Department of Geriatric, Oslo University Hospital, 0424 Oslo, Norway.
J Rehabil Med. 2019 Oct 4;51(9):646-651. doi: 10.2340/16501977-2588.
To examine the effects of individualized regular coaching and exercise on post-stroke cognitive and emotional function.
The Life After STroke (LAST) study investigated the differences between intervention and care-as-usual between 3 and 21 months post-stroke. Outcome measures were the Trail Making Test (TMT) A and B, Mini Mental State Examination (MMSE), Hospital Anxiety and Depression Scale (HADS), and adherence to the intervention.
Of the 362 patients included in the study, 177 were assigned to the intervention. The mean age was 71.7 (SD 11.3) years and 39.5% were female. The adjusted mean difference between groups for TMT A was 8.54 (CI 0.7 to 16.3), p = 0.032, for TMT B 8.6 (CI -16.5 to 33.6), p = 0.50, for MMSE -0.1 (CI -0.8 to 0. 6), p = 0.77, for HADS A -0.2 (CI -0.9 to 0.5), p = 0.56 and for HADS D -0.1 (CI -0.7 to 0.5), p = 0.76). A higher level of adherence to the intervention was significantly associated with increased MMSE (B = 0.030 (CI 0.005-0.055), p = 0.020) Conclusion: No clinically relevant effects on cognitive or emotional function were found of individualized regular coaching for physical activity and exercise. However, increased adherence to the intervention was associated with improved cognitive function.
研究个体化定期指导和运动对卒中后认知和情绪功能的影响。
在卒中后生活（LAST）研究中，比较了卒中后 3 至 21 个月时干预组与常规护理组之间的差异。评估指标包括连线测试（TMT）A 和 B、简易精神状态检查（MMSE）、医院焦虑抑郁量表（HADS）和对干预措施的依从性。
在纳入的 362 例患者中，177 例被分配到干预组。平均年龄为 71.7（SD 11.3）岁，39.5%为女性。TMT A 的组间调整平均差异为 8.54（CI 0.7 至 16.3），p=0.032，TMT B 为 8.6（CI-16.5 至 33.6），p=0.50，MMSE 为-0.1（CI-0.8 至 0.6），p=0.77，HADS A 为-0.2（CI-0.9 至 0.5），p=0.56，HADS D 为-0.1（CI-0.7 至 0.5），p=0.76。对干预措施的依从性越高，MMSE 评分越高（B=0.030（CI 0.005-0.055），p=0.020）。
针对身体活动和运动的个体化定期指导并未发现对认知或情绪功能有临床相关影响。然而，增加对干预措施的依从性与认知功能的改善相关。
