Effects of Combined Cognitive Training With Aerobic Exercise in Stroke Patients With MCI

Author(s):  
2021 ◽  
Vol 11 (4) ◽  
pp. 473
Author(s):  
Laura Amorós-Aguilar ◽  
Erica Rodríguez-Quiroga ◽  
Sara Sánchez-Santolaya ◽  
Margalida Coll-Andreu

(1) Background: Stroke is a major cause of permanent disability in multiple functions, including the cognitive domain. Since both cognitive training and aerobic physical exercise may exert positive effects on cognition after stroke, one may expect synergistic benefits when combining both interventions. (2) Methods: We carried out a systematic search of studies testing, in adult stroke patients, whether structured aerobic exercise combined with cognitive training led to higher cognitive benefits than either of these interventions when applied singly, or than interventions not including aerobic exercise or cognitive training. (3) Results: Five fair-quality randomized controlled trials fulfilled the search criteria. Exercise intensity was moderate–vigorous and cognitive training was mainly computer-based. The studies were heterogeneous regarding the cognitive tests used, and for this reason, a meta-analysis was not performed. Only three studies included follow-up assessment. The combined intervention was associated with pre-post improvement in at least one cognitive test in all the studies, and with higher positive effects compared to other conditions (although statistical significance was not always reached) in four studies. (4) Conclusions: Further trials including a long-term follow-up and comprehensive neuropsychological testing should be undertaken to determine whether combined aerobic exercise and cognitive training leads to additive cognitive benefits after stroke.


2014 ◽  
Vol 29 (3) ◽  
pp. 717-730 ◽  
Author(s):  
Mark A. McDaniel ◽  
Ellen F. Binder ◽  
Julie M. Bugg ◽  
Emily R. Waldum ◽  
Carolyn Dufault ◽  
...  

2019 ◽  
Author(s):  
Geneviève Richard ◽  
Knut Kolskår ◽  
Kristine M. Ulrichsen ◽  
Tobias Kaufmann ◽  
Dag Alnæs ◽  
...  

AbstractCognitive deficits are important predictors for outcome, independence and quality of life after stroke, but often remain unnoticed and unattended because other impairments are more evident. Computerized cognitive training (CCT) is among the candidate interventions that may alleviate cognitive difficulties, but the evidence supporting its feasibility and effectiveness is scarce, partly due to the lack of tools for outcome prediction and monitoring. Magnetic resonance imaging (MRI) provides candidate markers for disease monitoring and outcome prediction. By integrating information not only about lesion extent and localization, but also regarding the integrity of the unaffected parts of the brain, advanced MRI provides relevant information for developing better prediction models in order to tailor cognitive intervention for patients, especially in a chronic phase.Using brain age prediction based on MRI based brain morphometry and machine learning, we tested the hypotheses that stroke patients with a younger-appearing brain relative to their chronological age perform better on cognitive tests and benefit more from cognitive training compared to patients with an older-appearing brain. In this randomized double-blind study, 54 patients who suffered mild stroke (>6 months since hospital admission, NIHSS<7 at hospital discharge) underwent 3-weeks CCT and MRI before and after the intervention. In addition, patients were randomized to one of two groups receiving either active or sham transcranial direct current stimulation (tDCS). We tested for main effects of brain age gap (estimated age – chronological age) on cognitive performance, and associations between brain age gap and task improvement. Finally, we tested if longitudinal changes in brain age gap during the intervention were sensitive to treatment response. Briefly, our results suggest that longitudinal brain age prediction based on automated brain morphometry is feasible and reliable in stroke patients. However, no significant association between brain age and both performance and response to cognitive training were found.


2021 ◽  
Vol 13 ◽  
Author(s):  
NanNan Gu ◽  
Hechun Li ◽  
Xinyi Cao ◽  
Ting Li ◽  
Lijuan Jiang ◽  
...  

The entorhinal cortex (EC) plays an essential role in age-related cognitive decline. However, the effect of functional connectivity (FC) changes between EC and other cerebral cortices on cognitive function remains unclear. The aim of this study was to explore the modulation of two interventions (cognitive training and aerobic exercise) on EC-FC in community-dwelling older adults. In total, 94 healthy older adults aged between 65 and 75 years were assigned to either the cognitive training or aerobic exercise group to receive 24 sessions over 12 weeks, or to a control group. Resting-state functional magnetic resonance imaging was performed at both baseline and 12-month follow-up. Compared to the cognitive training group, the aerobic exercise group showed greater EC-FC in the bilateral middle temporal gyrus, right supramarginal gyrus, left angular gyrus, and right postcentral gyrus. Compared to the control group, the cognitive training group had a decreased EC-FC in the right hippocampus, right middle temporal gyrus, left angular gyrus, and right postcentral gyrus and an increased EC-FC in the bilateral pallidum, while the aerobic exercise group showed increased EC-FC between the right medial prefrontal cortex(mPFC), bilateral pallidum, and right precuneus. Baseline EC-FC in the mPFC was positively correlated with the visuospatial/constructional index score of the Repeatable Battery for the Assessment of Neuropsychological Status. In the cognitive training group, EC-FC value changes in the right hippocampus were negatively correlated with changes in the RBANS delayed memory index score, while in the aerobic exercise group, EC-FC value changes in the left angular gyrus were positively correlated with changes in the RBANS attention index score. These findings support the hypothesis that both cognitive training and aerobic exercise can modulate EC-FC in aging populations but through different neural pathways.


2021 ◽  
Vol 7 (5) ◽  
pp. 3168-3173
Author(s):  
NING Min ◽  
ZENG Hui

Objective To study the nursing effect of individualized health education combined with cognitive training in elderly stroke patients. Methods 112 elderly stroke patients treated in the Department of Neurology of our hospital from January to June 2017 were randomly divided into experimental group and control group. In the control group, routine treatment, nursing and rehabilitation exercises were carried out, and regular health education was carried out. The experimental group, on the basis of routine treatment, nursing and rehabilitation exercise, carried out individualized health education and cognitive training combining the content of individualized health education. The effect of intervention was evaluated by Montreal Cognitive Assessment Scale (MoCA), health education questionnaire, daily life self-care scale (ADL) and nurse job satisfaction questionnaire before intervention, at the end of intervention for 4 weeks and at the end of intervention for 12 weeks. Results At the end of 4th and 12th week after intervention, the scores o MoCA, the awareness rate of health education, ADL and job satisfaction of nurses were higher than those before intervention, and the observation group was higher than that of the control group (P<0.05), with statistical difference (P<0.05). Conclusion Individualized health education combined with cognitive training can effectively improve the patients’ cognitive function, improve the patients’ awareness of stroke disease and the compliance of health education, improve the patients’ self-care ability in daily life and the satisfaction of nursing work, so as to improve the patients’ quality of life and quality of living.


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