A pilot study on the immediate and long-term effects of hybrid therapy of computer-based cognitive training and aerobic exercise in stroke patients with cognitive decline

Abstract

While the salient physical disability after stroke has long been emphasized, post-stroke cognitive decline hindering motor and functional recovery is often ignored. This study evaluated the immediate and long-term effects of hybrid therapies of computer-based cognitive training and aerobic exercise in stroke patients with cognitive decline. Stroke survivors with cognitive decline were separated into sequential (SEQ) and control groups (CON). Participants in the SEQ group ( n = 15) received 30-minute aerobic exercise followed by 30-minute computerized cognitive training; participants in the CON group ( n = 12) received 30-minute non-aerobic exercise (e.g., stretching and muscle strengthening) and 30-minute unstructured cognitive training (e.g., reading newspapers and playing board games). All participants received trainings for three days per week for 12 weeks. The cognitive function outcomes included Montreal Cognitive Assessment (MoCA) and Verbal Paired Associates and Word Lists subtests from the Wechsler Memory Scale-III (WMS-III). Health-related quality of life was measured by EQ5D. Outcome measures were administered at baseline, immediately after training (3rd month), and at 6-month follow-up (9th month). Preliminary results showed that the SEQ group showed greater improvement in MoCA, WMS-Verbal Pair and Word Lists at post-training than the CON group, but not the EQ5D. These effects remained or had less decrements 6 months post-training compared to the CON group. Hybrid therapy of computer-based cognitive training and aerobic exercise training is favored to facilitate cognitive function in stroke survivors with cognitive decline. Our study demonstrates the potential benefit of this hybrid approach for long-term enhancement of cognition following stroke.