Hege Ihle-Hansen, Birgitta Langhammer, Stian Lydersen, Mari Gunnes, Bent Indredavik, Torunn Askim
Department of Medicine, Oslo University Hospital, 0424 Oslo, Norway. E-mail: hmihle@ous-hf.no
DOI: 10.2340/16501977-2588

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 (SD 11. 3) years and 39. 5% were female. The adjusted mean difference between groups for TMT A was 8. 54 (CI 0. 7 to 16. 3), p = 0. 032, for TMT B 8. 6 (CI –16. 5 to 33. 6), p = 0. 50, for MMSE –0. 1 (CI –0. 8 to 0. 6), p = 0. 77, for HADS A –0. 2 (CI –0. 9 to 0. 5), p = 0. 56 and for HADS D –0. 1 (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 (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.

Physical activity may help to keep the brain healthier and preserve cognitive ability and mood years after a stroke. In The Life After STroke (LAST) study, stroke survivors were allocated into 2 groups. A training group was encouraged to perform physical activity for 30 min daily, and 45–60 min of moderate-to-intense physical exercise every week. A control group was followed by their general practitioner as usual. This study aimed to measure the effect on cognitive and emotional function in both groups after 18 months. Of the 362 participants, almost half were in the training group. The mean age was 72 years and 40% were female. There were no differences between the groups regarding effect on cognitive or emotional function. In conclusion, this study did not show an effect of the physical training programme on cognition or mood after stroke.

Table III