{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,19]],"date-time":"2026-08-19T05:30:22Z","timestamp":1787117422525,"version":"build-2736575974"},"reference-count":69,"publisher":"Oxford University Press (OUP)","issue":"1","license":[{"start":{"date-parts":[[2024,11,8]],"date-time":"2024-11-08T00:00:00Z","timestamp":1731024000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100000024","name":"Canadian Institutes of Health Research","doi-asserted-by":"publisher","award":["MOP-126130"],"award-info":[{"award-number":["MOP-126130"]}],"id":[{"id":"10.13039\/501100000024","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Jack Brown and Family Alzheimer Research Foundation Society"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2024,12,11]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Exercise (EX) or cognitive and social enrichment (ENRICH) are 2 strategies for promoting cognition poststroke. Whether sleep moderates the effects of EX or ENRICH on cognition in adults with chronic stroke is unknown.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>A 3-arm parallel randomized clinical trial among community-dwelling adults aged 55+ years with chronic stroke (ie, \u226512 months since stroke). Participants were randomized to 2\u00d7 per week EX, ENRICH, or balance and tone control (BAT). At baseline, device-measured sleep duration and efficiency were measured using wrist-worn actigraphy; self-reported quality was measured by Pittsburgh Sleep Quality Index (PSQI). Participants were categorized at baseline as having good or poor device-measured duration, device-measured efficiency, or self-reported quality based on PSQI. The primary cognitive outcome was Alzheimer\u2019s Disease Assessment Scale Plus (ADAS-Cog-Plus) measured at baseline, 6 months (end of intervention), and 12 months (6-month follow-up). We examined if baseline sleep categorizations (ie, good vs poor) moderated the effects of EX or ENRICH on ADAS-Cog-Plus.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>We enrolled 120 participants in the trial (EX\u2005=\u200534; ENRICH\u2005=\u200534; BAT\u2005=\u200552). Sleep quality (ie, device-measured sleep efficiency or self-reported sleep quality) categorization moderated effects of EX (but not ENRICH) on ADAS-Cog-Plus. Compared with BAT participants with poor sleep quality, EX participants with poor sleep quality had better ADAS-Cog-Plus performance at 6 months (estimated mean difference for those with poor device-measured sleep efficiency: \u22120.48; 95% CI [\u22120.85, \u22120.10]; p\u2005=\u2005.010); estimated mean difference for those with poor self-reported sleep quality: \u22120.38; 95% CI [\u22120.70, \u22120.07]; p\u2005=\u2005.014). There was no effect of EX on ADAS-Cog-Plus for participants with good sleep quality. Device-measured sleep duration did not moderate intervention effects.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>Exercise is particularly beneficial in improving cognitive function in adults with chronic stroke and poor sleep quality.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/gerona\/glae264","type":"journal-article","created":{"date-parts":[[2024,11,8]],"date-time":"2024-11-08T16:04:07Z","timestamp":1731081847000},"source":"Crossref","is-referenced-by-count":5,"title":["Does Sleep Moderate the Effects of Exercise Training or Complex Mental and Social Activities on Cognitive Function in Adults With Chronic Stroke? Secondary Analysis of a Randomized Trial"],"prefix":"10.1093","volume":"80","author":[{"given":"Ryan S","family":"Falck","sequence":"first","affiliation":[{"name":"Aging, Mobility and Cognitive Health Laboratory, Faculty of Medicine, Department of Physical Therapy, University of British Columbia , Vancouver, British Columbia ,","place":["Canada"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ryan G","family":"Stein","sequence":"additional","affiliation":[{"name":"Aging, Mobility and Cognitive Health Laboratory, Faculty of Medicine, Department of Physical Therapy, University of British Columbia , Vancouver, British Columbia ,","place":["Canada"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5274-4293","authenticated-orcid":false,"given":"Jennifer C","family":"Davis","sequence":"additional","affiliation":[{"name":"Applied Health Economics Laboratory, Faculty of Management, University of British Columbia \u2013 Okanagan Campus , Kelowna, British Columbia ,","place":["Canada"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2093-0788","authenticated-orcid":false,"given":"Janice J","family":"Eng","sequence":"additional","affiliation":[{"name":"Neurorehabilitation Research Program, GFS Rehabilitation Centre, Faculty of Medicine, Department of Physical Therapy, University of British Columbia , Vancouver, British Columbia ,","place":["Canada"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laura E","family":"Middleton","sequence":"additional","affiliation":[{"name":"Department of Kinesiology and Health Sciences, University of Waterloo , Waterloo, Ontario ,","place":["Canada"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7730-0552","authenticated-orcid":false,"given":"Peter A","family":"Hall","sequence":"additional","affiliation":[{"name":"School of Public Health Sciences, University of Waterloo 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