Fluid Cognitive Abilities Are Important for Learning and Retention of a New, Explicitly Learned Walking Pattern in Individuals After Stroke

French, Margaret A; Cohen, Matthew; Pohlig, Ryan T.; Reisman, Darcy S.

doi:10.1177/15459683211001025

Cited by 13 publications

(28 citation statements)

References 64 publications

(130 reference statements)

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“…A recent study in individuals poststroke also demonstrates a strong relationship between cognition and the capacity for instructive motor learning. 45 The high cognitive burden of instructive learning is likely intuitive to many clinicians; an external feedback-heavy treatment approach is often ineffective for improving motor behaviors in patients with cognitive deficits.…”

Section: Four Mechanisms Of Motor Learningmentioning

confidence: 99%

Updates in Motor Learning: Implications for Physical Therapist Practice and Education

et al. 2021

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Over the past 3 decades, the volume of human motor learning research has grown enormously. As such, the understanding of motor learning (ie, sustained change in motor behavior) has evolved. It has been learned that there are multiple mechanisms through which motor learning occurs, each with distinctive features. These mechanisms include use-dependent, instructive, reinforcement, and sensorimotor adaptation-based motor learning. It is now understood that these different motor learning mechanisms contribute in parallel or in isolation to drive desired changes in movement, and each mechanism is thought to be governed by distinct neural substrates. This expanded understanding of motor learning mechanisms has important implications for physical therapy. It has the potential to facilitate the development of new, more precise treatment approaches that physical therapists can leverage to improve human movement. This Perspective describes scientific advancements related to human motor learning mechanisms and discusses the practical implications of this work for physical therapist practice and education.

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Section: Four Mechanisms Of Motor Learningmentioning

confidence: 99%

Updates in Motor Learning: Implications for Physical Therapist Practice and Education

et al. 2021

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“…20 Cognitive control impairments, especially in fluid abilities, are a common outcome of stroke [21][22][23][24][25][26][27][28][29] and are likely to contribute to impairments in motor learning. 15,30,31 In sensorimotor adaptation, subjects with stroke show impaired adaption to force-field perturbations 31 and to visuomotor perturbations. 32 Furthermore, even though subjects with stroke succeeded in adapting to a gain perturbation to 1 target, they performed poorly when needed to generalize to others in comparison to control subjects.…”

Section: Introductionmentioning

confidence: 99%

Cognitive Impairments After Stroke Do Not Attenuate Explicit Visuomotor Adaptation in Reaching and Savings With the Unaffected Arm

Binyamin-Netser

Goldhamer²,

Avni

et al. 2023

Neurorehabil Neural Repair

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Background Accumulating evidence suggests that motor performance is affected by the cognitive control abilities of the subject. Performance in motor tasks in populations with cognitive deficits such as older adults and subjects with stroke is therefore expected to deteriorate. The goal of this study is to investigate the relationship between cognitive impairments and motor control and learning impairments in a visuomotor adaptation task in subjects with stroke. Methods Twenty-seven post-stroke, 31 age matched controls, and 30 young control subjects completed a sensorimotor adaptation task composed of 2 adaptation blocks separated by a washout block. Explicit learning was assessed by cueing subjects to suppress their strategy. Cognitive assessment was conducted using the Montreal Cognitive Assessment (MoCA) and a verbal learning test. Subjects with stroke performed the task with their unaffected arm. Results Despite the cognitive deterioration, the adaptation and savings of the stroke group and age matched controls were comparable. Adaptation and savings were smaller with respect to the young subjects. Savings was associated with a significant improvement in the explicit component across blocks. Finally, the explicit enhancement between blocks was significantly correlated with the MoCA scores in the stroke group and with the results of the verbal learning test in the young controls. Conclusion The lack of stroke-induced attenuation on adaptation, despite a correlation between cognitive abilities and explicit learning in adaptation, suggests that subjects with stroke have enough cognitive resources to support sensorimotor adaptation. The availability of cognitive resources for motor learning following brain damage could be utilized in the rehabilitation process.

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“…Thus, a more comprehensive battery of cognitive assessments would determine whether specific cognitive domains (or specific cognitive deficits) more closely predict motor skill retention in this population. For example, visuospatial deficits may interfere with upper-extremity learning ( 23 – 25 , 52 , 53 ), while fluid cognitive skills or executive function may interfere with lower-extremity learning ( 54 ). While these previous studies have not focused on motor learning in PD specifically, the effects of particular cognitive deficits may not be PD-specific but instead generalize to a number of older patient populations who may be receiving motor rehabilitation for a number of reasons (e.g., stroke, joint replacement).…”

Section: Discussionmentioning

confidence: 99%

Relating Global Cognition With Upper-Extremity Motor Skill Retention in Individuals With Mild-to-Moderate Parkinson's Disease

VanGilder

Lopez-Lennon

Paul

et al. 2021

Front. Rehabilit. Sci.

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Background and Purpose: Cognition has been linked to rehabilitation outcomes in stroke populations, but this remains unexplored in individuals with Parkinson's disease (PD). The purpose of this secondary data analysis from a recent clinical trial (NCT02600858) was to determine if global cognition was related to skill performance after motor training in individuals with PD.Methods: Twenty-three participants with idiopathic PD completed 3 days of training on an upper-extremity task. For the purposes of the original clinical trial, participants trained either “on” or “off” their dopamine replacement medication. Baseline, training, and 48-h retention data have been previously published. Global cognition was evaluated using the Montreal Cognitive Assessment (MoCA). Linear regression examined whether MoCA score predicted longer-term retention at nine-day follow-up; baseline motor task performance, age, PD severity, depressive symptoms, and group (medication “on”/“off”) were included as covariates. Baseline and follow-up motor task performance were assessed for all participants while “on” their medication.Results: MoCA score was positively related to follow-up motor task performance, such that individuals with better cognition were faster than those with poorer cognition. Baseline task performance, age, PD severity, depressive symptoms, and medication status were unrelated to follow-up performance.Discussion and Conclusions: Results of this secondary analysis align with previous work that suggest cognitive impairment may interfere with motor learning in PD and support the premise that cognitive training prior to or concurrent with motor training may enhance rehabilitative outcomes for individuals with PD. Findings also suggest that assessing cognition in individuals with PD could provide prognostic information about their responsiveness to motor rehabilitation.

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Fluid Cognitive Abilities Are Important for Learning and Retention of a New, Explicitly Learned Walking Pattern in Individuals After Stroke

Cited by 13 publications

References 64 publications

Updates in Motor Learning: Implications for Physical Therapist Practice and Education

Updates in Motor Learning: Implications for Physical Therapist Practice and Education

Cognitive Impairments After Stroke Do Not Attenuate Explicit Visuomotor Adaptation in Reaching and Savings With the Unaffected Arm

Relating Global Cognition With Upper-Extremity Motor Skill Retention in Individuals With Mild-to-Moderate Parkinson's Disease

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