The Effect of Exercise Intervention On Reducing the Depressive and Cognitive Disorders Risk in Post-stroke: A systematic review and meta-analysis

Zixian Yang ¹ Shaokun Qin ² Jiaxing Li ¹ Cong Li ³ Ye Lu ⁴ Pei He ^4* Jia Liu ^4* Lin Pei ^4*

• ¹ Hebei University of Chinese Medicine, Shijiazhuang, Hebei Province, China
• ² The Second Affiliated Hospital of Hebei University of Chinese Medicine, Dingzhou, China
• ³ Shijiazhuang Medical College, Shijiazhuang, Hebei Province, China
• ⁴ Hebei Academy of Chinese Medicine Sciences, Shijiazhuang, China

Background: Stroke patients often have sequela such as depressive symptoms, cognitive impairment, and abnormal physical function, and exercise intervention may be an effective and safe non-drug treatment to solve these health problems.Objective: The aim of the present meta-analytical review was to explore the effects of exercise intervention program on depressive symptoms, cognitive function, physical function, and quality of life in stroke patients and to find appropriate exercise programs.Methods: Seven databases were searched from library construction until August 30, 2024. Meta-analysis was performed and risk of bias was assessed using Review Manager 5.4, sensitivity analysis using Stata 16.0, and overall certainty of evidence was rated using GRADE methods.Results: In total, 11607 studies were identified. Of these, 20 studies, including 1848 patients, were deemed eligible for the present network meta-analysis. Compared with the control group, the effects of exercise on cognitive function (SMD = 1.08, 95% CI = 0.40~1.75, P = 0.002), physical balance ability (MD = 0.80, 95% CI = 0.23~1.37, P < 0.01) , physical walking ability (MD = 48.39, 95% CI = 8.06 ~ 88.72, P = 0.02) and quality of life were significantly improved. However, exercise had no significant effect on depressive symptoms (SMD = -0.2, 95% CI= -0.46~0.05, P = 0.11). Subgroup analysis showed that a longer duration of exercise ( > 3months) can effectively improve depressive symptoms in stroke patients.Conclusion: The results showed that the cognitive function, balance, walking speed and quality of life of stroke patients were improved after exercise intervention, and longer exercise duration ( > 3months) helped to improve the depressive symptoms of stroke patients. Consequently, we advocate that stroke patients partake in physical exercise 3 times a week for 1 hour each time. The exercise duration should be continued for no less than 3 months to ensure the best therapeutic effect. Moreover, the determination of exercise intensity should be a personalized process, carefully tailored to align with the unique physical capabilities and limitations of each patient.