A telehealth exercise program to improve cognition in people with stroke

Due to severe physical impairments and reduced mobility, post-stroke cognitive impairment is often not prioritized in the acute physical therapy rehabilitation phase. This creates a need for cognitive reinforcement to be prioritized later in rehabilitation. We investigated the benefits of a cognitive reinforcement training program using exercise and performed via telehealth in people with stroke, compared to healthy older adults. A pretest/posttest cross-sectional study design with Healthy older adults (HOA, n = 9), and subjects' post-stroke (SPS, n = 8participated in a telehealth physical therapist-led group exercise class set to music while seated, that included cognitive challenges, three times per week for five weeks. Each class involved full body strengthening with cognitive challenges (dual-tasking). Functional outcome measures performed were repeated using a dual-task paradigm. After 15 one-hour telehealth exercise sessions, the most significant results were the 2 Minute Walk Test (adjusted mean difference 18; 95% CI 204, 222) and 30 s Sit to Stand Test (30STS) (adjusted mean difference 4.2; 95% CI 10.6, 14.8) resulting in an intergroup main effect, with both groups improving (p < .013 and p < .002, respectively) in the standard task as well as when combined with a cognitive Verbal Fluency Test for the 30STS (adjusted mean difference 3; 95% CI 5.8, 8.8) (p < .002). In individuals with stroke, a telehealth exercise program, as described in this study, is safe and efficient in improving one's ability to perform daily functional activities with dual tasking.Clinical Trial Registration NCT05919251 (26-06-2023).