Li · Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology 2026 · systematic review and meta-analysis · n=44 studies (4,450 participants)

Exercise effects on cognitive function and molecular markers in post-stroke patients with cognitive impairment: a systematic review and meta-analysis.

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Level 1 - systematic review of randomized trials

Systematic review and meta-analysis of randomized controlled trials

PubMed 42201410 · doi:10.1007/s10072-026-09135-9 · record verified 2026-08-28

What was done

Authors conducted a systematic review and meta-analysis of randomized controlled trials published from January 1, 2000, to March 6, 2025, across seven databases (PubMed, Cochrane Library, Embase, Wanfang, CNKI, CSTJ, and China Medical Information Database). They assessed the effects of different exercise modalities on cognitive function, motor function, activities of daily living, and serum molecular biomarkers (BDNF, GSH, NSE, and IL-6) in patients with post-stroke cognitive impairment (PSCI). Methodological quality was appraised using the Cochrane Risk of Bias Tool, and data were synthesized with Review Manager.

What was found

Across 44 RCTs with 4,450 patients with PSCI: - Combining aerobic exercise with task-based interventions (cognitive-motor dual-tasking and functional motor training) significantly improved cognition (SMD = 1.18, 95% CI [0.68, 1.68]). - Patients showed improvements in motor function (MD = 13.98, 95% CI [10.06, 17.89]) and activities of daily living (MD = 16.78, 95% CI [12.97, 20.58]). - Serum levels of BDNF, GSH, and NSE increased significantly, while IL-6 decreased notably; specific effect sizes and confidence intervals for molecular biomarkers were not reported in the abstract.

Why it matters

This meta-analysis demonstrates that combined aerobic and task-oriented exercise improves functional and cognitive recovery in stroke survivors, providing clinical evidence aligned with neuroplastic and anti-inflammatory biomarker changes.

Limits

The abstract omits the measurement scales used for motor function and activities of daily living, as well as exact effect sizes and confidence intervals for all biomarker changes. Details on intervention duration, stroke chronicity, blinding, and long-term durability of cognitive improvements are not provided.

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