechanics Interest Group. Her research interests include the mechanisms of running-related musculoskeletal injuries, wearable technology and using advanced analysis techniques to better understand biomechanical signals for gait analysis. Symposia, tutorial and colloquium summaries were provided by the submitter.

Wellcoaches created the animated movie How Coaching Works to explain health and well-being coaching when the field was in its infancy. Now with almost 2 million views, the video remains a useful illustration of the best qualities of a helping relationship. This blog series aims to share the psychological underpinnings of the cartoon. This current installment, the second in the series, simplifies the script for coach-client dialogue.

Scene One: MEET

Coach: Hello. Thanks for meeting today. Let’s begin by having you tell me more about what you hope for most for your life. Who would you be if you were at your best?

Client: I would engage in activities that energize me, strive for optimal health, and live life with gratitude and a sense of purpose every day. I’ve been thinking about this for a while, but when I start, it doesn’t last — it doesn’t get done. And when I think about all of the things that get in my way, I’m overwhelmed.

Coach: Wow! That’s an appealing vision, and I hear your deep yearning to get there. Let’s talk about how we can work together. I’ll help you construct a roadmap to your future. You’ll bring a wealth of insight about what works for you and what doesn’t. With the help of my toolbox, you’ll get it done. Let’s explore more about your life today.

Scene Two: VISION

Coach: Tell me more about that vision. What is important to you about it?

Client: Taking control of my life. I’ve let my priorities get out of order.

Coach: Why now?

Client: Life is going quickly, and I realize that I don’t want it to pass me by. I used to have big dreams … and then work and family responsibilities got in the way.

Coach: What will be possible when you achieve it?

Client: I’ll feel proud of myself and have more confidence. I think that’s what I miss most about my younger self — feeling like I can do anything.

Coach: When you are at your best, you are confident and optimistic that you can achieve anything you set your mind to. Let’s expand your vision to address what strengths you’ll apply to get there, your major challenges, and some of the strategies you might use to rise above your challenges.

Scene Three: THE PLAN

Coach: Let’s start working on how you will get to the vision you yearn for. What is the first thing you’d like to be doing in three months that would get you closer?

Client: That’s a good question. The first thing I’d like to be doing in three months is spending time with my spouse most evenings.

Coach: What do you mean by spending time?

Client: We used to play games together; that was always fun. Or, taking walks — I see couples doing that and always think, “How lovely.”

Coach: What would be the benefits of spending more fun time with your spouse?

Client: I always feel less stressed when I take time to relax. And my spouse is my best friend; I always feel better about myself when we have time to be together. We talk about new things to pursue together.

Coach: So, if you were to set a goal around this for the next three months, how would you write it? Let’s make it very specific and detailed. How much time would be enough to energize, relax and inspire you?

Client: By the end of three months, I’d like to spend two evenings and one half day on the weekend together.

Coach: Would you be willing to change the language to say, “I will spend two evenings and one half day on the weekend with my spouse”?

Client: Yes, that sounds great!

Coach: Let’s work on the rest of your plan. What’s the second goal you’d like to pursue in the next three months? (They continue the conversation, addressing additional goals.)

Scene Four: THE JOURNEY

Coach: Now let’s work on the first step you’ll take toward your three-month goals and your vision. What’s a small step you can take next week?

Client: I’m not really sure. I’m so busy with work in the evenings and weekends, and it’s been hard to take time out for myself, let alone spend time with my spouse.

Coach: You’re feeling overwhelmed right now because on one hand, it’s important to you to spend time with your spouse and, on the other hand, you are committed to doing a good job at work.

Client: Yes, exactly. But I know in the end, my spouse and my health are precious, and I feel badly that they are not higher on my priority list.

Coach: Tell me about a time when you and your spouse were taking time for each other. What was happening when you felt really connected?

Client: Let me think about that … when we first got together, we used to take walks in the park near our home every night. After dinner, we would go for a 15- or 20-minute walk, just to digest our food and talk about our days.

Coach: What did you enjoy about that?

Client: Talking, being best friends … it also felt great to get outside at least once a day.

Coach: You loved being connected to your spouse, and you benefited from the exercise and fresh air.

Client: Yes, we never made any plans those evenings until 7 p.m. so we could be sure to walk.

Coach: What could you learn from that and use today?

Client: It seems that what was most important was that it was kind of an unspoken, nonnegotiable agreement that we’d walk every day.

Coach: So, which part of that worked — the agreement, or the walking every day?

Client: It was the agreement we had together. And just taking a short time. Fifteen minutes seems possible.

Coach: What do you want to commit to this week?

Client: I will take a 30-minute walk on Friday after work with my spouse.

(Fast forward: The client attempts the goal but has a setback and “falls off of the ladder.”)

One week later …

Coach: Tell me what went well with your goal of taking a 30-minute walk on Friday after work with your spouse.

Client: It didn’t go as well as I’d hoped.

Coach: Which part didn’t go as well as you’d hoped?

Client: We didn’t actually take a walk, but we did have some time during a car ride to start talking about what we’d like to do together.

Coach: Sounds like just talking about the idea was a great way to connect.

Client: Yes, it was.

Coach: What did happen on Friday?

Client: We ended up being invited to go to a friend’s house; it was a last-minute invite from some friends we hadn’t seen in a while. The downside was that, even though we were both there, we were off talking to other people at opposite ends of the house.

Coach: What did you learn from trying out this goal?

Client: That Friday nights probably aren’t the best night to plan for our alone time together. It does tend to be the night we are most likely to do something with other people.

Coach: Okay, so it’s time to step back and rethink the goal. Take a smaller step, perhaps.

Client: I think it would be more likely to happen if we planned for a weeknight instead of a weekend night.

Coach: What night would be best next week?

Client: Tuesday is the least busy.

Coach: If you’ve chosen the best day, what else will it take to be successful with this?

Client: I need to turn off my phone during dinner so I don’t get caught up in a phone call — my family tends to call in the evening — instead of going on the walk.

Coach: What is your goal this week?

Client: I will take a walk with my spouse on Tuesday evening after dinner, and I’ll turn off my phone so we don’t get interrupted.

Coach: How important is it to you that this happens?

Client: Very. My spouse and I really are looking forward to it.

Coach: On a scale of 1-10, how confident are you that this will happen?

Client: 10!

Coach: Great work thinking this one through! I’m really looking forward to hearing about your success.

Scene Four: Success

Coach: Welcome back! I’ve been really excited to hear about your week. What was the best part of it?

Client: Working on one goal got me thinking about the other areas of my life where I could make some improvements.

Coach: Tell me more.

Client: On Sunday, after having a big dinner, I was getting ready to cut out a big slice of my favorite kind of cheesecake when I remembered our conversation. Remember when I said that my goal is do more activities that give me energy? Well, I was already full from dinner, and it dawned on me that adding cheesecake on top of it was going to put me into a food coma.

Coach: You were really paying attention to the signals your body was sending. What did you decide?

Client: I didn’t eat the cake! I told myself that I’d really enjoyed a great-tasting dinner and that I would appreciate it more if I stopped eating now.

Coach: How do you feel about that choice?

Client: Surprised! I haven’t had that kind of willpower for years.

Coach: It’s pretty exciting when you take control. How did you use that willpower when you worked on your goal of walking on Tuesday after dinner without your phone?

Client: We had such an incredible walk. The weather was perfect that evening, just the right temperature for a walk. We got to talk about our day and even do some planning for the next day.

Coach: What did you most enjoy about working on this goal?

Client: Giving myself 15 minutes to relax, away from the TV, and with my spouse. We laughed a lot.

Coach: Sounds like you felt more energized and entertained than you usually are when you watch TV instead.

Client: Yes, I usually use the TV to wind down, but it never really helps me relax.

Coach: What did you learn about yourself this week?

Client: That I really am ready to make some changes in my life. I can do it!

Coach: I’m certain that you can — and you already are. What’s next?


Related content:
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