To investigate the effects of metacognition training combined with pharmacotherapy treatment on cognitive function and mobility in patients with ischemic stroke (IS).

A retrospective study was conducted on IS patients admitted to the Affiliated Hospital of Yangzhou University from February 2020 to December 2024. After screening according to inclusion and exclusion criteria, patients were divided into two groups according to treatment modality: a combination group (receiving metacognitive training plus pharmacotherapy) and a control group (receiving conventional treatment). Using propensity score matching (1∶1) to minimize confounding factors, 26 patients were included in each group. Cognitive function was assessed using the Montreal Cognitive Assessment (MoCA), daily living activities with the modified Barthel index (MBI), sleep quality with the Pittsburgh sleep quality index (PSQI), and quality of life with the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ-C30). Assessments were performed at baseline and after 1, 2, and 3 months of treatment. Repeated measures ANOVA was used to compare cognitive and mobility outcomes, independent t-tests for sleep and quality of life scores, and chi-square tests for intergroup therapeutic effects.

No significant between-group differences in MoCA scores were observed at baseline (P>0.05). After 1, 2 and 3 months of treatment, the combination group showed significantly higher MoCA scores (16.54±3.55, 19.85±3.22, 22.46±4.07) than the control group (13.96±3.08, 15.54±3.16, 19.87±3.54). The group × time interaction, time effect, and group effect were statistically significant (F=3.765, 22.472, 58.201, respectively; all P<0.05). Similarly, while baseline MBI scores did not differ (P>0.05), the combination group demonstrated significantly higher MBI scores at 1, 2, and 3 months (70.70±9.42, 78.58±8.87, 84.33±8.61) compared to the control group (65.54±8.54, 69.67±7.98, 74.14±9.33), with significant interaction, time, and group effects (F=165.208, 58.366, 231.291, respectively; all P<0.05). Baseline PSQI and EORTC QLQ-C30 scores were comparable (all P>0.05). After treatment, the combination group showed significantly better EORTC QLQ-C30 scores (62.73±10.49 vs 46.20±8.36, t=6.284, P<0.001) and lower PSQI scores (1.26±0.36 vs 2.73±0.49, t=12.328, P<0.001). After treatment, the combination group also had a significantly higher excellent/good response rate (88.46% vs 50.00%, χ²=9.028, P=0.003).

Metacognition training combined with pharmacotherapy can effectively improve the cognitive function, mobility, sleep quality, and quality of life in patients with IS.