A Study On The Effect Of Moderate Intensity Aerobic Exercise On Cognitive Function In Patients With Mild Cognitive Impairment After Stroke

Background:In recent years,stroke is characterized by high incidence rate and high disability rate in China.Post stroke cognitive impairment（PSCI）is a common complication of stroke,especially mild cognitive impairment.Mechanism research has confirmed that aerobic exercise can improve cognitive function through multiple pathways.However,there is limited research on the cognitive function of stroke patients through aerobic exercise,especially moderate intensity aerobic exercise.There is still controversy over whether it can improve cognitive function in stroke patients,especially memory function.ObjectiveThe purpose of this study was to investigate the effect of moderate intensity aerobic exercise on working memory（WM）in stroke patients with mild cognitive impairment.Methods:Twenty stroke patients with mild cognitive impairment who were hospitalized in our hospital from December 2021 to February 2023 were randomly divided into an experimental group and a control group,with 10 people in each group.In addition to routine rehabilitation training,the experimental group also underwent moderate intensity aerobic exercise,while the control group only underwent routine rehabilitation training 5 times a week for 2 weeks.Routine rehabilitation training methods include physical factor treatment of limbs and trunk,acupuncture and moxibustion treatment,turning,transfer training,limb stretching,joint activity,balance and coordination function training,standing and walking training,hand function and daily living ability training.Aerobic exercise is a rehabilitation treadmill with resistance and power limitations.Measure the power corresponding to peak oxygen uptake（PVO₂）and the heart rate maximum through cardiopulmonary exercise testing.Warm up for 5 minutes at a load of 25%of the power corresponding to PVO₂,followed by aerobic exercise at a load of 50%of the power corresponding to PVO₂for30 minutes,and then relax for 5 minutes at a load of 25%of the power corresponding to PVO₂.During exercise,participants are required to wear a pulse oximeter to ensure that the heart rate during exercise is about 65%of the heart rate maximum through the number of revolutions.Before and 2 weeks after the intervention,all participants were required to evaluate the n-back task,Montreal Cognitive Assessment（MoCA）,Mini Mental State Examination（MMSE）,and Body Mass Index（BMI）.Collect data for statistical analysis of population data,baseline analysis,efficacy analysis,and comparative analysis between the experimental group and the control group.All statistical analyses were completed using SPSS 25.0,and measurement data were described using mean and standard deviation.The main indicators of this study were compared using independent sample t-tests to compare the differences in clinical data between the two groups.Paired sample t-tests were used to compare the differences in various indicators before and after intervention,with p<0.05 indicating statistically significant differences.Results:1.There were no differences in demographic data and baseline levels between the two groups of participants.We compared the demographic data and baseline levels of two groups of participants and found that the experimental group and control group showed no statistically significant differences in age,gender,disease course,BMI value,baseline MMSE total score,MoCA total score,1-back accuracy,1-back response time（RT）,2-back accuracy,2-back RT,3-back accuracy,and 3-back RT values（p>0.05,Table 3-1）.2.Moderate intensity aerobic exercise can improve the working memory and language and delayed memory function on MoCA scale of stroke patients with mild cognitive impairment.Compared with before intervention,after moderate intensity aerobic exercise,the total scores of MMSE and MoCA in stroke patients increased,and the accuracy of 2-back tasks increased,with statistical significance（p<0.05,Table 3-2a）.The accuracy of 1-back test and 1-back RT also showed slight improvement,but there was no statistical significance（p>0.05,Table 3-2a）.Subsequently,statistical analysis was conducted on various scores in the MoCA and MMSE scales,and it was found that compared with the before intervention,moderate intensity aerobic exercise can increase the scores of language and delayed recall in the MoCA scale,with statistical significance（p<0.05,Table 3-2b）.There was no significant change in visual space and executive function,naming,attention,abstraction,and orientation before and after the intervention,and the difference was not statistically significant（p>0.05,Table 3-2b）.There were no significant changes in orientation,memory,attention and calculation,naming,recall,retelling ability,three-step command,retelling ability,reading ability,and writing ability in the MMSE scale before and after intervention,and the differences were not statistically significant（p>0.05,Table 3-2c）.3.Routine rehabilitation training cannot improve the working memory and other cognitive functions of stroke patients with mild cognitive impairment.Compared with before intervention,there was no significant change in MMSE total score,MoCA total score,the accuracy and response time of 1-back,2-back,and3-back task tests after routine rehabilitation training,and the difference was not statistically significant（p>0.05,Table 3-3a）.Compared with before intervention,there was no significant change in the scores of the MoCA scale in the control group after routine rehabilitation training,and the difference was not statistically significant（p>0.05,Table 3-3b）.The scores of the MMSE scale also showed no significant change before and after intervention,and the difference was not statistically significant（p>0.05,Table 3-3c）.4.Compared with the control group,the experimental group can better improve working memory and the cognitive functions on MoCA scale of stroke patients with mild cognitive impairment.Compared with the control group,the experimental group had a higher total score of MoCA scale after intervention,a higher accuracy rate of 3-back task testing（Table 3-4）,and a higher difference in total score of MoCA scale before and after intervention（Table 3-5）,with statistical significance（p<0.05）.5.Moderate intensity aerobic exercise can improve the BMI values in stroke patients.Compared with the control group,after aerobic exercise,the BMI value of stroke patients decreased significantly,and the difference was statistically significant（p<0.05,Table 3-6a）.Compared with before intervention,the BMI values of the experimental group members decreased after intervention,while the BMI values of the control group increased.There was a statistical difference in the BMI values of the experimental group before and after intervention（p<0.05,Table 3-6b）,while there was no statistical difference in the BMI values of the control group before and after intervention（p>0.05,Table 3-6c）.Conclusion:1.Moderate intensity aerobic exercise can improve working memory of stroke patients with mild cognitive impairment,while conventional rehabilitation training cannot improve working memory of stroke patients with mild cognitive impairment.2.Moderate intensity aerobic exercise mainly improves language and delayed recall function on the MoCA scale in stroke patients with mild cognitive impairment,but does not improve various cognitive functions on the MMSE scale.Routine rehabilitation therapy cannot improve the various cognitive functions on the MoCA and MMSE scales.3.Moderate intensity aerobic exercise can improve the BMI value in stroke patients.