Effects of Hyperbaric Oxygen Combined With Aerobic Exercise on Working Memory Among Stroke Patients

Effects of Combined Hyperbaric Oxygen Therapy and Moderate-Intensity Aerobic Exercise on Working Memory in Stroke Patients: A Randomized Controlled Trial

This single-center randomized controlled trial enrolled stroke patients with working memory impairment. Participants were randomly divided into the hyperbaric oxygen combined low-intensity focused ultrasound intervention group and the conventional rehabilitation control group. The intervention lasted for a fixed course, and indicators including working memory performance and prefrontal cortex activation detected by fNIRS were compared before and after treatment. The study aims to verify whether combined intervention can better improve cognitive function in stroke survivors. All subjects signed informed consent and obtained ethical approval before enrollment.

A prospective single-center randomized controlled study was conducted among inpatients with ischemic stroke complicated with working memory deficit admitted to the Sixth Hospital of Wuhan, Affiliated Hospital of Jianghan University from December 6, 2024 to May 1, 2025. Eligible participants were randomly allocated into two groups: the experimental group received hyperbaric oxygen therapy plus low-intensity focused ultrasound neuromodulation on the prefrontal cortex, while the control group received routine occupational therapy and cognitive rehabilitation training with equal treatment duration. The primary outcomes were 2-back task accuracy and reaction time assessed by neurobehavioral tests; secondary outcomes included oxygenated hemoglobin concentration in bilateral DLPFC monitored by functional near-infrared spectroscopy before intervention, after 2 weeks and after the full course. Demographic data, stroke lesion characteristics and adverse events were recorded synchronously. Statistical analysis adopted independent sample t-test and repeated-measures ANOVA to compare inter-group and intra-group differences. The whole research scheme was approved by the hospital ethics committee, and written informed consent was acquired from each participant before enrollment.

Inclusion Criteria:

• First-ever ischemic stroke confirmed by cranial MRI/CT;
• Age 65-85 years old;
• MoCA score 18-26 points (mild cognitive impairment after stroke);
• Right-handed, able to complete 2-back cognitive task and fNIRS detection;
• Signed written informed consent voluntarily.

Exclusion Criteria:

• History of dementia, traumatic brain injury or other central nervous system diseases;
• Severe visual/auditory impairment unable to finish cognitive assessment;
• Contraindications for hyperbaric oxygen therapy (untreated pneumothorax, severe emphysema etc.);
• Severe cardiac insufficiency or unstable vital signs;
• Taking cognitive improvement drugs within 1 month before enrollment;
• Dropping out voluntarily during the 14-day intervention.