Deans' stroke musings: Physical activity interventions for post-stroke cognitive recovery: a systematic review and network meta-analysis of comparative effects

Changing stroke rehab and research worldwide now.Time is Brain! trillions and trillions of neurons that DIE each day because there are NO effective hyperacute therapies besides tPA(only 12% effective). I have 523 posts on hyperacute therapy, enough for researchers to spend decades proving them out. These are my personal ideas and blog on stroke rehabilitation and stroke research. Do not attempt any of these without checking with your medical provider. Unless you join me in agitating, when you need these therapies they won't be there.

What this blog is for:

My blog is not to help survivors recover, it is to have the 10 million yearly stroke survivors light fires underneath their doctors, stroke hospitals and stroke researchers to get stroke solved. 100% recovery. The stroke medical world is completely failing at that goal, they don't even have it as a goal. Shortly after getting out of the hospital and getting NO information on the process or protocols of stroke rehabilitation and recovery I started searching on the internet and found that no other survivor received useful information. This is an attempt to cover all stroke rehabilitation information that should be readily available to survivors so they can talk with informed knowledge to their medical staff. It lays out what needs to be done to get stroke survivors closer to 100% recovery. It's quite disgusting that this information is not available from every stroke association and doctors group.

Monday, September 8, 2025

Physical activity interventions for post-stroke cognitive recovery: a systematic review and network meta-analysis of comparative effects

Incomplete research! Didn't provide the 100% recovery protocols for physical activities! Doesn't anyone in stroke ever think at all?

Physical activity interventions for post-stroke cognitive recovery: a systematic review and network meta-analysis of comparative effects

Hongyu Wang¹

Dong Li²^*

Shuang Li¹

Xiaolin Zhang¹

Wanli Zang³

Ying Zhu¹

Shixuan Zhang⁴

Feng Xu⁵

Zixian Xiao²

Kelei Guo²^*

¹School of Physical Education and Health, Guangxi Normal University, Guilin, China
²School of Physical Education and Health, Zhaoqing University, Zhaoqing, China
³Postgraduate School, University of Harbin Sport, Harbin, China
⁴School of Computer Science, Guangxi Normal University, Guilin, China
⁵College of Physical Education and Health, Guangxi Medical University, Nanning, China

Background: Post-stroke cognitive dysfunction imposes significant burdens on individuals and healthcare systems. Although physical activity are increasingly recognized as adjunct therapies for cognitive rehabilitation, uncertainties persist regarding their comparative effectiveness. The current evidence lacks direct or indirect comparisons of physical activity programs. This study systematically evaluated the effectiveness of intervention measures through network meta-analysis, providing reference measures for cognitive function recovery in stroke populations.

Methods: We systematically searched PubMed, Cochrane Library, Embase, and Web of Science from their inception through August 2024 to identify randomized controlled trials investigating the effects of physical activity interventions on cognitive function in stroke patients. Two independent reviewers conducted literature screening, data extraction, and quality assessment. Network meta-analysis was performed using Stata 15.1.

Results: A total of 26 randomized controlled trials involving 1,408 participants were included in the analysis. The findings revealed that compared with routine medical care, multi-modal exercise significantly improved cognitive function (SMD = −5.58, 95% CI: −8.00 to −3.16), followed by aerobic exercise (SMD = −4.22, 95% CI: −7.04 to −1.41). The surface under the cumulative ranking curve (SUCRA) probabilities for the eight intervention types were as follows: multi-modal exercise (96.7%), aerobic exercise (80.9%), etc.

Conclusion: Our study indicates that multi-modal exercise (e.g., combined programs integrating strength training, balance exercises, and aerobic training such as running and cycling) and high-intensity aerobic exercise show superior efficacy in enhancing cognitive recovery among stroke patients. Furthermore, while physical activity is proven to be beneficial, the major challenge remains in developing effective strategies to promote long-term adherence to regular physical activity routines.

Systematic review registration: https://www.crd.york.ac.uk/prospero/, identifier CRD42024579294.