Dose-response relationship of exercise intervention on cognitive function in patients with stroke: a systematic review and meta-analysis
In brief
Stroke exercise review finds highest predicted cognitive benefit near 465 MET-minutes weekly
Across 19 randomized trials involving 1,324 patients, exercise was linked to a modest improvement in global cognitive function after stroke. A dose-response model estimated a relatively large benefit near 465 MET-minutes per week, but the curve was exploratory and does not establish an optimal exercise dose; that estimate needs confirmation in further studies.
- Journal
- Topics in stroke rehabilitation (Q1)
- Published
- 23 October 2026
- Study design
- Systematic review / meta-analysis of RCTs
- Evidence level
- Level 1, High (CEBM 1a)
- Authors
- Huimin Yang, Ziqi Gao, Yaxin Wang, Chang Liu, Jiahe Wu, Shenghui Liang, et al.
- PMID
- 42912759
- DOI
- 10.1080/10749357.2026.2746400
Why clinicians should know about it
- Picked for Rehabilitation (top studies of the week, 25 October 2026): Synthesizes exercise effects and dose-response for post-stroke cognition
Abstract
OBJECTIVE: To systematically evaluate the effects of exercise interventions on cognitive function in stroke patients and to explore the dose-response relationship based on metabolic equivalent minutes per week (MET·min/week). METHODS: A comprehensive search was conducted from database inception through 25 August 2026, across five electronic databases (PubMed, Embase, Scopus, Web of Science, and the Cochrane Library), two clinical trial registries (ClinicalTrials.gov and the WHO International Clinical Trials Registry Platform [ICTRP]), and a gray literature database (ProQuest Dissertations & Theses Global). A nonlinear dose-response model was used to examine the association between weekly exercise dose (MET·min/week) and improvement in cognitive function after stroke. RESULTS: Eighteen articles (19 RCTs; 1,324 patients) were included. Exercise interventions were associated with improvements in global cognitive function (SMD = 0.25, 95% CI 0.14-0.36, p < 0.001). Between-subgroup differences were significant for exercise modality (p = 0.047), but not for exercise frequency, intervention duration, session duration, or time since stroke. The dose-response curve suggested a potentially nonlinear association between weekly exercise dose and cognitive effects within the observed dose range, with a relatively high model-predicted effect at approximately 465 MET·min/week (Hedges' g = 0.50, 95% CI: 0.26-0.73). CONCLUSIONS: Exercise interventions were associated with improvements in post-stroke cognitive function. Dose-response analysis suggested a potentially nonlinear association between weekly exercise dose and cognitive effects, with a relatively high effect estimate at approximately 465 MET·min/week. However, this finding was exploratory and requires further validation.
Abstract as published, via PubMed.
For healthcare professionals. The summary is generated by AI from the published abstract, and the evidence level is assigned automatically from the study design on the Oxford CEBM hierarchy. Neither is medical advice. Read the full paper before changing practice.