Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

Keynote webinar | Spotlight on medication adherence

LIVE: Thursday 27th June 2024, 18:00-19:30 (CEST)
Join our expert panel to discover why you need to understand the drivers of non-adherence in your patients, and how you can optimize medication adherence in your clinics to drastically improve patient outcomes.
ADVANCED SEARCH
Log in
Top
Trials
Published in: Trials 1/2017

Open Access 01-12-2017 | Study protocol

Synergistic effects of aerobic exercise and cognitive training on cognition, physiological markers, daily function, and quality of life in stroke survivors with cognitive decline: study protocol for a randomized controlled trial

Authors: Ting-ting Yeh, Ching-yi Wu, Yu-wei Hsieh, Ku-chou Chang, Lin-chien Lee, Jen-wen Hung, Keh-chung Lin, Ching-hung Teng, Yi-han Liao

Published in: Trials | Issue 1/2017

Login to get access

Abstract

Background

Aerobic exercise and cognitive training have been effective in improving cognitive functions; however, whether the combination of these two can further enhance cognition and clinical outcomes in stroke survivors with cognitive decline remains unknown. This study aimed to determine the treatment effects of a sequential combination of aerobic exercise and cognitive training on cognitive function and clinical outcomes.

Methods/design

Stroke survivors (n = 75) with cognitive decline will be recruited and randomly assigned to cognitive training, aerobic exercise, and sequential combination of aerobic exercise and cognitive training groups. All participants will receive training for 60 minutes per day, 3 days per week for 12 weeks. The aerobic exercise group will receive stationary bicycle training, the cognitive training group will receive cognitive-based training, and the sequential group will first receive 30 minutes of aerobic exercise, followed by 30 minutes of cognitive training. The outcome measures involve cognitive functions, physiological biomarkers, daily function and quality of life, physical functions, and social participation. Participants will be assessed before and immediately after the interventions, and 6 months after the interventions. Repeated measures of analysis of variance will be used to evaluate the changes in outcome measures at the three assessments.

Discussion

This trial aims to explore the benefits of innovative intervention approaches to improve the cognitive function, physiological markers, daily function, and quality of life in stroke survivors with cognitive decline. The findings will provide evidence to advance post-stroke cognitive rehabilitation.

Trial registration

ClinicalTrials.gov, NCT02550990. Registered on 6 September 2015.
Appendix
Available only for authorised users
Literature
1.
Qu Y, Zhuo L, Li N, et al. Prevalence of poststroke cognitive impairment in China: a community-based, cross-sectional study. PLoS One. 2015;10:1–13.
2.
Jacquin A, Binquet C, Rouaud O, et al. Post-stroke cognitive impairment: high prevalence and determining factors in a cohort of mild stroke. J Alzheimers Dis. 2014;40:1029–38.PubMed
3.
Garcia PY, Roussel M, Bugnicourt JM, et al. Cognitive impairment and dementia after intracerebral hemorrhage: a cross-sectional study of a hospital-based series. J Stroke Cerebrovasc Dis. 2013;22:80–6.CrossRefPubMed
4.
5.
Pollock A, St George B, Fenton M, et al. Top 10 research priorities relating to life after stroke - consensus from stroke survivors, caregivers, and health professionals. Int J Stroke. 2014;9:313–20.CrossRefPubMed
6.
Ploughman M, McCarthy J, Bossé M, et al. Does treadmill exercise improve performance of cognitive or upper-extremity tasks in people with chronic stroke? A randomized cross-over trial. Arch Phys Med Rehabil. 2008;89:2041–7.CrossRefPubMed
7.
Pyöriä O, Talvitie U, Nyrkkö H, et al. The effect of two physiotherapy approaches on physical and cognitive functions and independent coping at home in stroke rehabilitation. A preliminary follow-up study. Disabil Rehabil. 2007;29:503–11.CrossRefPubMed
8.
9.
van de Ven RM, Murre JM, Veltman DJ, et al. Computer-based cognitive training for executive functions after stroke: a systematic review. Front Hum Neurosci. 2016;10:1–27.
10.
Blanchet S, Richards CL, Leblond J, et al. Cardiorespiratory fitness and cognitive functioning following short-term interventions in chronic stroke survivors with cognitive impairment: a pilot study. Int J Rehabil Res. 2016;39:153–9.CrossRefPubMed
11.
Gillespie DC, Bowen A, Chung CS, et al. Rehabilitation for post-stroke cognitive impairment: an overview of recommendations arising from systematic reviews of current evidence. Clin Rehabil. 2015;29:120–8.CrossRefPubMed
12.
Starovasnik Žagavec B, Mlinaric Lešnik V, Goljar N. Training of selective attention in work-active stroke patients. Int J Rehabil Res. 2015;38:370–2.CrossRefPubMed
13.
Westerberg H, Jacobaeus H, Hirvikoski T, Clevberger P, Östensson ML, Bartfai A, Klingberg T. Computerized working memory training after stroke – a pilot study. Brain Inj. 2007;9052:20–9.
14.
Lin ZC, Tao J, Gao YL, Yin DZ, Chen AZ, Chen LD. Analysis of central mechanism of cognitive training on cognitive impairment after stroke: resting-state functional magnetic resonance imaging study. J Int Med Res. 2014;42:659–68.CrossRefPubMed
15.
Laurin D, Verreault R, Lindsay J, MacPherson K, Rockwood K. Physical activity and risk of cognitive impairment and dementia in elderly persons. Arch Neurol. 2001;58:498–504.CrossRefPubMed
16.
Cumming TB, Tyedin K, Churilov L, et al. The effect of physical activity on cognitive function after stroke: a systematic review. Int Psychogeriatr. 2012;24:557–67.CrossRefPubMed
17.
Barber SE, Clegg AP, Young JB. Is there a role for physical activity in preventing cognitive decline in people with mild cognitive impairment? Age Ageing. 2012;41:5–8.CrossRefPubMed
18.
Cumming TB, Marshall RS, Lazar RM. Stroke, cognitive deficits, and rehabilitation: still an incomplete picture. Int J Stroke. 2013;8:38–45.CrossRefPubMed
19.
Gómez-Palacio-Schjetnan A, Escobar ML. Neurotrophins and synaptic plasticity. Curr Top Behav Neurosci. 2013;15:117–36.CrossRefPubMed
20.
Komulainen P, Pedersen M, Hänninen T, Bruunsgaard H, Lakka TA, Kivipelto M, et al. BDNF is a novel marker of cognitive function in ageing women: the DR’s EXTRA Study. Neurobiol Learn Mem. 2008;90:596–603.CrossRefPubMed
21.
Zhang XY, Liang J, Chen DC, Xiu MH, Yang FD, Kosten TA, et al. Low BDNF is associated with cognitive impairment in chronic patients with schizophrenia. Psychopharmacology (Berl). 2012;222:277–84.CrossRef
22.
Angelucci F, Peppe A, Carlesimo GA, et al. A pilot study on the effect of cognitive training on BDNF serum levels in individuals with Parkinson’s disease. Front Hum Neurosci. 2015;9:1–11.CrossRef
23.
Langdon KD, Corbett D. Improved working memory following novel combinations of physical and cognitive activity. Neurorehabil Neural Repair. 2012;26:523–32.CrossRefPubMed
24.
Fabre C, Chamari K, Mucci P. Improvement of cognitive function by mental and / or individualized aerobic training in healthy elderly subjects. Int J Sports Med. 2002;33:415–21.CrossRef
25.
Law LLF, Barnett F, Yau MK, et al. Effects of combined cognitive and exercise interventions on cognition in older adults with and without cognitive impairment: a systematic review. Ageing Res Rev. 2014;15:61–75.CrossRefPubMed
26.
Liu-Ambrose T, Eng JJ. Exercise training and recreational activities to promote executive functions in chronic stroke: a proof-of-concept study. J Stroke Cerebrovasc Dis. 2015;24:130–7.CrossRefPubMed
27.
Labban J, Etnier J. Effects of acute exercise on long-term memory. Res Q Exerc Sport. 2011;82:712–21.CrossRefPubMed
28.
Coles K, Tomporowski PD. Effects of acute exercise on executive processing, short-term and long-term memory. J Sports Sci. 2008;26:333–44.CrossRefPubMed
29.
Kim GY, Han MR, Lee HG. Effect of dual-task rehabilitative training on cognitive and motor function of stroke patients. J Phys Ther Sci. 2014;26:1–6.CrossRefPubMedPubMedCentral
30.
Carvalho A, Rea IM, Parimon T, Cusack BJ. Physical activity and cognitive function in individuals over 60 years of age: a systematic review. Clin Interv Aging. 2014;9:661–82.PubMedPubMedCentral
31.
Tanaka H, Monahan KD, Seals DR. Age-predicted maximal heart rate revisited. J Am Coll Cardiol. 2001;37:153–6.CrossRefPubMed
32.
Borg G. Psychophysical bases of perceived exertion. Med Sci Sports Exerc. 1982;14:377–81.PubMed
33.
Chiti G, Pantoni L. Use of Montreal cognitive assessment in patients with stroke. Stroke. 2014;45:3135–40.CrossRefPubMed
34.
Tu Q-Y, Jin H, Ding B-R, Yang X, Lei Z-H, Bai S, et al. Reliability, validity, and optimal cutoff score of the Montreal cognitive assessment (Changsha version) in ischemic cerebrovascular disease patients of Hunan province, China. Dement Geriatr Cogn Dis Extra. 2013;3:25–36.CrossRefPubMedPubMedCentral
35.
Wechsler D. Wechsler memory scale. 3rd ed. San Antonio: The Psychological Corporation; 1997.
36.
Groth-Marnet G. Handbook of psychological assessment. Hoboken: John Wiley & Sons, Inc.; 2009.
37.
Wechsler D. WAIS-R Manual. New York: Psychological; 1981.
38.
George S, Crotty M. Establishing criterion validity of the useful field of view assessment and stroke drivers’ screening assessment: comparison to the result of on-road assessment. Am J Occup Ther. 2010;64:114–22.CrossRefPubMed
39.
Baetens T, De Kegel A, Palmans T, Oostra K, Vanderstraeten G, Cambier D. Gait analysis with cognitive-motor dual tasks to distinguish fallers from nonfallers among rehabilitating stroke patients. Arch Phys Med Rehabil. 2013;94:680–6.CrossRefPubMed
40.
Ottenbacher KJ, Hsu Y, Granger CV, Fiedler RC. The reliability of the functional independence measure: a quantitative review. Arch Phys Med Rehabil. 1996;77:1226–32.CrossRefPubMed
41.
Hsueh I-P, Lin J-H, Jeng J-S, Hsieh C-L. Comparison of the psychometric characteristics of the functional independence measure, 5 item Barthel index, and 10 item Barthel index in patients with stroke. J Neurol Neurosurg Psychiatry. 2002;73:188–90.CrossRefPubMedPubMedCentral
42.
Lawton MP, Brody EM. Assessment of older people; self- maintaining and instrumental activity of daily living. Gerontologist. 1969;9:179–86.CrossRefPubMed
43.
Vellone E, Savini S, Fida R, Dickson VV, Melkus GD, Carod-Artal FJ, et al. Psychometric evaluation of the Stroke Impact Scale 3.0. J Cardiovasc Nurs. 2015;30:229–41.CrossRefPubMed
44.
Elmståhl S, Malmberg B, Annerstedt L. Caregiver’s burden of patients 3 years after stroke assessed by a novel caregiver burden scale. Arch Phys Med Rehabil. 1996;77:177–82.CrossRefPubMed
45.
Greiner W, Weijnen T, Nieuwenhuizen M, Oppe S, Badia X, Busschbach J, et al. A single European currency for EQ-5D health states: results from a six-country study. Eur J Heal Econ. 2003;4:222–31.CrossRef
46.
Podsiadlo D, Richardson S. The timed Up & Go: a test of basic functional mobility for frail elderly persons. J Am Geriatr Soc. 1991;39:142–8.CrossRefPubMed
47.
Ng SS, Hui-Chan CW. The timed up & go test: its reliability and association with lower-limb impairments and locomotor capacities in people with chronic stroke. Arch Phys Med Rehabil. 2005;86:1641–7.CrossRefPubMed
48.
Fulk GD, Echternach JL, Nof L, O’Sullivan S. Clinometric properties of the six-minute walk test in individuals undergoing rehabilitation poststroke. Physiother Theory Pract. 2008;24:195–204.CrossRefPubMed
49.
Freedson PS, Melanson E, Sirard J. Calibration of the computer science and applications, Inc. accelerometer. Med Sci Sports Exerc. 1998;30(5):777–81.CrossRefPubMed
50.
Craig CL, Marshall AL, Sjöström M, Bauman AE, Booth ML, Ainsworth BE, et al. International physical activity questionnaire: 12-country reliability and validity. Med Sci Sports Exerc. 2003;35:1381–95.CrossRefPubMed
51.
Macfarlane DJ, Lee CCY, Ho EYK, Chan KL, Chan DTS. Reliability and validity of the Chinese version of IPAQ (short, last 7 days). J Sci Med Sport. 2007;10:45–51.CrossRefPubMed
52.
Hsieh Y, Wu C, Lin K, Chang Y, Chen C, Liu J. Responsiveness and validity of three outcome measures of motor function after stroke rehabilitation. Stroke. 2009;40:1386–91.CrossRefPubMed
53.
Sanford J, Moreland J, Swanson LR, Stratford PW, Gowland C. Reliability of the Fugl-Meyer assessment for testing motor performance in patients following stroke. Phys Ther. 1993;73:447–54.CrossRefPubMed
54.
Morganti B, Scivoletto G, Ditunno P, Ditunno JF, Molinari M. Walking index for spinal cord injury (WISCI): criterion validation. Spinal Cord. 2005;43:27–33.CrossRefPubMed
55.
Willer B, Ottenbacher KJ, Coad ML. The community integration questionnaire. A comparative examination. Am J Phys Med Rehabil. 1994;73:103–11.CrossRefPubMed
56.
Dalemans RJP, De Witte LP, Beurskens AJHM, Van Den Heuvel WJA, Wade DT. An investigation into the social participation of stroke survivors with aphasia. Disabil Rehabil. 2010;32:1678–85.CrossRefPubMed
57.
Agrell B, Dehlin O. Comparison of six depression rating scales in geriatric stroke patients. Stroke. 1989;20:1190–4.CrossRefPubMed
58.
Sun M-K, Nelson TJ, Alkon DL. Towards universal therapeutics for memory disorders. Trends Pharmacol Sci. 2015;36:384–94.CrossRefPubMed
59.
Zheng G, Zhou W, Xia R, et al. Aerobic exercises for cognition rehabilitation following stroke: a systematic review. J Stroke Cerebrovasc Dis. 2016;25:2780–9.CrossRefPubMed
Metadata
Title
Synergistic effects of aerobic exercise and cognitive training on cognition, physiological markers, daily function, and quality of life in stroke survivors with cognitive decline: study protocol for a randomized controlled trial
Authors
Ting-ting Yeh
Ching-yi Wu
Yu-wei Hsieh
Ku-chou Chang
Lin-chien Lee
Jen-wen Hung
Keh-chung Lin
Ching-hung Teng
Yi-han Liao
Publication date
01-12-2017
Publisher
BioMed Central
Published in
Trials / Issue 1/2017
Electronic ISSN: 1745-6215
DOI
https://doi.org/10.1186/s13063-017-2153-7

Other articles of this Issue 1/2017

Trials 1/2017 Go to the issue

Study protocol

General Anesthesia versus Local Anesthesia in StereotaXY (GALAXY) for Parkinson’s disease: study protocol for a randomized controlled trial

Study protocol

Efficacy and safety of Lian-Ju-Gan-Mao capsules for treating the common cold with wind-heat syndrome: study protocol for a randomized controlled trial

Study protocol

The effectiveness of an educational intervention for sodium restriction in patients with hypertension: study protocol for a randomized controlled trial

Study protocol

Targeted anti-staphylococcal therapy with endolysins in atopic dermatitis and the effect on steroid use, disease severity and the microbiome: study protocol for a randomized controlled trial (MAAS trial)

Study protocol

Coping with Unusual ExperienceS for 12–18 year olds (CUES+): a transdiagnostic randomised controlled trial of the effectiveness of cognitive therapy in reducing distress associated with unusual experiences in adolescent mental health services: study protocol for a randomised controlled trial

Study protocol

A home-based exercise program for children with congenital heart disease following interventional cardiac catheterization: study protocol for a randomized controlled trial