Aerobic exercises and cognitive function in post-stroke patients: A systematic review with meta-analysis

Abstract

Objective: To study the effect of aerobic exercise on cognitive function of post-stroke patients, especially to identify specific interventions that the most likely to maximize cognitive benefits of stroke patients. Methods: According to the PRISMA principle, the databases of Web of Science, EMBASE, PubMed and Cochrane library were searched to collect randomized controlled trial data of aerobic exercise on cognitive function intervention of post-stroke patients. The Cochrane bias risk evaluation instrument was used to assess the methodological quality of included studies. Review Manager 5.4.1 software was used to analyze heterogeneity and potential publication bias. Results: A total of 11 criteria studies that satisfied the association between aerobic exercise and cognitive function following stroke were selected to be included in the review. Global cognition ability was significantly improved after aerobic exercise intervention (0.51; 95% confidence interval [CI] 0.16–0.86; P = .004), moderate intensity had the largest effect size on improving global cognition ability (0.98; 95% CI 0.48–1.47; P = .0001), none of cognitive flexibility, working memory, selective attention and conflict resolution showed the significant difference from zero. Conclusion: Aerobic exercise has a good impact on enhancing the cognitive dysfunction of patients after stroke, which stroke patients were found to benefit the most from moderate-intensity exercise. However, our studies did not found that aerobic exercise had an active result on cognitive flexibility, working memory, selective attention and contention resolution.

The effect of moderate and vigorous aerobic exercise training on the cognitive and walking ability among stroke patients during different periods: A systematic review and meta-analysis

“…In addition, our results also echo the results of Anjos study on the improvement of walking speed in patients with aerobic exercise, and the conclusion that aerobic exercise promotes cardiopulmonary function in stroke patient [13]. Although there is a certain heterogeneity in the results of cognitive improvement, it has a positive effect on the improvement of patients ' cognitive ability, which is similar to the results of Li [15] and Tiozzo [8].…”

“…For the intervention, Li [15], Mah and Amoros-Aguilar [16,17] proposed in the study that moderate and vigorous aerobic training has the best rehabilitation effect on stroke patients. And there is little difference between the therapeutic effect of moderate intensity aerobic exercise and the therapeutic effect of high intensity aerobic exercise.…”

“…We used the Mini-Mental State Examination score (MMSE) and Montreal Cognitive Assessment (MoCA) to measure the improvement of training effect on global cognitive function. In the study of cognitive function, Li [15] integrated MoCA, MMES and Addenbrooke's cognitive examination revised (ACE-R) as a measurement tool to evaluate cognitive function, and showed its feasibility. Therefore, although there are differences in the cognitive domains measured by MoCA and MMES, they are all data tables for measuring cognitive level in the final analysis, and have been practiced by scholars.…”

Physiotherapists’ use of aerobic exercise during stroke rehabilitation: a qualitative study using chart-stimulated recall

“…Evidence shows that aerobic exercise post-stroke improves cardiorespiratory fitness, and cardiovascular risk factors by decreasing systolic blood pressure, fasting glucose, fasting insulin levels, and increasing high-density lipoprotein cholesterol levels [2]. Furthermore, aerobic exercise can improve cognition [3], walking capacity [4] and facilitate the completion of activities of daily living [5]. Therefore, clinical guidelines recommend the prescription of aerobic exercise during routine stroke rehabilitation [6].…”

The effect and mechanism of exercise for post-stroke pain

“…For stroke patients, exercise can improve trunk stability, enhance balance and walking ability to reduce the incidence of falls (Lee and Stone, 2020;Jung et al, 2021). It has been shown that exercise can improve cognitive function and activities of daily living in stroke patients (Li et al, 2022;Nindorera et al, 2022). Physical exercise is also effective in improving patients' quality of life and depressive symptoms after stroke (Ali et al, 2021;Zhang W. et al, 2021).…”