Effects of exercise on post-stroke cognitive function: a systematic review and meta-analysis of randomized controlled trials

Top Stroke Rehabil. 2024 Oct;31(7):645-666. doi: 10.1080/10749357.2024.2356393. Epub 2024 Jun 2.

Abstract

Background: A growing body of research examining the effect of exercise on cognitive function in stroke patients, while findings of available studies were conflicting.

Objectives: We aimed to estimate the effect of exercise on cognitive function in stroke patients.

Methods: For this systematic review and meta-analysis, we searched PubMed, Web of Science, Embase, Cochrane, and Scopus electronic databases, through 13 March 2023. The three-level restricted maximum likelihood random effects model was used to synthesize the data.

Results: Twenty-five studies met the inclusion criteria. There was a significant effect of exercise on improving cognitive function in stroke patients (Cohen's d = 0.37, 95% CI, 0.16 to 0.58, p < 0.01, I2 = 22.12%). Subgroup analysis showed that exercise significantly improved memory. In addition, aerobic exercise, exercise conducted 12 weeks or more, 3 times or more per week, less than 60 minutes per session, less than 180 minutes per week, and up to 12 months post-stroke increased cognitive function significantly.

Conclusions: Exercise improved cognitive function in stroke patients. To improve cognitive function, this meta-analysis provides clinicians with evidence to recommend that stroke patients participate in aerobic exercise at least 3 times per week for 30-60 minutes, with a goal of 180 minutes per week being achieved by increasing the frequency of exercise. Exercise initiated within 12 months post-stroke and continued for 12 weeks or more is most beneficial for improving cognitive function.

Keywords: Exercise; cognitive function; meta-analysis; stroke; systematic review.

Publication types

  • Meta-Analysis
  • Systematic Review
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Cognition / physiology
  • Cognitive Dysfunction / etiology
  • Cognitive Dysfunction / physiopathology
  • Cognitive Dysfunction / rehabilitation
  • Exercise / physiology
  • Exercise Therapy* / methods
  • Humans
  • Randomized Controlled Trials as Topic
  • Stroke Rehabilitation* / methods
  • Stroke* / complications