Effects of dual-task training in patients with post-stroke cognitive impairment: A randomized controlled trial

Abstract

BackgroundEvidence for the efficacy of cognitive-motor dual-task (CMDT) training in patients with post-stroke cognitive impairment (PSCI) and no dementia is still lacking. More importantly, although some studies on the cognitive effect of CMDT training show an improvement in cognitive performance, the results are still controversial, and the intervention mechanism of CMDT training on cognitive function improvement is not clear. The main purpose of this study was to analyze the effects of CMDT training on cognitive function, neuron electrophysiology, and frontal lobe hemodynamics in patients with PSCI.MethodsHere we tested the effects of CMDT training on cognitive function in PSCI patients. Forty subjects who met the criteria of PSCI were randomly assigned to control and experimental groups. CMDT training or cognitive task (CT) training was administered to each patient in the experimental and control groups, respectively. All subjects performed Mini-mental State Examination (MMSE) and Montreal Cognitive Assessment (MoCA) scale before and after the intervention, and the event-related potentials (ERP) and functional near-infrared spectroscopy (fNIRS) were used to evaluate the changes in neuron electrophysiology and hemodynamics.ResultsForty patients were randomized across Beijing Rehabilitation Hospital Capital Medical University in Beijing. At the end of the intervention, 33 subjects completed the experimental process. The CMDT group showed significant improvement in the MMSE (P = 0.01) and MoCA (P = 0.024) relative to the CT group. The results of ERP and fNIRS showed that CMDT training could shorten the latency of P300 (P = 0.001) and the peak time of oxygenated hemoglobin (P = 0.004). The results showed that CMDT training shortened the response time of central neurons and significantly increased the rate of oxygen supply to the frontal lobe.ConclusionCMDT training in patients with PSCI improved global cognitive function, which was supported by the improved neural efficiency of associated brain areas.Clinical trial registrationhttp://www.chictr.org.cn, identifier ChiCTR2000034862.

The influence of eight cognitive training regimes upon cognitive screening tool performance in post-stroke survivors: a network meta-analysis

“…Ultimately, 47 studies met the inclusion criteria. Additional searches in the references of published systematic reviews identified three more eligible studies, resulting in 50 randomized controlled trials included ( Chen et al, 2006 , 2019 , 2020 ; Liu et al, 2006 , 2019 , 2022 ; Ou et al, 2007 ; Shin et al, 2008 ; Yang and Liu, 2008 ; Wang et al, 2009 , 2013 ; Li and Gan, 2010 ; Kim et al, 2011 ; Zhang et al, 2012 , 2018 , 2020 ; Feng et al, 2014 ; Ye et al, 2014 ; Zucchella et al, 2014 ; Xu et al, 2015 ; Yoo et al, 2015 ; Li M. et al, 2016 ; Li X. et al, 2016 ; Cao et al, 2017 ; Gong, 2017 ; Jiang et al, 2017 ; Li et al, 2017 ; Lv et al, 2017 ; Maier et al, 2017 ; De Luca et al, 2018 ; Prokopenko et al, 2018 , 2019 ; Xiao, 2018 ; Mao et al, 2019 ; Wang, 2019 ; Xiao and Liang, 2019 ; Yeh et al, 2019 , 2022 ; Faria et al, 2020 ; Fu et al, 2020 ; Jung et al, 2020 ; Shao, 2021 ; Xuefang et al, 2021 ; Ho et al, 2022 ; Liao et al, 2022 ; Shang et al, 2022 ; Sun et al, 2022 ; Xia et al, 2022 ; Zhao et al, 2020 , 2022 ). The specific screening process is depicted in Figure 1 .…”

“…While most studies detailed their randomization process, 13 did not specify the method of random sequence generation. Only one study ( Sun et al, 2022 ), described allocation concealment, leading to the classification of the others as having an ‘unknown risk’ of bias in this regard. Due to the nature of the interventions, blinding of participants was not feasible.…”

“…The intervention comparison network diagram is shown in Figure 3B . Four studies investigated the impact of CBCT ( Ye et al, 2014 ; Prokopenko et al, 2018 , 2019 ; Wang, 2019 ), five focused on traditional cognitive training ( Li and Gan, 2010 ; Feng et al, 2014 ; Li X. et al, 2016 ; Gong, 2017 ; Zhang et al, 2018 ), and 18 compared different cognitive training methods ( Cao et al, 2017 ; Xiao, 2018 ; Chen et al, 2019 ; Liu et al, 2019 , 2022 ; Mao et al, 2019 ; Wang, 2019 ; Xiao and Liang, 2019 ; Yeh et al, 2019 , 2022 ; Faria et al, 2020 ; Shao, 2021 ; Xuefang et al, 2021 ; Ho et al, 2022 ; Liao et al, 2022 ; Shang et al, 2022 ; Sun et al, 2022 ; Zhao et al, 2022 ). Of these, 26 studies used a total score system for assessment, while one study scored only certain aspects of the scale.…”

“…Currently, numerous clinical studies worldwide have investigated various cognitive training treatments for PSCI ( Pang et al, 2018 ; Cho and Lee, 2019 ; Sun et al, 2022 ). Earlier systematic reviews and meta-analyses have documented the therapeutic impacts of specific cognitive training methods on PSCI patients.…”