Effects of a 1 year aerobic and strength training on cognitive functioning after transient ischemic attack or minor stroke: A randomized controlled trial

Inger A Deijle; Ilse M Jonkers; Astrid M Hooghiemstra; Gwenda Engels; Jos W R Twisk; Henry C Weinstein; Sander M Van Schaik; Renske M Van den Berg-Vos

doi:10.1016/j.jstrokecerebrovasdis.2023.107441

Effects of a 1 year aerobic and strength training on cognitive functioning after transient ischemic attack or minor stroke: A randomized controlled trial

J Stroke Cerebrovasc Dis. 2024 Jan;33(1):107441. doi: 10.1016/j.jstrokecerebrovasdis.2023.107441. Epub 2023 Nov 15.

Authors

Inger A Deijle¹, Ilse M Jonkers², Astrid M Hooghiemstra³, Gwenda Engels⁴, Jos W R Twisk⁵, Henry C Weinstein⁴, Sander M Van Schaik⁴, Renske M Van den Berg-Vos⁶

Affiliations

¹ Department of Neurology, OLVG, Amsterdam, the Netherlands; Department of Quality and Improvement, OLVG, Amsterdam, the Netherlands. Electronic address: I.deijle@olvg.nl.
² Department of Psychology, Woonzorggroep Samen, Schagen, the Netherlands.
³ Department of Neurology, Alzheimer Center Amsterdam, Amsterdam Neuroscience, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands.
⁴ Department of Neurology, OLVG, Amsterdam, the Netherlands.
⁵ Department of Epidemiology and Data Science, Amsterdam UMC, Amsterdam, the Netherlands.
⁶ Department of Neurology, OLVG, Amsterdam, the Netherlands; Department of Neurology, Amsterdam UMC, Location AMC, Amsterdam, the Netherlands.

PMID: 37966094
DOI: 10.1016/j.jstrokecerebrovasdis.2023.107441

Abstract

Objectives: Patients who have recently suffered a transient ischemic attack (TIA) or minor ischemic stroke are at increased risk of cognitive impairment. In the present study, we aimed to investigate the effect of a 1-year exercise intervention on cognitive functioning up to 2 years post intervention.

Material and methods: We conducted a single-blind randomized controlled trial to investigate the effect of an exercise intervention on cognitive functioning, compared with usual care, for up to 2 years. Patients with a TIA or minor stroke were randomly allocated to an intervention group receiving the 1-year exercise intervention (n = 60) or to usual care (n = 59). Outcome measures were assessed at baseline and after 1 and 2 years. We measured cognition with neuropsychological tests on three domains: (1) executive functioning, (2) attention-psychomotor speed, and (3) memory. Linear mixed models were used for longitudinal data to determine the effect of the exercise intervention on cognitive functioning. Statistical analyses were performed using IBM SPSS software 24.0.

Results: We found that over the two years study period -and corrected for age, sex, and educational level- the intervention group on average improved significantly more in executive functioning than the control group (β = 0.13; 95 % CI [0.02 to 0.25]; p = 0.03). No significant intervention effects were found on either memory or attention-psychomotor speed.

Conclusions: Our data show that a 1-year exercise intervention significantly improved executive functioning over time, compared to usual care. We recommend that health care professionals consider broadening standard secondary stroke prevention treatment in patients with TIA/minor stroke by adding exercise and physical activity.

Keywords: Aerobic exercise; Cognitive function; Ischemic stroke; Strength training; Transient ischemic attack.

Publication types

Randomized Controlled Trial

MeSH terms

Cognition
Humans
Ischemic Attack, Transient* / complications
Ischemic Attack, Transient* / diagnosis
Ischemic Attack, Transient* / therapy
Resistance Training*
Single-Blind Method
Stroke* / complications
Stroke* / diagnosis
Stroke* / therapy