Effectiveness of neurocognitive exercises on cognition among post-chemotherapy cancer survivors

Introduction
Chemotherapy is the most utilised treatment in any solid cancer diagnosis, but 15–50% of the patients receiving chemotherapy develop cancer-related cognitive impairment (CRCI), which has a lasting impact on their ability to lead a purposeful life. Current evidence suggests aerobic exercise with resistance training as a beneficial intervention for CRCI, but being a multimodal regimen, neurocognitive exercises are designed to target specific cognitive domains, offering a comprehensive approach to address the multifaceted challenges posed by CRCI. The aim of the study was to determine whether neurocognitive exercises focused on cognition are effective in treating CRCI, and to ascertain its impact on quality of life (QoL) among post-chemotherapy cancer survivors.

Material and methods
Seventy participants meeting the inclusion criteria were conveniently sampled and assessed for cognitive impairment and its impact on QoL using functional assessment of the cancer therapy-cognitive function (FACT-Cog) (version 3) and EORTC-QLQ (C-30) questionnaires. The experimental group received stimulus-specific aerobic and domain-specific cognitive exercises, while the control group received aerobic exercise and resistance training. Both groups underwent interventions 3 times a week for 6 weeks, followed by post-intervention evaluations.

Results
Statistical evaluation using the Wilcoxon signed rank test and Mann-Whitney U test showed that the cognitive exercise group scored significantly higher on FACT-Cog scores (68.1 ±6.93, p = 0.00014) than the aerobic exercise group (63.74 ±5.49). For the EORTC-QLQ (C30), the cognitive exercise group had a significantly higher mean score (56.8 ±7.73, p < 0.0001) than the aerobic exercise group (44.82 ±8.48).

Conclusions
Incorporating neurocognitive exercises into the care of post-chemotherapy cancer survivors can help alleviate the cognitive decline experienced after chemotherapy, addressing key domains like attention, memory, processing speed, and executive function, and it can significantly improve cognitive function and overall quality of life.