Cardiovascular exercise enhances motor learning across multiple sessions in people with Parkinson’s disease: a randomized controlled pilot trial

Motor learning is critical for effective motor rehabilitation, yet impaired in people with Parkinson's Disease (pwPD). Emerging evidence suggests that cardiovascular exercise (CVE), performed close to skill practice, may promote brain plasticity and motor learning. However, research has predominantly focused on acute effects of a single CVE session in neurotypical individuals. Here, we examined whether post-practice CVE enhances motor learning over multiple weeks. Twenty-four pwPD were randomly assigned to either moderate-intensity cycling or seated rest after practicing a novel balance task across six sessions. As hypothesized, CVE significantly improved motor learning, particularly in sessions 4 and 5. This effect was reflected in a non-significant trend toward greater within-session online learning, rather than in between-session offline gains. Exploratory analyses indicate that individuals with higher cardiorespiratory fitness benefited most from CVE. Our findings highlight CVE as an effective, low-cost tool to foster motor learning in neurorehabilitation and warrant further investigation.