Combined Aerobic Exercise and Task Practice Improve Health-Related Quality of Life Poststroke: A Preliminary Analysis

Rosenfeldt, Anson B.; Linder, Susan M; Davidson, Sara; Clark, Cynthia; Zimmerman, Nicole M.; Lee, John J.; Alberts, Jay L.

doi:10.1016/j.apmr.2018.11.011

Cited by 25 publications

(48 citation statements)

References 41 publications

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“…In contrast, only when the intervention time is controlled within 45 to 60 minutes can the cognitive benefit reach a significant level. e reason why the cognitive benefits of this exercise duration reach the maximum level in 45 to 60 minutes may be because the exercise intervention of this duration can obviously improve the glucose tolerance [27] and insulin sensitivity [50] of patients, while restoring motor and balance ability [51], reversing the decline of cardiopulmonary function caused by impaired motor function, and gradually improving self-perception [52] of the body and cognitive function [53].…”

Section: Discussionmentioning

confidence: 99%

Meta-Analysis on Cognitive Benefit of Exercise after Stroke

Yang

Wang

2021

Complexity

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ObjectiveThe objective of this paper is to evaluate the cognitive benefit of exercise after stroke, so as to provide more accurate and reliable guidance for targeted exercise intervention. Methods. Randomized controlled trials of the relationship between exercise and cognition after stroke were identified in Cochrane Library and PubMed. Methodological quality was assessed using the Cochrane tool of bias. SMD and 95% confidence intervals were calculated, and Chi-squared test (Q) was adopted to estimate the heterogeneity. Results. (a) Twenty-three studies met inclusion criteria, including 1528 participants. Heterogeneity was from low to high such as attention (I2 = 0.00%), executive function (I2 = 0.00%), cognition (I2 = 64%), and working memory (I2 = 77%). (b) The overall effect on cognition was small (SMD = 0.16 [0.04, 0.28]) but significant and there is a difference between cognitive domains in attention (SMD = −0.35 [−0.57, −0.14]), executive function (SMD = −0.24 [−0.40, −0.08]), and working memory (SMD = 0.36 [0.20, 0.53]). (c) Exercise training was less effective before the 18th month after stroke. Higher benefits on cognition were found after combined therapy compared with other exercise programs, and the older the stroke survivors, the less the cognitive benefit of exercise. Conclusion. Small-to-moderate effect of exercise on cognitive benefit after stroke was found, and the effect was moderated by treatment protocols and sample characteristics.

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Section: Discussionmentioning

confidence: 99%

Meta-Analysis on Cognitive Benefit of Exercise after Stroke

Yang

Wang

2021

Complexity

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“…Following baseline testing, participants were randomized to 1 of 3 groups using a nonreplenished sealed envelope pull method. The intervention arms, described in detail in our previous publication, 42 were as follows: (1) FE + UE repetitive task practice (FE+RTP); (2) VE + UE repetitive task practice (VE+RTP); or (3) stroke education + UE repetitive task practice (EDU+RTP). All groups engaged in 90-minute sessions 3 times per week for 8 weeks.…”

Section: Methodsmentioning

confidence: 99%

Forced, Not Voluntary, Aerobic Exercise Enhances Motor Recovery in Persons With Chronic Stroke

Linder

Rosenfeldt

Davidson

et al. 2019

Neurorehabil Neural Repair

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Background. The recovery of motor function following stroke is largely dependent on motor learning–related neuroplasticity. It has been hypothesized that intensive aerobic exercise (AE) training as an antecedent to motor task practice may prime the central nervous system to optimize motor recovery poststroke. Objective. The objective of this study was to determine the differential effects of forced or voluntary AE combined with upper-extremity repetitive task practice (RTP) on the recovery of motor function in adults with stroke. Methods. A combined analysis of 2 preliminary randomized clinical trials was conducted in which participants (n = 40) were randomized into 1 of 3 groups: (1) forced exercise and RTP (FE+RTP), (2) voluntary exercise and RTP (VE+RTP), or (3) time-matched stroke-related education and RTP (Edu+RTP). Participants completed 24 training sessions over 8 weeks. Results. A significant interaction effect was found indicating that improvements in the Fugl-Meyer Assessment (FMA) were greatest for the FE+RTP group ( P = .001). All 3 groups improved significantly on the FMA by a mean of 11, 6, and 9 points for the FE+RTP, VE+RTP, and Edu+RTP groups, respectively. No evidence of a treatment-by-time interaction was observed for Wolf Motor Function Test outcomes; however, those in the FE+RTP group did exhibit significant improvement on the total, gross motor, and fine-motor performance times ( P ≤ .01 for all observations). Conclusions. Results indicate that FE administered prior to RTP enhanced motor skill acquisition greater than VE or stroke-related education. AE, FE in particular, should be considered as an effective antecedent to enhance motor recovery poststroke.

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“…,0,1) (Wan et al, 2014;Luo et al, 2018). And in three studies (Bo et al, 2019;Ploughman et al, 2019;Rosenfeldt et al, 2019), subgroup data was provided separately and we obtained the total mean and SD using the formula:…”

Section: Data Collection and Extractionmentioning

confidence: 99%

“…There were two studies producing more than one publication (Tang et al, 2014(Tang et al, , 2016Liu-Ambrose et al, 2016;Hsu et al, 2017Hsu et al, , 2018Dao et al, 2019;Khattab et al, 2019), they were regarded as one study in the quantitative analysis. One publication (Rosenfeldt et al, 2019) was the secondary analysis of two randomized controlled trials (ClinicalTrials.gov registration numbers NCT02076776, National Institutes of Health, and NCT02494518, American Heart Association). As it was the only publication relevant to the two trials and provided more data interested than that on the official webpage of ClinicalTrials.gov, we considered the two trials as one study.…”

Section: Characteristics Of Included Studiesmentioning

confidence: 99%

“…There was no significant difference in age between intervention (66.1; SD:12) and control groups (68.2; SD:10.8). Patients were diagnosed with stroke in 10 studies (Quaney et al, 2009;El-Tamawy et al, 2014;Liu-Ambrose et al, 2016;Tang et al, 2016;Ploughman et al, 2018;Bo et al, 2019;Debreceni-Nagy et al, 2019;Ihle-Hansen et al, 2019;Nave et al, 2019;Rosenfeldt et al, 2019) and with small vessel ischemic disease in the rest one (Liu-Ambrose et al, 2016). Among the aerobic exercise interventions, one study maintained participants' heart rate reserve (HRR) below 40% (Debreceni-Nagy et al, 2019) and three studies adopted moderate intensity training (El-Tamawy et al, 2014;Liu-Ambrose et al, 2016;Nave et al, 2019).…”

Section: Characteristics Of Included Studiesmentioning

confidence: 99%

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Cognitive Gains of Aerobic Exercise in Patients With Ischemic Cerebrovascular Disorder: A Systematic Review and Meta-Analysis

Shu

Xie

et al. 2020

Front. Cell Dev. Biol.

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Background: Cognitive impairment has become an important problem in ischemic cerebrovascular disorder survivors as disease related deaths have been significantly reduced. Aerobic exercise, the most prevalent mode of physical activity, positively contributes to cognition in both healthy population and people with cognitive impairment. However, studies on its associations with cognitive gains in patients with ischemic cerebrovascular disease showed mixed findings.Objective: To explore the cognitive effects of aerobic exercise on ischemic cerebrovascular disorder survivors and investigate the possible moderators on exercise benefits.Method: Randomized controlled trials investigating the effects of sole aerobic exercise on cognitive function in population with ischemic intracranial vascular disorder compared to any control group who did not receive the intervention were enrolled in this systematic review and meta-analysis. Four online database (Pubmed, Cochrane Library, Embase, and Web of Science) were searched.Results: The initial search returned 1,522 citations and ultimately 11 studies were included in the systematic review. Analysis of seven studies showed the beneficial but not statistically significant impact of aerobic exercise on global cognitive function (0.13; 95% Cl −0.09 to 0.35; p = 0.25). Participants already with cognitive impairment benefited more from this intervention (0.31; 95% Cl 0.07–0.55; p = 0.01) and moderate intensity might be the optimal choice (0.34; 95% Cl −0.01 to 0.69; p = 0.06). The program duration and initiation time after stroke occurrence did not predict better cognitive outcome. Aerobic exercise was not associated with improvement of processing speed and executive function, the two subdomains of cognitive function.Conclusions: Aerobic exercise may contribute to cognitive gains in survivors of ischemic cerebrovascular disorder, especially for population already with cognitive decline. Our findings suggest that the adoption of moderate intensity aerobic exercise might improve cognition in such population.

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Combined Aerobic Exercise and Task Practice Improve Health-Related Quality of Life Poststroke: A Preliminary Analysis

Cited by 25 publications

References 41 publications

Meta-Analysis on Cognitive Benefit of Exercise after Stroke

Meta-Analysis on Cognitive Benefit of Exercise after Stroke

Forced, Not Voluntary, Aerobic Exercise Enhances Motor Recovery in Persons With Chronic Stroke

Cognitive Gains of Aerobic Exercise in Patients With Ischemic Cerebrovascular Disorder: A Systematic Review and Meta-Analysis

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