Aerobic exercise combined with hyperbaric oxygen therapy can improve post-stroke cognition and reduce oxidative stress / 中华物理医学与康复杂志

ABSTRACT

Objective:To investigate the effect of combining aerobic exercise with hyperbaric oxygen therapy on the cognition and oxidative stress of patients with post-stroke cognitive impairment (PSCI).Methods:Forty-five PSCI patients were divided randomly into a hyperbaric oxygen therapy (HBO) group (of 21) and a combination group (of 24). Both groups received HBO therapy, but the combination group also performed 30min of aerobic exercise using a cycle ergometer 5 times a week for 8 weeks. The HBO therapy involved 20min for pressurization, 20min of decompression, 60min of pressurized oxygen inhalation and 10min of air inhalation. The treatment pressure was 0.2MPa (2.0ATA). Before and after the intervention, cognitive functioning was measured using the mini-mental state examination (MMSE) and the Montreal cognitive assement (MoCA). The Barthel index quantified ability in the activities of daily living. Serum glutathione (GSH) and malondialdehyde (MDA) were measured spectrophotometrically.Results:The average MMSE scores of both groups had improved significantly after the treatment, with significantly better improvement in the combination group. After the treatment, the average MoCA score of the combination group had improved significantly while that of the HBO group had not. The average Barthel index scores of both groups improved significantly and there was no significant difference between them after the treatment. The average serum GSH increased after the treatment in the combination group, and the increase was weakly positively correlated with the increase in MMSE scores. The average MDA content of the HBO group decreased after the treatment, and the decrease was positively correlated to the increase in the MMSE scores, but again weakly.Conclusions:Aerobic exercise combined with hyperbaric oxygen therapy can effectively improve cognition among PSCI patients. Increases in serum GSH and decreases in serum MDA are weakly positively correlated with cognitive functioning.