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|The effects of high-intensity aerobic exercise on cognitive performance after stroke: a pilot randomised controlled trial|
|Pallesen H, Bjerk M, Pedersen AR, Nielsen JF, Evald L|
|Journal of Central Nervous System Disease 2019 Apr 22;11:1179573519843493|
|5/10 [Eligibility criteria: Yes; Random allocation: Yes; Concealed allocation: No; Baseline comparability: Yes; Blind subjects: No; Blind therapists: No; Blind assessors: Yes; Adequate follow-up: No; Intention-to-treat analysis: No; Between-group comparisons: Yes; Point estimates and variability: Yes. Note: Eligibility criteria item does not contribute to total score] *This score has been confirmed*|
BACKGROUND: Aerobic exercise is an effective treatment to improve aerobic capacity following stroke and might also improve cognitive impairments in sub-acute stroke survivors. The aim of the study was to assess the effect of high-intensity aerobic exercise on cognitive impairments in sub-acute stroke survivors. METHODS: A pilot, randomised controlled trial on the effects of aerobic exercise on cognitive impairments of stroke patients in the sub-acute (1 to 3 months) phase was conducted. Thirty patients with moderate cognitive impairments (maximum score of 5 on at least two items on the cognitive subscales of the Functional Independence Measure (FIM)) were included in the study and randomly assigned to either the intervention group - performing high-intensity aerobic exercise (above 70% of maximum heart rate), or the control group -- performing low-intensity aerobic exercise (below 60%). Patients in both groups exercised for 50 min twice a week for 4 weeks. Primary neuropsychological outcome: Trail Making Test B. RESULTS: Thirty stroke patients completed the interventions. The results showed that the high-intensity group, compared with the low-intensity group, achieved significant improvements on Trail Making Test B, which assesses processing speed and divided attention (p = 0.04 after training and p = 0.01 at follow-up). However, the significant improvements on Trail Making Test B might relate to a ceiling effect in the control group. CONCLUSIONS: This study does not provide evidence to support that aerobic exercise can improve cognition in stroke survivors, even though significant improvement was revealed on the primary outcome in sub-acute stroke survivors following high-intensity aerobic exercise compared with low-intensity general exercise.