1 Department of Physical Therapy, University of British Columbia, Vancouver, British Columbia, Canada.
2 Djavad Mowafaghian Centre for Brain Health, University of British Columbia, Vancouver, British Columbia, Canada.
3 Centre for Aging SMART at Vancouver Coastal Health, Vancouver Coastal Health Research Institute, Vancouver, British Columbia, Canada.
4 School of Biomedical Engineering, University of British Columbia, Vancouver, British Columbia, Canada.
5 Department of Radiology, University of British Columbia, Vancouver, British Columbia, Canada.
6 International Collaboration on Repair Discoveries, Vancouver, British Columbia, Canada.
7 Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, UK.
8 Barha Brain Health Laboratory, Faculty of Kinesiology, University of Calgary,Calgary, Alberta, Canada.
9 Department of Health, Kinesiology, and Applied Physiology, Concordia University, Montréal, Québec, Canada.
10 Division of Neurology, University of British Columbia, Vancouver, British Columbia, Canada.
11 Department of Medicine, King Saud University, College of Medicine, Riyadh, Saudi Arabia.
12 Department of Medicine, Division of Geriatric Medicine, University of British Columbia, Vancouver, British Columbia, Canada.
13 Department of Psychiatry, University of British Columbia, Vancouver, British Columbia, Canada.
14 Vancouver Stroke Program, Vancouver, British Columbia, Canada.
15 Faculty of Management, University of British Columbia-Okanagan, British Columbia, Kelowna, Canada.

Introduction: It is unknown whether progressive resistance training (PRT) improves cognitive function in adults with cerebral small vessel disease and mild cognitive impairment (i.e., subcortical vascular cognitive impairment [SVCI]).

Methods: We conducted a 12-month randomized trial comparing PRT versus balance and tone exercises (BAT) on the Alzheimer's Disease Assessment Scale Cognitive Plus (ADAS-Cog-Plus).

Results: Ninety-one participants were randomized (PRT = 45; BAT = 46); 76 completed the trial. Adherence was not different between groups (p = 0.18). At 12 months, PRT significantly improved ADAS-Cog-Plus scores (estimated mean difference: -0.18; 95% confidence interval [CI: -0.35, -0.01]; p = 0.04). Planned contrasts stratified by sex showed a significant PRT effect on ADAS-Cog-Plus scores for females (mean difference: -0.27; 95% CI: [-0.49, -0.05]; p = 0.02), but not for males. PRT also significantly reduced C-reactive protein (estimated mean difference: -2.93; 95% CI: [-5.36, -0.49]; p = 0.02). No significant differences were observed for other secondary outcomes.

Discussion: PRT may have a small beneficial effect on cognitive function in SVCI.

Clinical trial registration: This trial was registered with ClinicalTrials.gov (NCT02669394).