Effects of home-based exercise with or without cognitive training on cognition and mobility in cardiac patients: A randomized clinical trial

Abstract

This randomized controlled trial compared the effects of home-based exercise, with or without cognitive training, on cognition and physical function in individuals aged 50 years and older with stable CVD during the COVID-19 pandemic. 122 patients (67.3 ± 7.9 years, 71% men) with stable CVD (77% coronary heart disease) were randomly assigned (1:1) to (1) Home-based physical exercise alone, or (2) Home-based physical exercise combined with cognitive training. Cognition (executive functions (primary outcome), processing speed, episodic memory, and working memory) and physical functions were assessed remotely at baseline, 3 months, and 6 months. Adjusted mean changes from baseline to 3 months and 6 months for executive functions, episodic memory, working memory, sit-to-stand test, gait speed, and timed up-and-go test were significant in the overall sample (p < 0.05). Furthermore, executive functions, episodic memory, sit-to-stand test, and timed up-and-go performances were significantly improved at 6 months in both groups when analyzed separately although no group differences were observed. Mean exercise dose differed significantly between the 2 groups: 1413 vs 953 METs.min^-1 week^-1 respectively for the exercise and combined group (p < 0.01). Mean cognitive training duration was 25.6 ± 16.6 min.week^-1 for the combined intervention group. Results remained unchanged after accounting for the exercise dose. In adults affected by CVD, a remote combined intervention integrating sequential cognitive and exercise training yields comparable enhancements in executive function, episodic memory, and physical performances compared to exercise training alone. ClinicalTrials.gov: NCT04661189.

Keywords: COVID; Cardiovascular diseases; Cognition; Multidomain intervention; Physical activity; Rehabilitation.

Fig. 1

Changes from baseline to 3 and 6 months for Executive function and Processing speed Z scores. The violin box were created from raw data. The continuous red line is the median, the black dotted line is the interquartile range. Statistical tests are based on the linear mixed model. Stars indicate that the change from baseline is significant. *p < 0.05; **p < 0.01; ***p < 0.001

Fig. 2

Changes from baseline to 3 and 6 months for Episodic memory and Working memory Z scores. The violin box were created from raw data. The continuous red line is the median, the black dotted line is the interquartile range. Statistical tests are based on the linear mixed model. Stars indicate that the change from baseline is significant. *p < 0.05; **p < 0.01; ***p < 0.001