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We have previously demonstrated that the addition of computerised cognitive training (CCT) and aerobic training (AT) to a multimodal rehabilitation programme (MMR) yielded greater improvements in cognitive function compared to MMR alone in patients with ED. These effects were maintained at the 1\u2010year follow\u2010up for CCT, but not for AT. Building on these findings, the present study examined the extended long\u2010term effects of CCT and AT on cognitive function, psychological health, and work ability, 4.5\u00a0years after the interventions. Participants were recruited from a stress\u2010rehabilitation clinic and 56 of the initial 132 participants returned for the 4.5\u2010year follow\u2010up. Assessments were conducted before (T1), immediately after (T2), 1\u2010year after (T3) and 4.5\u2010years after (T4) the interventions. Mixed model analyses assessed changes in the intervention groups relative to the control group from T1 to T4, with follow\u2010up comparisons examining within\u2010group stability of outcomes between T3 to T4. The primary outcome was cognitive performance on a global cognitive score. Secondary outcomes included domain\u2010specific cognitive functioning, self\u2010reported cognitive function, psychological health (burnout, depression, anxiety, and fatigue), and work ability. The analysis revealed sustained long\u2010term effects on the global cognitive score, a trained updating task and episodic memory in the CCT group, with stable performance between one\u2010 and 4.5\u2010year follow\u2010up. The addition of AT did not yield any extended long\u2010term effects on cognitive performance. Both groups showed extended long\u2010term improvements in self\u2010reported memory problems, although findings were mixed. Extended long\u2010term improvements were observed on burnout for both groups, with additional effects on anxiety and work ability in the AT group. Notably, these effects were not present at the 1\u2010year follow\u2010up and are more plausibly explained by selective attrition rather than a delayed intervention effect. In conclusion, the result indicates that cognitive interventions such as CCT can have lasting positive effects on cognitive function in patients with ED, whereas the long\u2010term psychological effects should be interpreted with caution.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Trial Registration<\/jats:title>\n                    <jats:p>ClinicalTrials.gov: NCT0073772<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/smi.70218","type":"journal-article","created":{"date-parts":[[2026,9,5]],"date-time":"2026-09-05T06:51:09Z","timestamp":1788591069000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Extended Long\u2010Term Effects of Cognitive and Aerobic Training on Cognitive Function in Patients With Stress\u2010Related Exhaustion Disorder: A 4.5\u2010Year Follow\u2010Up of a Randomized Controlled Trial"],"prefix":"10.1002","volume":"42","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4161-8101","authenticated-orcid":false,"given":"Ingela","family":"Aronsson","sequence":"first","affiliation":[{"name":"Department of Psychology Ume\u00e5 University  Ume\u00e5 Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna Stigsdotter","family":"Neely","sequence":"additional","affiliation":[{"name":"Department of Health Education and Technology Lule\u00e5 University of Technology  Lule\u00e5 Sweden"},{"name":"Department of Social and Psychological Studies Karlstad University  Karlstad Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4458-6475","authenticated-orcid":false,"given":"Carl\u2010Johan","family":"Boraxbekk","sequence":"additional","affiliation":[{"name":"Institute for Clinical Medicine Faculty of Medical and Health Sciences University of Copenhagen  Copenhagen Denmark"},{"name":"Institute of Sports Medicine Copenhagen (ISMC) and Department of Neurology Copenhagen University Hospital Bispebjerg  Copenhagen Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Therese","family":"Eskilsson","sequence":"additional","affiliation":[{"name":"Department of Public Health and Clinical Medicine Section for Sustainable Health Umea\u030a University  Ume\u00e5 Sweden"},{"name":"Department of Community Medicine and Rehabilitation Physiotherapy Umea\u030a University  Ume\u00e5 Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3256-9018","authenticated-orcid":false,"given":"Hanna M.","family":"Gavelin","sequence":"additional","affiliation":[{"name":"Department of Psychology Ume\u00e5 University  Ume\u00e5 Sweden"},{"name":"Department of Public Health and Clinical Medicine Section for Sustainable Health Umea\u030a University  Ume\u00e5 Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,9,4]]},"reference":[{"key":"e_1_2_12_2_1","doi-asserted-by":"publisher","DOI":"10.1080\/16549716.2023.2212950"},{"key":"e_1_2_12_3_1","doi-asserted-by":"publisher","DOI":"10.1002\/14651858.CD003260.pub2"},{"key":"e_1_2_12_4_1","doi-asserted-by":"publisher","DOI":"10.18637\/jss.v067.i01"},{"key":"e_1_2_12_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpsychires.2013.08.009"},{"key":"e_1_2_12_6_1","doi-asserted-by":"publisher","DOI":"10.1136\/oem.57.5.353"},{"key":"e_1_2_12_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.tins.2024.04.004"},{"key":"e_1_2_12_8_1","doi-asserted-by":"publisher","DOI":"10.1037\/a0020683"},{"key":"e_1_2_12_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/s0022\u20105371(73)80034\u20109"},{"key":"e_1_2_12_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.apmr.2019.02.011"},{"key":"e_1_2_12_11_1","doi-asserted-by":"publisher","DOI":"10.1080\/09658210244000027"},{"key":"e_1_2_12_12_1","doi-asserted-by":"publisher","DOI":"10.1080\/10253890.2020.1797673"},{"key":"e_1_2_12_13_1","doi-asserted-by":"publisher","DOI":"10.1080\/02678373.2014.909545"},{"key":"e_1_2_12_14_1","volume-title":"Delis\u2010Kaplan Executive Function System","author":"Delis D. 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