Clinical efficacy of aerobic exercise combined with computer-based cognitive training in stroke: a multicenter randomized controlled trial

ABSTRACT

Purpose

The objectives are to evaluate the effects of a sequential combination of aerobic exercise and cognitive training, compared with exercise or cognitive training alone, on cognitive function, physical function, daily function, quality of life, and social participation in stroke survivors with cognitive impairment.

Methods

This is a single-blind, parallel, randomized controlled trial. Stroke patients with mild cognitive impairment (n = 56) were randomly assigned to aerobic exercise training (n = 18), computerized cognitive training (n = 18), and the sequential combination of aerobic exercise and computerized cognitive training (n = 20) group. All groups underwent training 60 min/day, 3 days/week, for a total of 12 weeks. The primary outcomes included Montreal Cognitive Assessment (MoCA), Wechsler Memory Scale-Third Edition, and the Stroop color-word test. Secondary outcomes were the Timed Up and Go test, 6-Minute Walk Test, Functional Independence Measure, Lawton Instrumental Activities of Daily Living Scale, Community Integration Questionnaire, and Stroke Impact Scale.

Results

56 participants completed the trial. Compared with a single type of aerobic exercise or cognitive training, the combined training group showed significant improvement in MoCA (P < .05, η2 = 0.13), and two sub-tests in WMS-III (both P’s < 0.05) following the intervention. However, no between-group differences were observed for physical functions, daily function, quality of life, and social participation measures.

Conclusions

The findings provide evidence for the potential synergistic intervention in stroke survivors. Future studies investigating the transfer effects and the optimal training parameters with a larger sample is needed.

KEYWORDS:

• Aerobic exercise
• cognitive training
• computer-based cognitive training
• sequential training
• stroke

Acknowledgments

We thank and acknowledge the support from the research team and the staff from our recruiting sites who contributed to setting up and running this study.

Additional information

Funding

This study was supported by Chang Gung Memorial Hospital [CMRPD1F0411-413, CMRPD1E0283]; the Ministry of Science and Technology [MOST106-2314-B-182-024-MY3]; Healthy Aging Research Center, Chang Gung University from the Featured Areas Research Center Program within the framework of the Higher Education Sprout Project by the Ministry of Education (MOE) [EMRPD1H0391] in Taiwan.