Introduction: Post-stroke cognitive decline is a major problem that affects up to 70% of stroke survivors. Combination of aerobic exercise and cognitive training has been found to be effective for improving cognitive functions in individuals with dementia and community-dwelling elderly. However, the training effects of combined training on stroke survivors with cognitive decline require further investigation.
Hypothesis: A sequential combination of aerobic exercise and cognitive training would be effective than control training on cognitive function, physical activity, and quality of life in stroke survivors with cognitive decline.
Methods: Stroke survivors with cognitive decline were recruited and separated into sequential (SEQ) and control groups (CON). Participants in the SEQ group (N=15) first received 30-minute aerobic exercise followed by 30-minute computerized cognitive training; participants in the CON group (N=15) received non-aerobic exercise and unstructured cognitive training for 60 minutes. All participants received trainings for three days per week for 12 weeks. The cognitive function outcomes included Montreal Cognitive Assessment (MoCA) and double decision (i.e., visual spatial processing). Six-minute walk test (6MWT) and International Physical Activity Questionnaire (IPAQ) were used to evaluate physical activity. Quality of life was assessed by Stroke Impact Scale (SIS). We used paired sample t-test to examine the within group training effect and analysis of covariance to determine the between groups training effect.
Results: From pre to post training, the SEQ group improved cognitive function (MoCA, p<0.001; double decision, p=0.006), physical function (6MWT, p=0.038; IPAQ, p=0.052) but not quality of life (SIS, p=0.47). The CON group, however, had no significant changes across all variables (all p’s>0.05). Compared to the CON group, the SEQ group improved cognitive function (MoCA, p=0.03) and physical activity (6MWT, p=0.025), but no group difference was found in double decision, IPAQ and SIS. (all p’s>0.05).
Conclusions: A sequential combination of aerobic exercise and cognitive training approach is favored to facilitate cognitive function and physical activity in stroke survivors with cognitive decline.