Department of Neurology, OLVG, Amsterdam, the Netherlands; Department of Quality and Improvement, OLVG, Amsterdam, the Netherlands.
Department of Psychology, Woonzorggroep Samen, Schagen, the Netherlands.
J Stroke Cerebrovasc Dis. 2024 Jan;33(1):107441. doi: 10.1016/j.jstrokecerebrovasdis.2023.107441. Epub 2023 Nov 15.
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.
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.
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.
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.
近期患有短暂性脑缺血发作(TIA)或小面积缺血性中风的患者认知功能受损风险增加。本研究旨在探讨为期 1 年的运动干预对 2 年随访期内认知功能的影响。
我们进行了一项单盲随机对照试验,以研究与常规护理相比,为期 1 年的运动干预对认知功能的影响,最长可达 2 年。将 TIA 或小中风患者随机分配至干预组(接受 1 年运动干预,n=60)或常规护理组(n=59)。在基线、1 年和 2 年后评估结局指标。我们使用神经心理学测试评估三个领域的认知功能:(1)执行功能,(2)注意力-心理运动速度,(3)记忆。线性混合模型用于纵向数据分析,以确定运动干预对认知功能的影响。统计分析使用 IBM SPSS 软件 24.0 进行。
我们发现,在两年的研究期间-并校正年龄、性别和教育水平-与对照组相比,干预组在执行功能方面的平均改善更为显著(β=0.13;95%CI[0.02 至 0.25];p=0.03)。在记忆或注意力-心理运动速度方面,未发现显著的干预效果。
我们的数据表明,与常规护理相比,为期 1 年的运动干预可随时间显著改善执行功能。我们建议医疗保健专业人员通过增加运动和体育活动来拓宽 TIA/小中风患者的标准二级中风预防治疗。