Liu-Ambrose Teresa, Eng Janice J
Aging, Mobility, and Cognitive Neuroscience Laboratory, University of British Columbia, Vancouver, British Columbia, Canada; Department of Physical Therapy, University of British Columbia, Vancouver, British Columbia, Canada; Brain Research Centre, Vancouver Coastal Health Research Institute, University of British Columbia, Vancouver, British Columbia, Canada; Centre for Hip Health and Mobility, Vancouver Coastal Health Research Institute, University of British Columbia, Vancouver, British Columbia, Canada.
Department of Physical Therapy, University of British Columbia, Vancouver, British Columbia, Canada; Rehab Research Laboratory, GF Strong Rehab Centre, Vancouver, British Columbia, Canada.
J Stroke Cerebrovasc Dis. 2015 Jan;24(1):130-7. doi: 10.1016/j.jstrokecerebrovasdis.2014.08.012. Epub 2014 Oct 18.
Stroke survivors represent a target population in need of intervention strategies to promote cognitive function and prevent dementia. Both exercise and recreational activities are promising strategies. We assessed the effect of a 6-month exercise and recreation program on executive functions in adults with chronic stroke.
A 6-month ancillary study within a multicentre randomized trial. Twenty-eight chronic stroke survivors (ie, ≥ 12 months since an index stroke) were randomized to 1 of 2 experimental groups: intervention (INT; n = 12) or delayed intervention (D-INT; n = 16). Participants of the INT group received a 6-month community-based structured program that included 2 sessions of exercise training and 1 session of recreation and leisure activities per week. Participants of the D-INT group received usual care. The primary outcome measure was the Stroop Test, a cognitive test of selective attention and conflict resolution. Secondary cognitive measures included set shifting and working memory. Mood, functional capacity, and general balance and mobility were additional secondary outcome measures.
Compared with the D-INT group, the INT group significantly improved selective attention and conflict resolution (P = .02), working memory (P = .04), and functional capacity (P = .02) at the end of the 6-month intervention period. Improved selective attention and conflict resolution was significantly associated with functional capacity at 6 months (r = .39; P = .04).
This is the first randomized study to demonstrate that an exercise and recreation program can significantly benefit executive functions in community-dwelling chronic stroke survivors who are mildly cognitively impaired-a population at high-risk for dementia and functional decline. Thus, clinicians should consider prescribing exercise and recreational activities in the cognitive rehabilitation of chronic stroke survivors.
中风幸存者是需要干预策略以促进认知功能和预防痴呆的目标人群。运动和娱乐活动都是很有前景的策略。我们评估了一项为期6个月的运动和娱乐项目对成年慢性中风患者执行功能的影响。
在一项多中心随机试验中进行的为期6个月的辅助研究。28名慢性中风幸存者（即自首次中风起≥12个月）被随机分为2个实验组之一：干预组（INT；n = 12）或延迟干预组（D-INT；n = 16）。INT组的参与者接受了一项为期6个月的社区结构化项目，该项目包括每周2次运动训练和1次娱乐休闲活动。D-INT组的参与者接受常规护理。主要结局指标是斯特鲁普测验，这是一项关于选择性注意和冲突解决的认知测试。次要认知指标包括任务转换和工作记忆。情绪、功能能力以及总体平衡和活动能力是额外的次要结局指标。
与D-INT组相比，INT组在6个月干预期结束时，选择性注意和冲突解决能力（P = 0.02）、工作记忆（P = 0.04）和功能能力（P = 0.02）有显著改善。6个月时，选择性注意和冲突解决能力的改善与功能能力显著相关（r = 0.39；P = 0.04）。
这是第一项随机研究，证明运动和娱乐项目可使轻度认知障碍的社区居住慢性中风幸存者的执行功能显著受益，这些幸存者是痴呆和功能衰退的高危人群。因此，临床医生在慢性中风幸存者的认知康复中应考虑开具运动和娱乐活动处方。
