Lin Huawei, Liu HuanHuan, Dai Yaling, Yin Xiaolong, Li Zuanfang, Yang Lei, Tao Jing, Liu Weilin, Chen Lidian
College of Rehabilitation Medicine, Fujian University of Traditional Chinese Medicine, Fuzhou, China.
National-Local Joint Engineering Research Center of Rehabilitation Medicine Technology, Fujian University of Traditional Chinese Medicine, Fuzhou, China.
Front Neurol. 2022 May 6;13:854158. doi: 10.3389/fneur.2022.854158. eCollection 2022.
This study investigates the effect of physical activity (PA) on cognition in patients with cerebrovascular disease and explored the maximum benefit of different PA characteristics.
Databases, such as Pubmed, Web of Science, Embase, and Cochrane Library, were searched from their inception to May 31, 2021. Standardized mean difference (SMD) and 95% confidence intervals (s) were calculated to generate a forest plot. In addition, subgroup analysis, moderation analysis, and regression analysis were performed to explore the possible adjustment factors.
In total, 22 studies that met the criteria were included, demonstrating data from 1,601 participants. The results indicated that PA produced a positive effect on the global cognition for patients with cerebrovascular disease (SMD: 0.20 [95% : 0.12-0.27]), at the same time, PA training prominently improved executive function (SMD: 0.09 [95% : 0.00-0.17]) and working memory (SMD: 0.25 [95% : 0.10-0.40]). Furthermore, patients with baseline cognitive impairment received the greater benefit of PA on cognition (SMD: 0.24 [95% : 0.14-0.34]) than those without cognitive impairment before intervention (SMD: 0.15 [95% : 0.04-0.26]). For patients in the acute stage (≤ 3 months), PA did not rescue impairment dysfunction significantly (SMD: 0.08 [95% : -0.04-0.21]) and remarkable cognitive gains were detected in the chronic stage of participants (>3 months) (SMD: 0.25 [95% : 0.16-0.35]). Moderate intensity PA showed a larger pooled effect size (SMD: 0.23 [95% : 0.11-0.36]) than low intensity (SMD: -0.01 [95% : -0.44-0.43]) and high intensity (SMD: 0.16 [95% : 0.03-0.29]). However, the different types, duration, and frequency of PA resulted in no differences in the improvement of cognitive function. Further regression analysis demonstrated that the beneficial effects of PA on cognition are negatively correlated with age ( < 0.05).
This study revealed that PA can prominently improve the cognitive ability in patients with cerebrovascular diseases and strengthened the evidence that PA held promise as a widely accessible and effective non-drug therapy for vascular cognitive impairment (VCI).
本研究调查了体育活动（PA）对脑血管疾病患者认知功能的影响，并探索了不同PA特征的最大益处。
检索了PubMed、Web of Science、Embase和Cochrane图书馆等数据库，检索时间从建库至2021年5月31日。计算标准化均值差（SMD）和95%置信区间以生成森林图。此外，进行了亚组分析、调节分析和回归分析以探索可能的调整因素。
共纳入22项符合标准的研究，涉及1601名参与者的数据。结果表明，PA对脑血管疾病患者的整体认知产生了积极影响（SMD：0.20 [95%：0.12 - 0.27]），同时，PA训练显著改善了执行功能（SMD：0.09 [95%：0.00 - 0.17]）和工作记忆（SMD：0.25 [95%：0.10 - 0.40]）。此外，基线认知障碍患者在PA对认知的益处方面（SMD：0.24 [95%：0.14 - 0.34]）比干预前无认知障碍的患者（SMD：0.15 [95%：0.04 - 0.26]）更大。对于急性期（≤3个月）的患者，PA并未显著挽救功能障碍（SMD：0.08 [95%： - 0.04 - 0.21]），而在慢性期（>3个月）的参与者中检测到显著的认知改善（SMD：0.25 [95%：0.16 - 0.35]）。中等强度PA显示出比低强度（SMD： - 0.01 [95%： - 0.44 - 0.43]）和高强度（SMD：0.16 [95%：0.03 - 0.29]）更大的合并效应量（SMD：0.23 [95%：0.11 - 0.36]）。然而，PA的不同类型、持续时间和频率在认知功能改善方面没有差异。进一步的回归分析表明，PA对认知的有益影响与年龄呈负相关（<0.05）。
本研究表明，PA可以显著提高脑血管疾病患者的认知能力，并强化了PA有望成为一种广泛可用且有效的血管性认知障碍（VCI）非药物治疗方法的证据。
