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, March 9, 2026

Comparative efficacy of non-pharmacological interventions for post-stroke cognitive impairment: a systematic review and network meta-analysis of randomized controlled trials

 You've known of cognitive impairment post stroke for over a decade and incompetently DONE NOTHING! Leaders solve problems! You're not leaders!

Comparative efficacy of non-pharmacological interventions for post-stroke cognitive impairment: a systematic review and network meta-analysis of randomized controlled trials


  • H

    Hongmei Niu 1,2

  • W

    Weili Li 3

  • L

    Lidong Du 4

  • X

    Xin Zheng 1

  • J

    Jin Liang 5

  • Xiujuan Yang

    Xiujuan Yang 4*

  • J

    Jun Luo 6*

  • 1. Northwest Minzu University, Gansu, China

  • 2. Key Laboratory of Environmental Ecology and Population Health in Northwest Ethnic Regions, State Ethnic Affairs Commission, Gansu, China

Abstract

Background: 

Post-stroke cognitive impairment (PSCI) substantially diminishes quality of life and functional independence in stroke survivors. Various non-pharmacological interventions have been proposed to improve cognitive and functional outcomes; however, their relative effectiveness remains uncertain.


Methods: 

A network meta-analysis of 23 RCTs (1,723 participants) evaluated seven non-drug therapies, including computer-based cognitive training (CCT), transcranial direct current stimulation (tDCS), repetitive transcranial magnetic stimulation (rTMS), acupuncture, exercise, and their combinations. Primary and secondary outcomes were MoCA and MBI scores, respectively.


Results: 

Regarding MoCA scores, the most effective intervention was CCT combined with tDCS (mean difference vs. control: 6.67; 95% CrI: 1.20–12.13), followed by acupuncture combined with rTMS (6.59; 95% CrI: 4.34–8.84) and rTMS alone (4.26; 95% CrI: 2.65–5.88). SUCRA rankings indicated that CCT + tDCS and acupuncture + rTMS had the highest probabilities of being the most effective treatments. For MBI scores, tDCS (8.41; 95% CrI: 4.50–12.32), exercise rehabilitation (6.87; 95% CrI: 4.92–8.82), and CCT (6.62; 95% CrI: 3.84–9.39) demonstrated the greatest improvements compared to control. Funnel plots revealed no significant publication bias, and contribution plots supported the stability of the network geometry.


Conclusion: 

Among non-pharmacological approaches for PSCI, combined CCT and tDCS produced the most consistent cognitive improvements, while tDCS and exercise rehabilitation yielded the most pronounced gains in functional recovery. These findings support the clinical integration of multimodal brain stimulation and cognitive rehabilitation strategies in the management of PSCI.

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