title: The effects of an aerobic and resistance exercise training program on cognition following stroke.
abstract: BACKGROUND
  Cognitive benefits obtained from exercise in healthy populations support the idea that aerobic and resistance training (AT+RT) would confer benefit for poststroke recovery. However, there is little evidence regarding the effectiveness of such programs.
  
  
  OBJECTIVE
  To evaluate the effects of a 6-month exercise program of AT+RT on cognition in consecutively enrolled patients with motor impairments ≥10 weeks poststroke.
  
  
  METHODS
  Outcomes were measured before and after 6 months of AT+RT on 41 patients. Cognition was measured by the Montreal Cognitive Assessment (MoCA). Secondary measures included evaluation of gas exchange anaerobic threshold (ATge), body composition by dual energy X-ray absorptiometry, and depressive symptoms by questionnaire.
  
  
  RESULTS
  There were significant improvements in overall MoCA scores (22.5 ± 4.5 to 24.0 ± 3.9, P < .001) as well as in the subdomains of attention/concentration (4.7 ± 1.7 to 5.2 ± 1.3, P = .03) and visuospatial/executive function (3.4 ± 1.1 to 3.9 ± 1.1, P = .002). There was a significant reduction in the proportion of patients meeting the threshold criteria for mild cognitive impairment (MCI) at baseline compared with posttraining (65.9% vs 36.6%, P < .001). In a linear regression model, there was a positive association between change in cognitive function and change in fat-free mass of the nonaffected limbs (β = .002; P = .005) and change in attention/concentration and change in ATge (β = .383; P ≤ .001), independent of age, sex, time from stroke, and change in fat mass and depression score.
  
  
  CONCLUSIONS
  A combined training model (AT+RT) resulted in improvements in cognitive function and a reduction in the proportion of patients meeting the threshold criteria for MCI. Change in cognition was positively associated with change in fat-free mass and ATge.
authors.affiliation: Institute of Medical Science, University of Toronto, Toronto, ON, Canada. Marzolini.susan@torontorehab.on.ca
authors.forename: Susan
authors.initials: S
authors.lastname: Marzolini
authors.forename: Paul
authors.initials: P
authors.lastname: Oh
authors.forename: William
authors.initials: W
authors.lastname: McIlroy
authors.forename: Dina
authors.initials: D
authors.lastname: Brooks
mesh_terms: D015502:Absorptiometry, Photon; D000368:Aged; D015308:Anaerobic Threshold / Q000502:physiology*; D001823:Body Composition; D003072:Cognition Disorders / Q000209:etiology* / Q000534:rehabilitation*; D004562:Electrocardiography; D015444:Exercise; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D053580:Muscle Strength; D009483:Neuropsychological Tests; D011659:Pulmonary Gas Exchange; D020127:Recovery of Function; D055070:Resistance Training / Q000379:methods*; D020521:Stroke / Q000150:complications*; D000071939:Stroke Rehabilitation; D016896:Treatment Outcome; D016138:Walking