Feasibility of a 6-Month Exercise and Recreation Program to Improve Executive Functioning and Memory in Individuals With Chronic Stroke

Background. Physical activity is beneficial for improving cognitive function in healthy older adults. However, research results on the benefits of physical activity on cognitive performance after stroke are limited. Objective. To determine if a combined exercise and recreation program can improve the executive functioning and memory of individuals with chronic stroke. Methods. In all, 11 ambulatory participants with chronic stroke (mean age 67 +/- 10.8 years) participated in a 6-month program of exercise for 2 hours and recreation for 1 hour weekly. Executive functions and memory were assessed at baseline and at 3 and 6 months by a battery of standard neuropsychological tests, including response inhibition, cognitive flexibility, dual task (motor plus cognitive), and memory. Motor ability was also assessed. Nonparametric statistics were used to obtain the differences between the 3 assessments. Results. At baseline, substantial deficits in all aspects of executive functioning were revealed. From baseline to 3 months, the mean improvement was 10% +/- 14% for the dual task (Walking While Talking), -3% +/- 22% (chi(2) = 2.4; P > .05) for response inhibition (Stroop Test), and 61% +/- 69% for memory (Rey Auditory Verbal Learning Test-long delay). From baseline to 6 months, the mean improvement was 7% +/- 7.5% for response inhibition (Stroop Test). In addition, knee strength and walking speed improved significantly at 3 months. Conclusions. This pilot study suggests that exercise and recreation may improve memory and executive functions of community-dwelling individuals with stroke. Further studies require a larger sample size and a control group.