SYSTEMATIC REVIEW article
Front. Neurol.
Sec. Stroke
Volume 16 - 2025 | doi: 10.3389/fneur.2025.1646328
This article is part of the Research TopicQuality of Stroke Care: What Could Be Improved, and How? - Volume IIView all 14 articles
Physical Activity Interventions for Post-Stroke Cognitive Recovery: A Systematic Review and Network Meta-Analysis of Comparative Effects
Provisionally accepted
Hongyu Wang1*
DONG LI2*
Shuang Li1Xiaolin Zhang1
Wanli Zang3Ying Zhu1Shixuan Zhang1Feng Xu4
Kelei Guo2*Zixian Xiao2- 1Guangxi Normal University, Guilin, China
- 2Zhaoqing University, Zhaoqing, China
- 3Harbin Sport University, Harbin, China
- 4GuangXi University of Chinese Medicine, Nanning, China
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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.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.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.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.
Keywords: physical activity, stroke patients, Cognitive Function, network meta-analysis. Trial registration, Interventions
Received: 13 Jun 2025; Accepted: 22 Jul 2025.
Copyright: © 2025 Wang, LI, Li, Zhang, Zang, Zhu, Zhang, Xu, Guo and Xiao. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
Hongyu Wang, Guangxi Normal University, Guilin, China
DONG LI, Zhaoqing University, Zhaoqing, China
Kelei Guo, Zhaoqing University, Zhaoqing, China
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