Poststroke Cardiorespiratory Exercise for Brain Volume and Cognition
Notice bibliographique
Résumé
Importance: Stroke increases the risk of cognitive impairment and dementia without proven prevention therapies. Cardiorespiratory exercise (CRX) preserves brain health. Objective: To determine whether a CRX intervention preserves hippocampal volume (HV) and cognition in patients after ischemic stroke. Design, Setting, and Participants: The Post-Ischemic Stroke Cardiovascular Exercise Study (PISCES)-Zoom Delivered Intervention Against Cognitive Decline (ZODIAC) is a phase 2b assessor-blinded randomized clinical trial performed at 4 metropolitan health care services in Melbourne, Australia. Eligible participants included adult patients who survived ischemic stroke without comorbidities prohibiting exercise or diagnosed cognitive disorder. Participants were recruited from May 26, 2016, to March 20, 2020, for PISCES in-person training and from November 9, 2020, to February 12, 2024, for ZODIAC remotely delivered home training. A total of 6921 participants were screened for eligibility, 130 were recruited, 107 were randomized (34 in PISCES and 73 in ZODIAC), and 104 continued to intervention. Study visits at 2, 4, and 12 months post stroke included brain magnetic resonance imaging and cognitive testing. Participants were randomized (1:1), stratified by baseline function (modified Rankin Scale score of 0-1 vs 2-3) and total brain volume. Primary, secondary efficacy, and safety outcome analyses were conducted using modified intention-to-treat (mITT) principle and per protocol. Intervention: Participants received 8 weeks of three 60-minute sessions/wk. Participants in the CRX group received prescribed intensity progressive aerobic and resistance training; the control group received balance and stretching training. Main Outcomes and Measures: The primary outcome was relative change in HV calculated as the difference between HV at times 1 and 2 divided by HV at time 1. Secondary outcome consisted of 12-month executive function test results (Trial Making Test, Part B [TMT-B]), adjusted for baseline TMT-B and mRS score. Results: The 104 participants included in primary outcome mITT analysis (55 in the control and 49 in the CRX groups; mean [SD] age, 64 [14] years; 67 [64.4%] male; equivalent baseline mRS score). One hundred participants (33 in PISCES and 67 in ZODIAC) completed 4-month assessments, and 97 (31 in PISCES and 66 in ZODIAC) completed 12-month assessments. There were no intervention-related serious adverse events. Mean (SD) difference in relative change in HV between the CRX (-0.26% [2.12%]) and control (-0.11% [2.35%]) groups was -0.10% (95% CI, -1.10% to 0.87%; P = .83). The CRX group (n = 43) performed better than the control group (n = 51) on the adjusted TMT-B at 12 months (adjusted mean difference, -3.75 [95% CI, -5.02 to -2.49] seconds). Conclusions and Relevance: In this randomized clinical trial of fitness training, CRX was safe but did not preserve HV more than a control condition. CRX may benefit cognitive preservation following ischemic stroke. Trial Registration: anzcrt.org Identifier: ACTRN12616000942459.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction distillée sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Apprise à partir de 10 348 étiquettes directes de Codex et de 10 348 étiquettes directes de Gemma. Le mode candidate est l'union des têtes enseignantes seuillées; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont ni des étiquettes humaines ni des étiquettes directes de modèles de pointe.
Scores Codex et Gemma par catégorie
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,001 | 0,000 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,000 |
| Bibliométrie | 0,000 | 0,000 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,000 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,000 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule tête enseignante, pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».