Post-Stroke Cognitive Impairments and Responsiveness to Motor Rehabilitation: A Review
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STROKE REHABILITATION (P RAGHAVAN, SECTION EDITOR)
Post-Stroke Cognitive Impairments and Responsiveness to Motor Rehabilitation: A Review Jennapher Lingo VanGilder 1 & Andrew Hooyman 1 & Daniel S. Peterson 2,3,4 & Sydney Y. Schaefer 1,4 Accepted: 3 September 2020 # Springer Science+Business Media, LLC, part of Springer Nature 2020
Abstract Purpose of Review This review discusses the prevalence of cognitive deficits following stroke and their impact on responsiveness to therapeutic intervention within a motor learning context. Recent Findings Clinical and experimental studies have established that post-stroke cognitive and motor deficits may impede ambulation, augment fall risk, and influence the efficacy of interventions. Recent research suggests the presence of cognitive deficits may play a larger role in motor recovery than previously understood. Summary Considering that cognitive impairments affect motor relearning, post-stroke motor rehabilitation therapies may benefit from formal neuropsychological testing. For example, early work suggests that in neurotypical adults, cognitive function may be predictive of responsiveness to motor rehabilitation and cognitive training may improve mobility. This sets the stage for investigations probing these topics in people post-stroke. Moreover, the neural basis for and extent to which these cognitive impairments influence functional outcome remains largely unexplored and requires additional investigation. Keywords Cognitive decline . Rehabilitation . Stroke . Falls . Gait . Function
Introduction Motor learning is important for motor rehabilitation as individuals must often relearn lost motor skills [1]. Evidence from clinical and experimental studies have long supported that specific cognitive abilities such as attention, working memory, and visuospatial ability are related to both performance and performance improvement on novel motor tasks (i.e., procedural learning) [2–10]. This may be problematic for stroke survivors, as these same domains are often impacted post-stroke. While the reporting of cognitive data has become more customary in stroke rehabilitation This article is part of the Topical Collection on Stroke Rehabilitation * Sydney Y. Schaefer [email protected] 1
School of Biological and Health Systems Engineering, Arizona State University, 501 E. Tyler Mall, MC 9709, Tempe, AZ 85287, USA
2
College of Health Solutions, Arizona State University, Tempe, USA
3
U.S. Department of Veterans Affairs, Phoenix, AZ, USA
4
Department of Physical Therapy and Athletic Training, University of Utah, 520 Wakara Way, Salt Lake City, UT 84108, USA
studies, these data are often limited to global cognitive screening tools that provide only a cursory glimpse into cognitive function and are typically used only to exclude individuals with low scores. Moreover, a comprehensive understanding of specific cognitive impairments in stroke survivors, and the extent to which they interfere with gait rehabilitation remains a critical knowledge gap. Here, we will briefly summariz
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