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

Abstract

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.

Aerobic exercises and cognitive function in post-stroke patients: A systematic review with meta-analysis

“…It believed that gender might be an important factor affecting the effectiveness of aerobic exercise in improving executive function, and women can benefit a lot from aerobic exercise. [ 28 ] Similarly, in our study, all the trials included in the analysis were male dominated. Therefore, more large-scale studies are needed to determine the impact of aerobic exercise on executive function, and to determine whether gender and disease site affect the intervention effect.…”

“…Compared with similar studies, the effect size obtained in this study was significantly higher than that in Shu et al’s study (d = 0.13). [ 28 ] Shu et al focused on the effects of aerobic exercise on cognitive ability in survivors of ischemic cerebrovascular disease, but not all subjects were stroke patients. In contrast, the 11 articles included in this research only involved stroke patients.…”

Brazilian practice guidelines for stroke rehabilitation: Part II

“…Evidence 121 suggests that physical activity is an intervention with a protective role that may improve poststroke cognition. In addition, it is a low-cost strategy with a positive impact on motor function, quality of life, and cardiopulmonary condition.…”

Comparative efficacy of various exercise interventions on cognitive function in patients with mild cognitive impairment or dementia: A systematic review and network meta-analysis

“… 9 However, these underlying mechanisms have been shown to exist only in animal models, and a number of studies that have examined these mechanisms have not yet shown that they are applicable to humans. Previous relevant studies have shown that distinctive types of exercise, such as aerobic exercise (AE) and resistance exercise (RE), might exert effects through some different molecular mechanisms and lead to various effect sizes (e.g., RE: standard mean difference (SMD) = 0.41−0.71; 10 , 11 , 12 AE: SMD = 0.13−0.58 12 , 13 ). Therefore, the type of exercise is an important factor that should be considered when clinical professionals prescribe exercise to prevent or slow cognitive decline.…”