A physical activity intervention to prevent cognitive decline after stroke: Secondary results from the life after stroke study, an 18-month randomized controlled trial

Abstract

Objective: To examine the effects of individualized regular coaching and exercise on post-stroke cognitive and emotional function. Methods: The Life after STroke (LAST) study investigated the differences between intervention and care-as-usual between 3 and 21 months post-stroke. Outcome measures were the Trail Making Test (TMT) A and B, Mini Mental State Examination (MMSE), Hospital Anxiety and Depression Scale (HADS), and adherence to the intervention. Results: of the 362 patients included in the study, 177 were assigned to the intervention. The mean age was 71.7 years (SD 11.3) and 39.5% were female. The adjusted mean difference between groups for TMT A was 8.54 (95% CI 0.7 to 6.3), p = 0.032, for TMT B 8.6 (95% CI -16.5 to 33.6), p = 0.50, for MMSE -0.1 (95% CI -0.8 to 0.6), p = 0.77, for HADS A -0.2 (95% CI -0.9 to 0.5), p = 0.56 and for HADS D -0.1 (95% CI -0.7 to 0.5), p = 0.76). A higher level of adherence to the intervention was significantly associated with increased MMSE (B = 0.030 (95% CI 0.005-0.055), p = 0.020). Conclusion: No clinically relevant effects on cognitive or emotional function were found of individualized regular coaching for physical activity and exercise. However, increased adherence to the intervention was associated with improved cognitive function.