Khattab Shereen, Wiley Elise, Fang Hanna, Richardson Julie, MacDermid Joy, Tang Ada
School of Rehabilitation Science, McMaster University, Hamilton, ON, Canada.
Department of Physical Therapy, University of Western, London, ON, Canada.
Disabil Rehabil. 2021 Dec;43(25):3574-3591. doi: 10.1080/09638288.2020.1744199. Epub 2020 Mar 27.
The aim of this systematic review was to investigate if sex moderated the effect of exercise on cognition in adults post-stroke.
A systematic review was conducted of randomized controlled trials that involved adults ≥18 years with stroke, any exercise intervention, and reported any outcome related to cognitive function. We compared effect sizes of cognitive outcomes between studies of lower and higher proportion of females (CRD42018092757).
The effects of exercise did not differ between studies of higher and lower female proportions with respect to memory ( =1.52, = 0.22), executive function ( = 0.56, = 0.45; Chi = 0.00, = 0.98), language (Chi = 3.17, = 0.08) or global cognition ( = 0.88, = 0.35).
There were no sex differences in the effects of exercise on memory, executive functioning, language or global cognition in individuals with stroke. Further research is warranted to address sex differences in individuals with stroke to enable better targeting, prevention, and interventions in stroke rehabilitation.IMPLICATIONS FOR REHABILITATIONUnderstanding sex differences and potentially similarities in the relationship between exercise and cognition is an important step in enhancing stroke rehabilitation and the development of optimal, sex-specific rehabilitation.Although our findings suggest that there is no clear rationale for incorporating sex into our clinical decision making, it is still imperative to consider sex factors in research and report results in the literature disaggregated by sex to help inform clinical practice.
本系统评价旨在研究性别是否会调节运动对中风后成年人认知功能的影响。
对涉及18岁及以上中风成年人、任何运动干预措施且报告了与认知功能相关任何结果的随机对照试验进行系统评价。我们比较了女性比例较低和较高的研究之间认知结果的效应大小（CRD42018092757）。
在记忆（=1.52，=0.22）、执行功能（=0.56，=0.45；卡方=0.00，=0.98）、语言（卡方=3.17，=0.08）或整体认知（=0.88，=0.35）方面，女性比例较高和较低的研究中运动的效果没有差异。
运动对中风患者的记忆、执行功能、语言或整体认知的影响不存在性别差异。有必要进行进一步研究以探讨中风患者的性别差异，从而在中风康复中实现更好的目标设定、预防和干预。
对康复的启示
了解运动与认知之间关系中的性别差异以及潜在的相似性是加强中风康复和制定最佳的、针对性别的康复方案的重要一步。
虽然我们的研究结果表明在临床决策中纳入性别因素没有明确的理论依据，但在研究中考虑性别因素并在文献中按性别分类报告结果以帮助指导临床实践仍然至关重要。
