Effects of high-intensity interval training and moderate-intensity continuous training on cognitive function in patients with neurodegenerative diseases:a meta-analysis

Tang Zhuolin; Yin Mingyue; Bai Mingyang; Zheng Huakun; Yan Henghao; Xu Kai; Liu Qian

doi:10.12307/2026.626

Abstract：OBJECTIVE:Cognitive impairment associated with neurodegenerative diseases seriously affects the quality of life of patients.High-intensity interval training and moderate-intensity continuous training can improve cognitive function by inducing the production of brain-derived neurotrophic factor and enhancing synaptic plasticity,but the advantages and disadvantages of the two are inconclusive.Therefore,the purpose of this study is to evaluate the difference between high-intensity interval training and moderate-intensity continuous training in improving cognitive function in patients with neurodegenerative diseases. METHODS:The Web of Science core collection,Medline(EBSCO Host),PubMed and Cochrane Library databases were searched to include randomized controlled trials on high-intensity interval training and moderate-intensity continuous training to improve cognitive function in neurodegenerative diseases patients.The search time was from the establishment of each database to July 25,2024.The PEDro scale was used for quality evaluation,and R Studio(version 4.4.1)was used for meta-analysis. RESULTS:A total of 27 randomized controlled trials were included,with a total of 1 613 subjects(592 in the high-intensity interval training group;405 cases in the moderate-intensity continuous training group;616 cases in the control group).Compared with the control group(no or low-intensity exercise),both high-intensity interval training and moderate-intensity continuous training could significantly improve the cognitive function of patients with neurodegenerative diseases[Hedges'g=0.15,95%confidence interval(0.02,0.29),P=0.02;Hedges'g=0.74,95%confidence interval(0.01,1.47),P=0.04].Subgroup analyses showed that different types of neurodegenerative diseases and different cognitive function assessment scales could significantly affect the interventional effect of moderate-intensity continuous training,and patients with Alzheimer's disease could achieve greater cognitive improvement than those with Parkinson's disease(Hedges'g=2.24 vs.0.15,P=0.02),The Mini-Mental State Examination could better capture the cognitive changes before and after intervention than the Unified Parkinson's Disease Rating Scale(Hedges'g=4.21 vs.0.25,P<0.01).In addition,age has a significant impact on the effect of moderate-intensity continuous training intervention(P=0.08),and patients≥65 years can achieve greater cognitive benefits than those under 65 years of age(Hedges'g=0.99 vs.0.22).There was no significant difference in the improvement of cognitive function between high-intensity interval training and moderate-intensity continuous training[Hedges'g=-0.02,95%confidence interval(-0.30,0.26),P=0.88]. CONCLUSION:Both high-intensity interval training and moderate-intensity continuous training can significantly improve the cognitive function of neurodegenerative diseases patients and are equally effective,but people of different ages may have different optimal training types:patients<65 years old may have greater cognitive benefits through high-intensity interval training intervention,while patients≥65 years old may have better cognitive function through moderate-intensity continuous training.It is worth noting that the interventional effect of moderate-intensity continuous training is subjected to multiple adjustments of disease type,evaluation tool and age,suggesting that a differentiated exercise prescription and evaluation system should be formulated according to the characteristics of patients in clinical practice.