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Combined Effects of Aerobic Exercise and Cognitive Training on Cognition After Stroke

Not Applicable
Completed
Conditions
Stroke
Interventions
Behavioral: Range of motion exercise
Behavioral: Aerobic training
Behavioral: Cognitive training
Behavioral: Unstructured mental activity
Registration Number
NCT01674790
Lead Sponsor
Marilyn MacKay-Lyons
Brief Summary

The objective of the 'Exploring potential synergistic effects of aerobic exercise and cognitive training on cognition after stroke' pilot trial is to investigate the combined effects of aerobic and cognitive training on cognition after stroke. This is to lay the groundwork for a larger RCT on the same topic. Twenty patients greater than 6 months post-stroke will be randomly assigned into one of four following treatment groups: (i) aerobic training (AEROBIC group), (ii) cognitive training (COGNITIVE group), (iii) aerobic exercise plus cognitive training (AEROBIC+COGNITIVE group); and (iv) non-aerobic range of motion (ROM) and unstructured mental activity (CONTROL group) (for group descriptions, please see detailed description below). We hypothesize that the combination of aerobic exercise and cognitive training will be more effective in improving cognition after stroke than either treatment on its own.

Detailed Description

Aerobic exercise: Body weight support (BWS) treadmill exercise at moderately high intensity (60-70% of heart rate reserve) using 15-30% BWS. An additional 6-10 min will be needed for warm-up and cool-down. Heart rate will be continuously monitored, and blood pressure and rating of perceived exertion (RPE) will be measured periodically.

Cognitive training: Computerized dual n-back training program that involves a working memory task, the difficulty of which adapts to the individual participant's performance.

ROM exercise: Non-aerobic passive and active movement of upper and lower extremity joints performed with the subject lying on a plinth. RPE will be recorded every 5 minutes to ensure intensity remains low. Mental activities: Unstructured mental activity: such as listening to light novels on tape, which will be selected by the subject from a pre-determined list.

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
22
Inclusion Criteria
  • ≥18 years of age
  • Diagnosis of ischemic or hemorrhagic stroke >6months ago
  • Be able to perform a two-step command
  • Be able to walk ≥10m with/without aid
  • Live within a 75km radius of the QE II
  • Pass a cardiology screen for safe participants in exercise training
Exclusion Criteria
  • Have moderate or severe receptive aphasia
  • Have terminal illness, life-threatening co-morbidity or concomitant neurological or psychiatric illness

Study & Design

Study Type
INTERVENTIONAL
Study Design
FACTORIAL
Arm && Interventions
GroupInterventionDescription
AEROBIC + COGNITIVE groupCognitive training6-week program of one 20-min session of aerobic training and one 20-min session of cognitive training 5 days/week.
CONTROL groupRange of motion exercise6-week program of one 20-min session of ROM exercise and one 20-min session of unstructured mental activity 5 days/week.
AEROBIC groupRange of motion exercise6-week program of one 20-min session of aerobic training and one 20-min session of ROM exercise 5 days/week.
COGNITIVE groupCognitive training6-week program of one 20-min session of cognitive training and one 20-min session of ROM exercise 5 days/week.
AEROBIC + COGNITIVE groupAerobic training6-week program of one 20-min session of aerobic training and one 20-min session of cognitive training 5 days/week.
AEROBIC groupAerobic training6-week program of one 20-min session of aerobic training and one 20-min session of ROM exercise 5 days/week.
COGNITIVE groupRange of motion exercise6-week program of one 20-min session of cognitive training and one 20-min session of ROM exercise 5 days/week.
CONTROL groupUnstructured mental activity6-week program of one 20-min session of ROM exercise and one 20-min session of unstructured mental activity 5 days/week.
Primary Outcome Measures
NameTimeMethod
Flanker Test10 weeks

Flanker Test is a computerized test of selective attention and reaction time that involves a motor response. The participant needs to focus and identify an item presented on a screen while ignoring task-irrelevant distractors. Performance on this test has been shown to improve with exercise.

Raven's matrices test10 weeks

A measure of non-verbal reasoning ability and fluid intelligence.

Sternberg digit memory task10 weeks

A measure of visual working memory wherein the subject is shown a set of n digits for study. After a short delay, a digit is shown and the subject is asked to recall whether that item was in the previously viewed set

Secondary Outcome Measures
NameTimeMethod
Peak oxygen consumption10 weeks
Fatigue Severity Scale10 weeks

Brief 9-item questionnaire designed to assess patient fatigue

Cognitive Failures Questionnaire10 weeks

A measure of self-reported deficits in completing simple everyday tasks due to failures in attention, memory, perception, and motor function.

Montreal Cognitive Assessment10 weeks
Expression of BDNF and IGF-1 in peripheral blood samples10 weeks

Trial Locations

Locations (2)

Nova Scotia Rehabilitation Centre

🇨🇦

Halifax, Nova Scotia, Canada

School of Physiotherapy, Dalhousie University

🇨🇦

Halifax, Nova Scotia, Canada

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