Background and Purpose Despite the social, health, and economic burdens associated with cognitive impairment post-stroke, there is considerable uncertainty about the types of interventions that might preserve or restore cognitive abilities. The objective of this systematic review and meta-analysis was to evaluate the effects of physical activity (PA) training on cognitive function post-stroke and identify intervention and sample characteristics that may moderate treatment effects. Methods Randomized controlled trials examining the association between structured PA training and cognitive performance post-stroke were identified using electronic databases EMBASE and MEDLINE. Intervention effects were represented by Hedges' g and combined into pooled effect sizes using random- and mixed-effects models. Effect sizes were subjected to moderation analyses using the between-group heterogeneity test. Results Fourteen studies met inclusion criteria, representing data from 736 participants. The primary analysis yielded a positive overall effect of PA training on cognitive performance (Hedges' g [95% CI]=0.304[0.14-0.47]). Mixed-effects analyses demonstrated that combined aerobic and strength training programs generated the largest cognitive gains, and that improvements in cognitive performance were achieved even in the chronic stroke phase (mean=2.6 years post-stroke). Positive moderate treatment effects were found for attention/processing speed measures (Hedges' g [CI]=0.37[0.10-0.63]), while the executive function and working memory domains did not reach significance (p>0.05). Conclusions We found a significant positive effect of PA training on cognition post-stroke with small to moderate treatment effects that are apparent even in the chronic stroke phase. Our findings support the use of PA training as a treatment strategy to promote cognitive recovery in stroke survivors.
Given the huge increase in remote work that has accompanied the Coronavirus disease (COVID-19) pandemic, understanding predictors of performance and wellbeing among remote workers has never been more timely. Effective communication is commonly cited as key to remote worker success, yet communication variables are rarely incorporated into remote work research. In the present study, we examined the relationship between communication frequency, communication quality, and supervisorset communication expectations with daily job performance and burnout in an occupationally-diverse sample of employees. We used an experience sampling design and our hypotheses were tested with data collected over a 4-week period with a sample of 471 employees who shifted to full-time remote work due to COVID-19. Results indicated that daily communication quality was associated with daily performance and burnout. In addition, the extent to which supervisors established expectations about communication practices (e.g., expected response times to email) at the onset of the transition to remote work was positively associated with performance, but not burnout. Task interdependence was also tested as a moderator. Task interdependence moderated the relationship between communication quality and performance, such that the relationship was stronger when task interdependence was higher than when it was lower. Task interdependence also moderated the relationship between supervisor-set expectations and performance such that the relationship was stronger when task interdependence was lower than when it was higher. Expected curvilinear relationships between communication frequency and outcomes were not detected. Based on our findings, we provide recommendations for practice and future research.
Hippocampal volume is a marker of brain health and is reduced with aging and neurological disease. Exercise may be effective at increasing and preserving hippocampal volume, potentially serving as a treatment for conditions associated with hippocampal atrophy (e.g., dementia). This meta‐analysis aimed to identify whether exercise training has a positive effect on hippocampal volume and how population characteristics and exercise parameters moderate this effect. Studies met the following criteria: (a) controlled trials; (b) interventions of physical exercise; (c) included at least one time‐point of hippocampal volume data before the intervention and one after; (d) assessed hippocampal volume using either manual or automated segmentation algorithms. Animal studies, voxel‐based morphometry analyses, and multi‐modal interventions (e.g., cognitive training or meditation) were excluded. The primary analysis in n = 23 interventions from 22 published studies revealed a significant positive effect of exercise on total hippocampal volume. The overall effect was significant in older samples (65 years of age or older) and in interventions that lasted over 24 weeks and had less than 150 min per week of exercise. These findings suggest that moderate amounts of exercise for interventions greater than 6 months have a positive effect on hippocampal volume including in older populations vulnerable to hippocampal atrophy.
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