Effect of Early Yoga Practice on Post Stroke Cognitive Impairment

Abstract

Background: Post-stroke cognitive impairment (PSCI) is a clinical entity that encompasses all types of cognitive impairment following an index stroke. Yoga has been proven to have a beneficial effect not only on cardiovascular risk factors but also on cognition. Hence, this study explored the PSCI spectrum and assessed the effect of yoga on PSCI. Methods: Forty stroke patients were enrolled in each yoga and control arm in this study. After the baseline assessment, control arm was administered standard care (including physiotherapy) while yoga arm received additional yoga intervention. Change in MoCA scores by 2 points in either direction, or FAB scale by 2 points at 6 months was taken as primary outcome, whereas improvement in MRS, CDPSS, CBS, and P300 values were considered as secondary outcomes. Results: Significant improvements were observed in MoCA, FAB, MRS, CPDSS, and CBS scores in both groups after 6 months. However, intergroup comparisons revealed better MoCA (25.5, IQR 22-27) and FAB scores (15.5, IQR 14-17) in yoga group compared to controls (24, IQR20-25.75) and (14, IQR12-15.75). Equivalent improvement was observed in MRS and CBS scores in both groups at 6 months; however, CDPSS score was better in yoga group (p = 0.0008). Both P300 amplitudes and latencies improved in all patients and median P300 amplitudes were significantly better in control group; however, no difference could be appreciated in P300 latencies improvement on intergroup comparisons at follow-up. Conclusion: Study reveals that early yoga intervention in stroke survivors leads to better improvement in cognitive abilities which would further facilitate in early reduction of caregiver burden.

Duration and Efficiency of Combined versus Isolated Aerobic Training Interventions in Post-Stroke Cognition: A Systematic Review

“…Regarding the types of exercises targeted at the intervention groups, the combined rehabilitation training programs involved: dual-task gait training [45,58,62], aerobic and cognitive training [29,40,54,59,60,66], aerobic activity and strength activity [44,46], Tai Chi [41,56], aerobic and endurance training [30,50,63,64]. The isolated aerobic training programs involved: aerobic training [31,42,48,49], high-intensity training [37,39,53,57], and yoga training [43,67]. On the other hand, the control groups participated in programs involving singletask gait training with a treadmill [45,62], performing conventional exercises [29,31,38,39,42,43,46,48,49,55,63,64,67], daily routines [30,41,61,65], ...…”

“…The isolated aerobic training programs involved: aerobic training [31,42,48,49], high-intensity training [37,39,53,57], and yoga training [43,67]. On the other hand, the control groups participated in programs involving singletask gait training with a treadmill [45,62], performing conventional exercises [29,31,38,39,42,43,46,48,49,55,63,64,67], daily routines [30,41,61,65], which included mobilization of upper and lower limbs, stretching and muscle strengthening with elastic bands and walking [51,52]. An overview of the study and participant characteristics is listed in Table 1.…”

“…Still, not in the control group [30,40,44,51,56,59,63,66], one reported no significant difference between the Baduanjin group and the controls for attention [61], and a single one [46] did not report improvements. The seven studies that used a stand-alone rehabilitation training program also assessed attention using neuropsychological tests [31,39,43,48,53,55,57]. Of these, four showed improvement in the intervention group but not in the control group [31,43,53,55], and three did not report any improvement [39,48,57], as shown in Table 1.…”

“…The seven studies that used a stand-alone rehabilitation training program also assessed attention using neuropsychological tests [31,39,43,48,53,55,57]. Of these, four showed improvement in the intervention group but not in the control group [31,43,53,55], and three did not report any improvement [39,48,57], as shown in Table 1.…”

“…Three reported improvements in the intervention group but not in the control group in visuospatial ability [56,59,60], and one reported no significant difference between the Baduanjin group and the controls [61]. Three other studies that used a stand-alone rehabilitation training program also assessed visuospatial ability [39,43,48]. Of these, one reported improvements in the intervention group but not in the control group [43], and two reported no improvements at all [39,48], as shown in Table 1.…”