Effects of exercise with probiotics, exercise alone, and probiotics alone on physical, motor, affective, and cognitive functions in stroke patients: a randomised controlled trial
Bibliographic record
Abstract
BACKGROUND: Physical and neuropsychiatric disturbances often persist after stroke, necessitating innovative rehabilitation strategies. Combining exercise with probiotics may synergistically enhance recovery by leveraging neuroplasticity and modulation of the gut-brain axis. This study evaluated the individual and combined effects of exercise and probiotics in stroke patients. METHODS: Ninety-six patients (32 per group) within 1 year post-stroke were randomized to exercise with probiotics (EWP) (90 min/session multimodal exercise, 3 times weekly, plus probiotics, 1 capsule/day, 3.3 billion CFU Lactobacillus rhamnosus and Bifidobacterium lactis, for 8 weeks), exercise alone (EA), or probiotics alone (PA). The primary outcomes of physical disability (modified Rankin Scale [mRS]) and depression (Hospital Anxiety and Depression Scale [HADS]-depression sub-scale) and secondary outcomes of motor function (Supplemental Motor Scale of National Institute of Health Stroke Scale [SMSNIHSS]), anxiety (HADS-anxiety sub-scale), and cognition (Montreal Cognitive Assessment [MoCA]) were assessed at baseline, 4th week, and 8th week. RESULTS: EWP showed significantly greater improvements in mRS (p < 0.05, η² = 0.26 at week 4, 0.46 at week 8), SMSNIHSS (p < 0.05, η² = 0.08 at week 4, 0.24 at week 8), HADS-D (p < 0.05, η² = 0.24 at week 8), HADS-A (p < 0.05, η² = 0.07 at week 4, 0.26 at week 8), and MoCA (p < 0.05, η² = 0.18 at week 4, 0.46 at week 8) compared to EA and PA at weeks 4 and 8, except for HADS-D at week 4 (p > 0.05, η² = 0.04). At week 8, EA significantly outperformed PA in mRS, SMSNIHSS, and MoCA (p < 0.05), but not HADS-D or HADS-A (p > 0.05). Transient stomach upset occurred in 9.4% (PA) and 6.3% (EWP), resolved with water. EA reported no adverse events. CONCLUSION: EWP showed superiority compared to either intervention alone in improving physical and motor functions, mood, and cognition in stroke patients. EA outperforms PA in physical, motor, and cognitive outcomes but shows comparable effects on depression and anxiety. Minimal adverse events support EWP's feasibility. These findings underscore the possibility of integrating exercise with probiotics to optimize post-stroke recovery in multiple domains. TRIAL REGISTRATION: Pan African Clinical Trial Registry (PACTR202408541705549), 13/08/2024.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.003 | 0.003 |
| Meta-epidemiology (narrow) | 0.002 | 0.001 |
| Meta-epidemiology (broad) | 0.009 | 0.004 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.002 |
| Scholarly communication | 0.002 | 0.002 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.004 | 0.003 |
| Insufficient payload (model declined to judge) | 0.009 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".