The Aphasia Physical EXercise (APEX) study: feasibility of a new high-intensity functional interval training for...

Converging evidence suggests that physical exercise promotes motor and cognitive recovery after stroke, yet its potential to support language outcomes in people with aphasia remains largely unexplored. Additionally, there is a lack of structured, high-intensity and accessible exercise programs that foster adherence among stroke survivors.

This pilot study evaluated the feasibility and explored the preliminary effects of a novel High-Intensity Functional Interval InterVention (HI-FIIV) program for stroke survivors with aphasia.

This Phase 1, proof of concept, pilot feasibility study employed a single-group, pre-test/post-test observational quantitative design. Seven individuals with mild-to-moderate aphasia completed an 8-week, thrice-weekly HI-FIIV intervention. Safety, adherence, and satisfaction were documented. Pre- and post-intervention assessments included standardized measures of language, cognition, and physical fitness.

The program was safe, well tolerated, and achieved high adherence (97.9% attendance). Participants reported high satisfaction (mean 9.6/10). Positive changes were observed on several higher-level language measures, including sentence comprehension and fluency, as well as on cognitive tasks targeting selective attention and working memory. Aerobic endurance increased significantly, and greater fitness gains were associated with larger changes in fluency and comprehension.

This feasibility trial demonstrated that people with aphasia can safely participate in high-intensity group exercise and show patterns of selective improvement in language and cognition. While preliminary, the observed relationship between cardiovascular endurance and specific improvements in language suggests that exercise-induced gains in aerobic fitness may support recovery in post-stroke aphasia. Overall, by targeting physical, cognitive, and linguistic domains simultaneously, the HI-FIIV program represents a promising candidate for further investigation as an augmentative approach for post-stroke rehabilitation.