Effects of Combined Interventions with Aerobic Physical Exercise and Cognitive Training on Cognitive Function in Stroke Patients: A Systematic Review

Amorós-Aguilar, Laura; Rodríguez-Quiroga, Erica; Sánchez-Santolaya, Sara; Coll-Andreu, Margalida

doi:10.3390/brainsci11040473

Cited by 22 publications

(16 citation statements)

References 60 publications

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“…Ultimately, according to the results obtained from the present research and previous studies, exercise and physical activities appear to prevent or postpone disability and lead to the patientsʹ recovery by way of two mechanisms: (i) cognitive mechanisms, including the many positive effects of physical activity on the spirit and mind and vitality and also the direct effects of exercise on physical fitness factors, releasing the mind of its treatment mode and inducing a sense of liveliness [3,51], and (ii) physiological mechanisms, includ-ing increased blood circulation, blood pressure control, increased oxygen tolerance, improved neurogenesis and angiogenesis, mitochondrial viability, inhibition of the acute inflammatory response, neuronal apoptosis and protection of the blood-brain barrier [14,32,52].…”

Section: Discussionmentioning

confidence: 61%

Can Early Neuromuscular Rehabilitation Protocol Improve Disability after a Hemiparetic Stroke? A Pilot Study

et al. 2022

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Background: The impairment of limb function and disability are among the most important consequences of stroke. To date, however, little research has been done on the early rehabilitation trial (ERT) after stroke in these patients. The purpose of this study was to evaluate the impact of ERT neuromuscular protocol on motor function soon after hemiparetic stroke. The sample included twelve hemiparetic patients (54.3 ± 15.4 years old) with ischemic stroke (n = 7 control, n = 5 intervention patients). ERT was started as early as possible after stroke and included passive range of motion exercises, resistance training, assisted standing up, and active exercises of the healthy side of the body, in addition to encouraging voluntary contraction of affected limbs as much as possible. The rehabilitation was progressive and took 3 months, 6 days per week, 2–3 hours per session. Fugle-Meyer Assessment (FMA), Box and Blocks test (BBT) and Timed up and go (TUG) assessments were conducted. There was a significantly greater improvement in the intervention group compared to control: FMA lower limbs (p = 0.001), total motor function (p = 0.002), but no significant difference in FMA upper limb between groups (p = 0.51). The analysis of data related to BBT showed no significant differences between the experimental and control groups (p = 0.3). However, TUG test showed significant differences between the experimental and control groups (p = 0.004). The most important finding of this study was to spend enough time in training sessions and provide adequate rest time for each person. Our results showed that ERT was associated with improved motor function but not with the upper limbs. This provides a basis for a definitive trial.

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Section: Discussionmentioning

confidence: 61%

Can Early Neuromuscular Rehabilitation Protocol Improve Disability after a Hemiparetic Stroke? A Pilot Study

et al. 2022

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“…Furthermore, among the benefits related to physical conditioning, such as functionality, mood, and cardiovascular health, it was identified that aerobic exercise might potentiate the neuroplasticity process with more robust responses in training programs with moderate to high-intensity exercises ( Penna et al, 2021 ). Finally, cognitive improvement is indicated in aerobic exercises combined with cognitive training, especially computerized training ( Amorós-Aguilar et al, 2021 ).…”

Section: Discussionmentioning

confidence: 99%

“…The meta-analysis by Sun et al (2021) showed significant benefits of combined cognitive exercise interventions (more specifically, cognitive behavioral training, computer-assisted cognitive training and physical training) compared to no intervention, delayed intervention, sham intervention, or passive training in patients with cognitive impairment post-stroke in executive, attention, and memory functions. In addition, another review that investigated the effects of aerobic exercise combined with cognitive training (mostly computerized) found that the combined intervention was associated with post-intervention improvement on at least one cognitive test across all included studies ( Amorós-Aguilar et al, 2021 ).…”

Section: Introductionmentioning

confidence: 99%

Systematic review on post-stroke computerized cognitive training: Unveiling the impact of confounding factors

et al. 2022

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BackgroundStroke is a highly incapacitating disease that can lead to disabilities due to cognitive impairment, physical, emotional, and social sequelae, and a decrease in the quality of life of those affected. Moreover, it has been suggested that cognitive reserve (patients’ higher levels of education or having a skilled occupation), for instance, can promote faster cognitive recovery after a stroke. For this reason, this review aims to identify the cognitive, functional, and behavioral effects of computerized rehabilitation in patients aged 50 years or older who had a stroke, considering cognitive reserve proxies.MethodsWe followed the Preferred Reporting Items for Systematic Reviews and Meta-Analysis—PRISMA, and performed the search for peer-reviewed randomized controlled trials without a date restriction on CINAHL, LILACS, PubMed, Scopus, and Web of Science databases were chosen.ResultsWe screened 780 papers and found 19 intervention studies, but only 4 met the inclusion criteria and shared data. These studies included computerized tools for motor and cognitive rehabilitation in the experimental groups. In all studies, computerized training was combined with other interventions, such as standard therapy, occupational therapy, and aerobic exercises. There were 104 participants affected by ischemic or hemorrhagic stroke, predominantly male (57.69%), and all with cognitive impairment.ConclusionDespite a limited number of studies, varied methods and insufficient information available, schooling as a CR proxy combined with high-intensity computerized cognitive training was key to mediating cognitive improvement. The systematic review also identified that the associated ischemic stroke and shorter time of onset for rehabilitation contribute to the cognitive evolution of patients. Findings do not support a greater benefit of computerized cognitive training compared to conventional cognitive therapies.Systematic review registration[https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=296193], identifier [CRD42022296193].

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“…However, although promising, results remain inconclusive due to study heterogeneity and methodological limitations. Some authors have further analyzed the additive gains of combining CCT with PE in stroke patients, with preliminary positive results ( Amorós-Aguilar et al, 2021 ).…”

Section: Introductionmentioning

confidence: 99%

Effects and mechanisms of mindfulness training and physical exercise on cognition, emotional wellbeing, and brain outcomes in chronic stroke patients: Study protocol of the MindFit project randomized controlled trial

Bermudo-Gallaguet

Ariza²,

Dacosta-Aguayo³

et al. 2022

Front. Aging Neurosci.

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BackgroundPost-stroke cognitive and emotional complications are frequent in the chronic stages of stroke and have important implications for the functionality and quality of life of those affected and their caregivers. Strategies such as mindfulness meditation, physical exercise (PE), or computerized cognitive training (CCT) may benefit stroke patients by impacting neuroplasticity and brain health.Materials and methodsOne hundred and forty-one chronic stroke patients are randomly allocated to receive mindfulness-based stress reduction + CCT (n = 47), multicomponent PE program + CCT (n = 47), or CCT alone (n = 47). Interventions consist of 12-week home-based programs five days per week. Before and after the interventions, we collect data from cognitive, psychological, and physical tests, blood and stool samples, and structural and functional brain scans.ResultsThe effects of the interventions on cognitive and emotional outcomes will be described in intention-to-treat and per-protocol analyses. We will also explore potential mediators and moderators, such as genetic, molecular, brain, demographic, and clinical factors in our per-protocol sample.DiscussionThe MindFit Project is a randomized clinical trial that aims to assess the impact of mindfulness and PE combined with CCT on chronic stroke patients’ cognitive and emotional wellbeing. Furthermore, our design takes a multimodal biopsychosocial approach that will generate new knowledge at multiple levels of evidence, from molecular bases to behavioral changes.Clinical trial registrationwww.ClinicalTrials.gov, identifier NCT04759950.

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Effects of Combined Interventions with Aerobic Physical Exercise and Cognitive Training on Cognitive Function in Stroke Patients: A Systematic Review

Cited by 22 publications

References 60 publications

Can Early Neuromuscular Rehabilitation Protocol Improve Disability after a Hemiparetic Stroke? A Pilot Study

Can Early Neuromuscular Rehabilitation Protocol Improve Disability after a Hemiparetic Stroke? A Pilot Study

Systematic review on post-stroke computerized cognitive training: Unveiling the impact of confounding factors

Effects and mechanisms of mindfulness training and physical exercise on cognition, emotional wellbeing, and brain outcomes in chronic stroke patients: Study protocol of the MindFit project randomized controlled trial

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