One of the strongest non-pharmacological tools we currently have for promoting neuroplasticity is aerobic exercise.
Research shows that aerobic training increases BDNF, enhances brain connectivity, improves motor learning, and supports structural brain changes. In people with cerebellar ataxia, recent studies have shown that regular aerobic exercise can improve coordination, fatigue, and physical function.
This wasn’t something I believed at first, it became something I experienced.
During the first year after developing cerebellar ataxia, I had almost no physical endurance. Cardio wasn’t even an option.
In my second year, I tried to exercise, but my heart rate would skyrocket, I became short of breath very quickly, and the sensation honestly scared me. So I rarely stuck with it.
Everything changed last year.
As my mobility slowly improved, I decided to make aerobic exercise part of my rehabilitation. I started small—about 20 minutes per session, five days a week. Even that pushed my heart rate to around 150 bpm.
After a couple of weeks, my body adapted well.
The same workouts no longer sent my heart rate soaring, and moving became noticeably easier. Then I started noticing changes that went far beyond fitness.
After aerobic sessions, my ataxia symptoms often felt milder. I felt steadier, less shaky, my speech flowed a little more easily, and my body simply felt calmer. By the end of the year, cardio had become one of my favorite parts of recovery. Whether I was walking fast, cycling, or doing HIIT, my cardiovascular fitness had improved so much that my heart rate rarely went above 115 bpm, while my resting heart rate stayed around 50 bpm.
Since improving my aerobic fitness, I’ve noticed:
• Better balance
• Faster movements
• Quicker adaptation to new motor tasks
• Less fatigue
• Faster recovery after physical activity
• Better mood and overall well-being
Of course, this is my personal experience, not proof that everyone will respond the same way.
But it’s encouraging that current research points in the same direction. Aerobic exercise appears to create a biological environment that makes the brain more capable of changing, learning, and recovering.
A Little Science: The Mitochondria Connection
When people think about aerobic exercise, they often think about the heart or lungs. But one of its most profound effects happens inside our cells: in the mitochondria.
Mitochondria are the cell’s power plants, producing the ATP that fuels every movement, thought, and repair process. The brain, particularly the cerebellum, has exceptionally high energy demands, making healthy mitochondrial function essential for normal neurological function.
Regular aerobic exercise is one of the most effective non-pharmacological ways to improve mitochondrial health.
Research has shown that aerobic training:
- Stimulates mitochondrial biogenesis, leading to the formation of new mitochondria.
- Improves the efficiency of existing mitochondria, allowing cells to produce more ATP with less oxidative stress.
- Enhances blood flow and oxygen delivery to the brain.
- Increases neurotrophic factors such as BDNF, creating an environment that supports neuroplasticity and motor learning.
Recent clinical trials support this concept. A 2025 randomized clinical trial published in JAMA Neurology demonstrated significant improvements in coordination, fatigue, and aerobic fitness in people with cerebellar ataxia following a structured aerobic training program. In 2026, a randomized trial published in The Lancet Neurology showed that individualized aerobic exercise safely improved cardiorespiratory fitness in people with Friedreich’s ataxia.
Although exercise is not a cure for ataxia, the growing body of evidence suggests that improving mitochondrial health and aerobic capacity may help optimize the brain’s ability to compensate, adapt, and function more efficiently.
References
- Barbuto M, et al. Home Training for Cerebellar Ataxias: A Randomized Clinical Trial. JAMA Neurology (2025)
https://jamanetwork.com/journals/jamaneurology/article-abstract/2838884 - Effects of Physiotherapy on Degenerative Cerebellar Ataxia: A Systematic Review and Meta-analysis. Frontiers in Neurology (2024)
https://www.frontiersin.org/journals/neurology/articles/10.3389/fneur.2024.1491142/full - World Health Organization. Physical Activity Guidelines
https://www.ncbi.nlm.nih.gov/books/NBK566046/ - Erickson KI, et al. Exercise Interventions Preserve Hippocampal Volume: A Meta-analysis.
https://stacks.cdc.gov/view/cdc/225710 - The Lancet Neurology (2026) – Randomized Controlled Trial: Safety and efficacy of individualised exercise and NAD⁺ precursor supplementation in patients with Friedreich’s ataxia in the USA
https://pubmed.ncbi.nlm.nih.gov/42009009/
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