Exploring the associations between physical activity level, cognitive performance, and response to computerized cognitive training among chronic stroke patients

TL;DR

This study finds that physical activity level does not predict cognitive performance or response to cognitive training in chronic stroke patients.

Contribution

The study provides new evidence on the limited role of physical activity as a predictor in cognitive rehabilitation outcomes for chronic stroke patients.

Findings

Baseline physical activity level does not predict cognitive performance or response to computerized cognitive training.

Patients with small-vessel disease show more sedentary behavior compared to those with cardioembolism.

Stroke characteristics do not predict future physical activity levels in chronic stroke patients.

Abstract

Post‐stroke attentional and working memory deficits are common and represent relevant predictors of long‐term functional recovery and outcome. The individual responses to cognitive rehabilitation and interventions vary between patients and are influenced by multiple factors. Recently, a link between the level of engagement in physical activities and cognitive rehabilitation has been suggested. However, few previous studies have tested the predictive value of physical activity on cognitive performance and response to cognitive training among chronic stroke patients. There is also a lack of knowledge concerning the prognostic value of index stroke characteristics on physical activity in chronic phase.

In this cross‐sectional and longitudinal study, including stroke survivors suffering mild‐to‐moderate strokes (n = 52, mean age = 70 years), we used Bayesian regression to test the association between cognitive performance and response to a 3‐week intervention with a commonly used computerized cognitive training (CCT) system and baseline physical activity level measured with International Physical Activity Questionnaire. We also tested the association between physical activity level in chronic phase and stroke characteristics, including stroke severity (National Institutes of Health Stroke Scale), ischemic stroke etiology (Trial of Org 10172 in Acute Stroke Treatment), and stroke location (n = 66, mean age = 68 years). For descriptive purposes, we included 104 sex‐ and age‐matched healthy controls (mean age = 69 years).

The analyses revealed anecdotal evidence of a positive association between overall cognitive performance and daily minutes of sedentary behavior, indicating that better cognitive performance was associated with more daily hours of sitting still. We found no support for an association between cognitive performance and response to CCT with activity level. In addition, the analysis showed group differences in sedentary behavior between patients with small‐vessel disease (n = 20) and cardioembolism (n = 7), indicating more sedentary behavior in patients with small‐vessel disease. There was no further support for a predictive value of index stroke characteristics on physical activity level.

The results do not support that baseline physical activity level is a relevant predictor of the overall performance or response to CCT in this sample of chronic stroke patients. Similarly, the analyses revealed little evidence for an association between index stroke characteristics and future activity level in patients surviving mild‐to‐moderate stroke.

Our findings do not support that baseline physical activity level is a relevant predictor of the overall performance or response to computerized cognitive training in this sample of chronic stroke patients. Additional analyses revealed little evidence for an association between index stroke characteristics and future activity level in patients surviving mild‐to‐moderate stroke.

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