The effects of exercise modality and dose on improving executive function in stroke patients: A systematic review and Bayesian network dose-response meta-analysis

IF 4.7 3区医学 Q2 GERIATRICS & GERONTOLOGY

Archives of gerontology and geriatrics Pub Date : 2026-03-01 Epub Date: 2025-12-11 DOI:10.1016/j.archger.2025.106117

Shaoqi Zheng , Qiuxue Pan , Liping Chen

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引用次数: 0

Abstract

Objective

This Bayesian network meta-analysis examined exercise effects on executive function in stroke patients, exploring dose-response relationships and comparing the efficacy of different modalities to identify the optimal rehabilitation protocol.

Methods

A systematic search was conducted in PubMed, Embase, the Cochrane Library, Web of Science, and SPORTDiscus from inception to September 15, 2025. Twenty randomized controlled trials (RCTs) were included. Study quality was assessed using the PEDro scale. A Bayesian random-effects network meta-regression model examined the nonlinear dose–response relationship between exercise dosage (in Metabolic Equivalent of Task-minutes, MET-mins) and executive function, with heterogeneity, publication bias, and model robustness evaluated.

Results

The analysis demonstrated a significant inverted U-shaped relationship between weekly exercise dose and improvements in executive function, with the peak effect occurring at approximately 1000 MET-minutes per week (mean effect size = 0.65, 95 % credible interval: 0.34–1.00). Among different exercise modalities, exercise combined with cognitive training showed the most favorable and consistent association across a broad weekly dose range (approximately 170–1000 MET-minutes). Multicomponent exercise exhibited apparent benefits only at higher weekly doses (around 890–1000 MET-minutes), though with greater statistical uncertainty, whereas other modalities did not demonstrate clear or consistent effects.

Conclusion

The association between exercise and executive function in stroke patients appears to follow an optimal weekly dose (∼1000 MET-minutes) rather than a maximal one. Exercise combined with cognitive training provides synergistic, stable benefits within this range. These findings offer moderate-quality evidence to guide individualized rehabilitation that optimizes cognitive recovery and improves quality of life after stroke.

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运动方式和剂量对改善脑卒中患者执行功能的影响：一项系统综述和贝叶斯网络剂量-反应荟萃分析。

目的：通过贝叶斯网络荟萃分析，探讨运动对脑卒中患者执行功能的影响，探讨不同运动方式的剂量-反应关系，并比较不同运动方式的疗效，以确定最佳康复方案。方法：系统检索PubMed、Embase、Cochrane Library、Web of Science和SPORTDiscus自成立至2025年9月15日的文献。纳入20项随机对照试验（rct）。采用PEDro量表评估研究质量。一个贝叶斯随机效应网络元回归模型检验了运动剂量（任务分钟代谢当量，met -min）与执行功能之间的非线性剂量-反应关系，并评估了异质性、发表偏倚和模型稳健性。结果：分析表明，每周运动剂量与执行功能改善之间存在显著的倒u型关系，峰值效应发生在每周约1000 met -分钟（平均效应大小= 0.65,95%可信区间：0.34-1.00）。在不同的运动方式中，运动与认知训练相结合在较宽的周剂量范围内（约170-1000 met -分钟）显示出最有利和一致的关联。多组分运动只有在较高的周剂量（约890-1000 met -分钟）下才显示出明显的益处，尽管在统计上有更大的不确定性，而其他模式没有显示出明确或一致的效果。结论：卒中患者的运动和执行功能之间的关联似乎遵循最佳每周剂量（~ 1000 met -min），而不是最大剂量。运动与认知训练相结合在这个范围内提供了协同的、稳定的益处。这些发现为指导个性化康复提供了中等质量的证据，以优化脑卒中后的认知恢复和改善生活质量。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Archives of gerontology and geriatrics 医学-老年医学

CiteScore

7.30

自引率

5.00%

发文量

198

审稿时长

16 days

期刊介绍： Archives of Gerontology and Geriatrics provides a medium for the publication of papers from the fields of experimental gerontology and clinical and social geriatrics. The principal aim of the journal is to facilitate the exchange of information between specialists in these three fields of gerontological research. Experimental papers dealing with the basic mechanisms of aging at molecular, cellular, tissue or organ levels will be published. Clinical papers will be accepted if they provide sufficiently new information or are of fundamental importance for the knowledge of human aging. Purely descriptive clinical papers will be accepted only if the results permit further interpretation. Papers dealing with anti-aging pharmacological preparations in humans are welcome. Papers on the social aspects of geriatrics will be accepted if they are of general interest regarding the epidemiology of aging and the efficiency and working methods of the social organizations for the health care of the elderly.