Background: The Bugher Stroke and Exercise Study examines the impact of a structured exercise and cognitive training program after stroke. In this preliminary analysis we investigated baseline predictors and demographics related to physical, cognitive and affective improvements.
Methods: Participants with recent stroke and limited physical activity ≥ 3 months prior to enrollment were randomized to one of two arms of a 3-month intervention. Arm 1 (N=62) received exercise (strength & cardiovascular) and cognitive training. Arm 2 (N=35) received light stretching and sham cognitive training. Outcome measures included depression (CES-D), cognition (MoCA), stroke impact scale (SIS), impairment (NIHSS), degree of disability (mRS), and physical measures of hand grip (HG), time up and go (TUG), 30-second chair stand test, 6-minute walk, waist circumference, BMI and blood pressure (BP). The trial is ongoing, therefore treatment group comparisons were not available. T-tests evaluated change in outcome measures among all participants. Regression analyses evaluated demographic variables and baseline factors (i.e., time-since-stroke, ischemic vs. hemorrhagic, & pre-stroke physical activity) associated with change in outcome measures.
Results: To date, 97 participants were enrolled (Mage 59±11 years; 34% women; 53% white, 49% Hispanic, 39% black & 7% other). Participants demonstrated significant improvement on the CES-D (p=.005), MoCA (p=.005), NIHSS (p<.001), SIS (p=.015), mRS (p<.001), HG (p=.002), TUG (p=.004), 30-second chair (p<.001), 6-minute walk (p=.001), waist circumference (p=.010), and both systolic (p=.009) and diastolic (p<.001) BP. Regression analyses revealed that older adults were less likely to improve in MoCA scores (p=.010), 6-minute walk (p=.041), and systolic BP (p=.032). Participants with more pre-stroke physical activity demonstrated greater improvement in 6-minute walk (p=.024). Black participants saw less decline in systolic BP (p=.033) while participants with hemorrhagic (vs. ischemic) stroke saw less decline in diastolic BP (p=.039).
Conclusions: Participation in an exercise and cognitive training intervention benefit stroke survivors; however, improvement may depend on baseline and demographic factors.