Effects of exercise combined with cognitive dual-task training on cognitive function and sustained effects in stroke patients: a systematic review and meta-analysis

We investigated the effect of exercise combined with cognitive dual-task training on the improvement of cognitive function in stroke patients by conducting a systematic review and meta-analysis of current relevant studies. Four electronic databases, PubMed, Web of Science, Cochrane Library, and Embase, were searched for randomized controlled trials (RCTs) on the effects of exercise combined with cognitive dual-task training on cognitive function in patients with stroke that were publicly available from the starting year of the databases to 10 July 2024. A total of 14 RCTs were included. Statistical results showed that exercise combined with cognitive dual-task training had a small effect size improvement in cognitive function for stroke patients (<i>SMD</i> = 0.41, 95% CI: [0.26, 0.57], <i>p</i> = 0.00). Moreover, persistent effects on cognitive functioning were observed after the end of the intervention (<i>SMD</i> = 0.24, 95% CI: [0.05, 0.43], <i>p</i> = 0.01). Subgroup analyses revealed that working memory, cognitive flexibility, total execution function, and total cognitive function had significant improvements in the cognitive function dimension group. Subgroup analyses of different exercise modalities, intervention periods, and different forms of control revealed significant differences within each subgroup. Exercise combined with cognitive dual-task training significantly improves cognitive function in stroke patients with favorable sustained effects. Exercise combined with cognitive dual-task training improves cognitive function in stroke patients with good sustained effects.Exercise combined with cognitive dual-task training was more significant if the intervention lasted longer than four weeks and the frequency of the intervention was three times per week.Rehabilitation professionals may consider exercise combined with cognitive dual-task training as a good choice of modality to improve cognitive functioning in stroke patients, which has good sustained results. Exercise combined with cognitive dual-task training improves cognitive function in stroke patients with good sustained effects. Exercise combined with cognitive dual-task training was more significant if the intervention lasted longer than four weeks and the frequency of the intervention was three times per week. Rehabilitation professionals may consider exercise combined with cognitive dual-task training as a good choice of modality to improve cognitive functioning in stroke patients, which has good sustained results.

本研究通过对当前相关研究开展系统评价与元分析，探究运动联合认知双任务训练对脑卒中患者认知功能改善的作用效果。本研究检索了PubMed、Web of Science、Cochrane Library、Embase四大电子数据库，筛选自建库起始年份至2024年7月10日公开的、关于运动联合认知双任务训练对脑卒中患者认知功能影响的随机对照试验（randomized controlled trials, RCTs），最终共纳入14项随机对照试验。统计结果显示，运动联合认知双任务训练可小幅提升脑卒中患者的认知功能（标准化均数差（standardized mean difference, SMD）=0.41，95%置信区间（confidence interval, CI）=[0.26, 0.57]，p=0.00）。此外，干预结束后仍可观察到认知功能的持续改善效应（SMD=0.24，95%CI=[0.05, 0.43]，p=0.01）。亚组分析结果显示，在认知功能维度亚组中，工作记忆、认知灵活性、整体执行功能及整体认知功能均得到显著改善。针对不同运动方式、干预时长及不同对照形式的亚组分析显示，各亚组内均存在显著差异。运动联合认知双任务训练可显著改善脑卒中患者的认知功能，且具有良好的持续效应。当干预时长超过4周、干预频率为每周3次时，该训练方式的改善效果更为显著。康复专业人员可将运动联合认知双任务训练作为改善脑卒中患者认知功能的优选方案，该方案具有良好的持续获益效果。运动联合认知双任务训练可显著改善脑卒中患者的认知功能，且具有良好的持续效应。当干预时长超过4周、干预频率为每周3次时，该训练方式的改善效果更为显著。康复专业人员可将运动联合认知双任务训练作为改善脑卒中患者认知功能的优选方案，该方案具有良好的持续获益效果。