Exercise-Based Cardiac Rehabilitation Improves Cognitive Function Among Patients With Cardiovascular Disease

Abstract

Purpose: To investigate the effects of cardiac rehabilitation (CR) exercise training on cognitive performance and whether the changes are associated with alterations in prefrontal cortex (PFC) oxygenation among patients with cardiovascular disease. Methods: Twenty (men: n = 15; women: n = 5) participants from an outpatient CR program were enrolled in the study. Each participant completed a cognitive performance test battery and a submaximal graded treadmill evaluation on separate occasions prior to and again upon completion of 18 individualized CR sessions. A functional near-infrared spectroscopy (fNIRS) device was used to measure left and right prefrontal cortex (LPFC and RPFC) oxygenation parameters (oxyhemoglobin [O2Hb], deoxyhemoglobin [HHb], total hemoglobin [tHb], and oxyhemoglobin difference [Hbdiff]) during the cognitive test battery. Results: Patients showed improvements in cardiorespiratory fitness (+1.4 metabolic equivalents [METs]) and various cognitive constructs. A significant increase in PFC oxygenation, primarily in the LPFC region, occurred at post-CR testing. Negative associations between changes in cognition (executive function [LPFC O2Hb: r = −0.45, P = .049; LPFC tHb: r = −0.49, P = .030] and fluid composite score [RPFC Hbdiff: r = −0.47, P = .038; LPFC Hbdiff: r = −0.45, P = .048]) and PFC changes were detected. The change in cardiorespiratory fitness was positively associated with the change in working memory score (r = 0.55, P = .016). Conclusion: Cardiovascular disease patients enrolled in CR showed significant improvements in multiple cognitive domains along with increased cortical activation. The negative associations between cognitive functioning and PFC oxygenation suggest an improved neural efficiency.

Effect of Respiratory Training Combined with Core Muscle Training on the Overall Motor Function and Activities of Daily Living of Patients with Early and Midterm Stroke

“…While the body needs to readjust its balance due to external force or internal changes, the normal way is to rely on the rapid reactive contraction of the external oblique muscles and rectus abdominis. erefore, in the clinical rehabilitation training of stroke patients, the training of core trunk muscles is conducive to improving the coordination and control of various motor muscles; optimizing the generation, transmission, and control of strength; improving movement efficiency; and promoting the recovery of limbs [18]. Some foreign scholars believed that [19] respiratory dysfunction could affect the control ability and balance ability of trunk and recovery of limb function.…”

The Utility of High Intensity Interval Training to Improve Cognitive Aging in Heart Disease Patients

“…Twelve of the thirteen studies assessed cognitive function [ 14 , 15 , 88 , 89 , 90 , 91 , 92 , 93 , 94 , 95 , 96 , 97 , 98 ] ( Table 1 ). Six of nine studies found a significant improvement in global cognitive function, using the Montreal Cognitive Assessment (MoCA) [ 93 , 98 ], Mini-Mental State Examination (MMSE) [ 95 ] Modified MMSE [ 90 ], Functional Independence Cognitive Measure [ 97 ], and NIH Toolbox Fluid Composite Score [ 96 ]. Seven of eight studies showed improvements in at least one test related to attention-psychomotor function [ 88 , 89 , 90 , 91 , 92 , 95 , 96 ].…”

“…Six of nine studies found a significant improvement in global cognitive function, using the Montreal Cognitive Assessment (MoCA) [ 93 , 98 ], Mini-Mental State Examination (MMSE) [ 95 ] Modified MMSE [ 90 ], Functional Independence Cognitive Measure [ 97 ], and NIH Toolbox Fluid Composite Score [ 96 ]. Seven of eight studies showed improvements in at least one test related to attention-psychomotor function [ 88 , 89 , 90 , 91 , 92 , 95 , 96 ]. Only Lee et al [ 94 ] found no improvement in attention-psychomotor function.…”

“…Only Lee et al [ 94 ] found no improvement in attention-psychomotor function. Three of seven studies showed improvements in executive function [ 88 , 95 , 96 ], while four studies found no improvement [ 90 , 91 , 92 , 94 ] ( Table 1 ). Three of five studies found an improvement in verbal memory [ 90 , 91 , 92 ] while two studies found no change [ 94 , 96 ].…”

Factors Associated With Cardiac Rehabilitation Participation in Older Adults After Myocardial Infarction

“…4 Although not originally designed for older patients, CR has unique benefits in the geriatric population, including improvements in physical function, cognitive function, and mental health. [5][6][7][8][9] Despite evidence of major benefits of CR after AMI, rates of participation are remarkably low, 10,11 particularly among older adults. 12,13 In the early days of CR, the patients referred were typically younger, middle-aged males, but over the decades the population with AMI has become older and there is a higher prevalence of females.…”