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Abstract
BackgroundAerobic exercise and cognitive training have been effective in improving cognitive functions; however, whether the combination of these two can further enhance cognition and clinical outcomes in stroke survivors with cognitive decline remains unknown. This study aimed to determine the treatment effects of a sequential combination of aerobic exercise and cognitive training on cognitive function and clinical outcomes.Methods/designStroke survivors (n = 75) with cognitive decline will be recruited and randomly assigned to cognitive training, aerobic exercise, and sequential combination of aerobic exercise and cognitive training groups. All participants will receive training for 60 minutes per day, 3 days per week for 12 weeks. The aerobic exercise group will receive stationary bicycle training, the cognitive training group will receive cognitive-based training, and the sequential group will first receive 30 minutes of aerobic exercise, followed by 30 minutes of cognitive training. The outcome measures involve cognitive functions, physiological biomarkers, daily function and quality of life, physical functions, and social participation. Participants will be assessed before and immediately after the interventions, and 6 months after the interventions. Repeated measures of analysis of variance will be used to evaluate the changes in outcome measures at the three assessments.DiscussionThis trial aims to explore the benefits of innovative intervention approaches to improve the cognitive function, physiological markers, daily function, and quality of life in stroke survivors with cognitive decline. The findings will provide evidence to advance post-stroke cognitive rehabilitation.Trial registrationClinicalTrials.gov, NCT02550990. Registered on 6 September 2015.
Highlights
Aerobic exercise and cognitive training have been effective in improving cognitive functions; whether the combination of these two can further enhance cognition and clinical outcomes in stroke survivors with cognitive decline remains unknown
This trial aims to explore the benefits of innovative intervention approaches to improve the cognitive function, physiological markers, daily function, and quality of life in stroke survivors with cognitive decline
These results provide evidence that intensive cognitive training can improve cognitive function in stroke survivors
Summary
Aerobic exercise and cognitive training have been effective in improving cognitive functions; whether the combination of these two can further enhance cognition and clinical outcomes in stroke survivors with cognitive decline remains unknown. Starovasnik Žagavec et al [12] studied the effect of computer-based cognitive rehabilitation on work-active patients after stroke and reported a moderate to strong effect on the divided attention and a mild effect on the alertness They suggested that the attention system can be rehabilitated by training the reaction speed and learning the awareness and selection of suitable stimuli. Another randomized controlled trial examined the effects of 5 weeks working memory training in stroke survivors and found training effects on attention and subjective experience of cognitive functioning in daily living (as measured by the Cognitive Failure Questionnaire) [13]. A recent study suggests that the increased resting-state functional connectivity of the hippocampus with the frontal and parietal lobes may be an important mechanism of cognitive recovery after stroke [14]
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