title: Exercise training and recreational activities to promote executive functions in chronic stroke: a proof-of-concept study.
abstract: BACKGROUND
  Stroke survivors represent a target population in need of intervention strategies to promote cognitive function and prevent dementia. Both exercise and recreational activities are promising strategies. We assessed the effect of a 6-month exercise and recreation program on executive functions in adults with chronic stroke.
  
  
  METHODS
  A 6-month ancillary study within a multicentre randomized trial. Twenty-eight chronic stroke survivors (ie, ≥ 12 months since an index stroke) were randomized to 1 of 2 experimental groups: intervention (INT; n = 12) or delayed intervention (D-INT; n = 16). Participants of the INT group received a 6-month community-based structured program that included 2 sessions of exercise training and 1 session of recreation and leisure activities per week. Participants of the D-INT group received usual care. The primary outcome measure was the Stroop Test, a cognitive test of selective attention and conflict resolution. Secondary cognitive measures included set shifting and working memory. Mood, functional capacity, and general balance and mobility were additional secondary outcome measures.
  
  
  RESULTS
  Compared with the D-INT group, the INT group significantly improved selective attention and conflict resolution (P = .02), working memory (P = .04), and functional capacity (P = .02) at the end of the 6-month intervention period. Improved selective attention and conflict resolution was significantly associated with functional capacity at 6 months (r = .39; P = .04).
  
  
  CONCLUSIONS
  This is the first randomized study to demonstrate that an exercise and recreation program can significantly benefit executive functions in community-dwelling chronic stroke survivors who are mildly cognitively impaired-a population at high-risk for dementia and functional decline. Thus, clinicians should consider prescribing exercise and recreational activities in the cognitive rehabilitation of chronic stroke survivors.
authors.affiliation: Aging, Mobility, and Cognitive Neuroscience Laboratory, University of British Columbia, Vancouver, British Columbia, Canada; Department of Physical Therapy, University of British Columbia, Vancouver, British Columbia, Canada; Brain Research Centre, Vancouver Coastal Health Research Institute, University of British Columbia, Vancouver, British Columbia, Canada; Centre for Hip Health and Mobility, Vancouver Coastal Health Research Institute, University of British Columbia, Vancouver, British Columbia, Canada. Electronic address: teresa.ambrose@ubc.ca.
authors.forename: Teresa
authors.initials: T
authors.lastname: Liu-Ambrose
authors.affiliation: Department of Physical Therapy, University of British Columbia, Vancouver, British Columbia, Canada; Rehab Research Laboratory, GF Strong Rehab Centre, Vancouver, British Columbia, Canada.
authors.forename: Janice J
authors.initials: JJ
authors.lastname: Eng
mesh_terms: D000339:Affect; D000368:Aged; D002908:Chronic Disease; D018592:Cross-Over Studies; D056344:Executive Function; D005081:Exercise Therapy / Q000009:adverse effects / Q000379:methods* / Q000523:psychology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010349:Patient Compliance; D010806:Physical Education and Training / Q000379:methods*; D004856:Postural Balance; D011998:Recreation; D020521:Stroke / Q000523:psychology; D000071939:Stroke Rehabilitation; D016896:Treatment Outcome
keywords: Exercise; chronic stroke; executive functions; socialization