Effects of exercise on post-stroke cognitive function: a systematic review and meta-analysis of randomized controlled trials

Abstract

ABSTRACT Background A growing body of research examining the effect of exercise on cognitive function in stroke patients, while findings of available studies were conflicting. Objectives We aimed to estimate the effect of exercise on cognitive function in stroke patients. Methods For this systematic review and meta-analysis, we searched PubMed, Web of Science, Embase, Cochrane, and Scopus electronic databases, through 13 March 2023. The three-level restricted maximum likelihood random effects model was used to synthesize the data. Results Twenty-five studies met the inclusion criteria. There was a significant effect of exercise on improving cognitive function in stroke patients (Cohen’s d = 0.37, 95% CI, 0.16 to 0.58, p < 0.01, I2 = 22.12%). Subgroup analysis showed that exercise significantly improved memory. In addition, aerobic exercise, exercise conducted 12 weeks or more, 3 times or more per week, less than 60 minutes per session, less than 180 minutes per week, and up to 12 months post-stroke increased cognitive function significantly. Conclusions Exercise improved cognitive function in stroke patients. To improve cognitive function, this meta-analysis provides clinicians with evidence to recommend that stroke patients participate in aerobic exercise at least 3 times per week for 30–60 minutes, with a goal of 180 minutes per week being achieved by increasing the frequency of exercise. Exercise initiated within 12 months post-stroke and continued for 12 weeks or more is most beneficial for improving cognitive function.