The Active Ingredient of Cognitive Restoration: A Multicenter Randomized Controlled Trial of Sequential Combination of Aerobic Exercise and Computer-Based Cognitive Training in Stroke Survivors With Cognitive Decline

Yeh, Ting-Ting; Chang, Ku‐Chou; Wu, Ching‐yi

doi:10.1016/j.apmr.2018.12.020

Cited by 50 publications

(58 citation statements)

References 40 publications

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“…Cognitive and motor dysfunction is a common symptom after stroke; more than 80% of the patients have different degrees of cognitive and limb motor impairment during 3 to 12 months after stroke [1], which is associated with memory decline, attention deficits, and executive dysfunction [2]. Although survivors can get timely treatment, sedentary behavior caused by long recovery cycle of limb function can further lead to anxiety, depression, and other bad emotional states, which in turn hinder the recovery process, such as poor adherence to rehabilitation plan, high recurrence rate of stroke, and high mortality involved with suicide [3].…”

Section: Introductionmentioning

confidence: 99%

“…Additionally, sample characteristics such as session duration, frequency, intervention length, type of exercise, and the time from stroke onset to initiation of the intervention, which may moderate the exercise-cognition relationship, have also been rated, so as to identify the optimal exercise training dose parameters and then maximize cognitive benefit of exercise after stroke. [2,14, (Figure 1).…”

Section: Introductionmentioning

confidence: 99%

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[Retracted] Meta‐Analysis on Cognitive Benefit of Exercise after Stroke

Yang

Wang

2021

Complexity

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ObjectiveThe objective of this paper is to evaluate the cognitive benefit of exercise after stroke, so as to provide more accurate and reliable guidance for targeted exercise intervention. Methods. Randomized controlled trials of the relationship between exercise and cognition after stroke were identified in Cochrane Library and PubMed. Methodological quality was assessed using the Cochrane tool of bias. SMD and 95% confidence intervals were calculated, and Chi-squared test (Q) was adopted to estimate the heterogeneity. Results. (a) Twenty-three studies met inclusion criteria, including 1528 participants. Heterogeneity was from low to high such as attention (I2 = 0.00%), executive function (I2 = 0.00%), cognition (I2 = 64%), and working memory (I2 = 77%). (b) The overall effect on cognition was small (SMD = 0.16 [0.04, 0.28]) but significant and there is a difference between cognitive domains in attention (SMD = −0.35 [−0.57, −0.14]), executive function (SMD = −0.24 [−0.40, −0.08]), and working memory (SMD = 0.36 [0.20, 0.53]). (c) Exercise training was less effective before the 18th month after stroke. Higher benefits on cognition were found after combined therapy compared with other exercise programs, and the older the stroke survivors, the less the cognitive benefit of exercise. Conclusion. Small-to-moderate effect of exercise on cognitive benefit after stroke was found, and the effect was moderated by treatment protocols and sample characteristics.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

[Retracted] Meta‐Analysis on Cognitive Benefit of Exercise after Stroke

Yang

Wang

2021

Complexity

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“…In one trial, evaluations were conducted twice after interventions at 3 and 6 months [ 17 ]. The test sites included two at the rehabilitation hospital [ 16 , 18 ], two at the hospital rehabilitation center [ 15 , 19 ], and one in the community [ 17 ]. The total number of interventions in each study ranged from 18 to 48, the training frequency was 2–3 times a week, and the training duration was 30–60 min.…”

Section: Resultsmentioning

confidence: 99%

“…One trial assessed the effects of simultaneous cognitive-exercise intervention on cognitive function [ 18 ], and the other four assessed the effects of sequential cognitive-exercise intervention on cognitive function [ 15 – 17 , 19 ]. For three trials, the cognitive-exercise intervention included aerobic exercise, resistance exercise, or balance exercise with computer-aided cognitive training [ 15 , 16 , 19 ].…”

Section: Resultsmentioning

confidence: 99%

Effects of Combined Cognitive and Exercise Interventions on Poststroke Cognitive Function: A Systematic Review and Meta-Analysis

Sun

Zhu

et al. 2021

BioMed Research International

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Objective. We investigated combined cognitive and exercise interventions in the literature and summarized their effectiveness in improving poststroke cognitive impairment (PSCI). Data Sources. Electronic databases and trial registries were searched from their inception until July 2020. Study Selection. Trials were collected with the following study inclusion criteria: (1) patients over 18 years of age who were diagnosed with PSCI; (2) combined cognitive-exercise interventions, regardless of the order of the two types of interventions or whether they were administered simultaneously; (3) any control group studied at the same time that was deemed acceptable, including no intervention/routine care, delayed intervention, sham intervention, and passive training; (4) the use of any validated cognitive neuropsychological test to evaluate cognitive function; and (5) clinically administered random trials with controls. Data Extraction. Five randomized controlled trials met the inclusion criteria. Two reviewers independently assessed the eligibility of the full texts and methodological quality of the included studies using the Cochrane risk of bias tool. Inconsistent results were resolved by additional discussion or decided by a third examiner, if necessary. Data Analysis. Meta-analysis demonstrated that the combined interventions had a significant effect on executive function and working memory [Stroop test (time), standardized mean difference SMD = 0.42 , 95% confidence interval (CI): 0.80–0.04, p = 0.02 ; Trail Making Test, SMD = 0.49 , 95% CI: 0.82–0.16, p = 0.004 ; Forward Digit Span Test, SMD = 0.91 , 95% CI: 0.54–1.29, p ≤ 0.001 ]. While it was impossible to conduct a meta-analysis of global cognitive function and other cognitive domains, individual experiments demonstrated that the combined interventions played a significant role in global cognition, reasoning ability, logical thinking, and visual-spatial memory function. Conclusions. Our analyses demonstrated that the combined interventions had a significant effect on the improvement of PSCI, particularly in terms of executive function. However, the moderate risk of bias in the included trials and the small number of relevant studies indicated a need for more uniform diagnostic and evaluation criteria, and larger trials would provide stronger evidence to better understand the effectiveness of the combined interventions. This trial is registered with trial registration number INPLASY202160090.

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“…Furthermore, changes in cognitive outcomes after a stroke can have a concomitant impact on motor function and recovery outcomes. There is a correlation between cognitive and motor function and recovery outcomes, according to several studies [ 88 ].…”

Section: Bci Applications In Nerve Rehabilitation After Strokementioning

confidence: 99%

Exploring the Use of Brain-Computer Interfaces in Stroke Neurorehabilitation

Yang

et al. 2021

BioMed Research International

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With the continuous development of artificial intelligence technology, “brain-computer interfaces” are gradually entering the field of medical rehabilitation. As a result, brain-computer interfaces (BCIs) have been included in many countries’ strategic plans for innovating this field, and subsequently, major funding and talent have been invested in this technology. In neurological rehabilitation for stroke patients, the use of BCIs opens up a new chapter in “top-down” rehabilitation. In our study, we first reviewed the latest BCI technologies, then presented recent research advances and landmark findings in BCI-based neurorehabilitation for stroke patients. Neurorehabilitation was focused on the areas of motor, sensory, speech, cognitive, and environmental interactions. Finally, we summarized the shortcomings of BCI use in the field of stroke neurorehabilitation and the prospects for BCI technology development for rehabilitation.

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The Active Ingredient of Cognitive Restoration: A Multicenter Randomized Controlled Trial of Sequential Combination of Aerobic Exercise and Computer-Based Cognitive Training in Stroke Survivors With Cognitive Decline

Cited by 50 publications

References 40 publications

[Retracted] Meta‐Analysis on Cognitive Benefit of Exercise after Stroke

[Retracted] Meta‐Analysis on Cognitive Benefit of Exercise after Stroke

Effects of Combined Cognitive and Exercise Interventions on Poststroke Cognitive Function: A Systematic Review and Meta-Analysis

Exploring the Use of Brain-Computer Interfaces in Stroke Neurorehabilitation

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