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Meta-Analysis
. 2015;33(3):389-403.
doi: 10.3233/RNN-150510.

Emerging evidence of the association between cognitive deficits and arm motor recovery after stroke: A meta-analysis

Aditi A Mullick  1   2 , Sandeep K Subramanian  2   3 , Mindy F Levin  1   2
Affiliations
Free PMC article
Meta-Analysis

Emerging evidence of the association between cognitive deficits and arm motor recovery after stroke: A meta-analysis

Aditi A Mullick et al. Restor Neurol Neurosci. 2015.
Free PMC article

Abstract

Purpose: Motor and cognitive impairments are common and often coexist in patients with stroke. Although evidence is emerging about specific relationships between cognitive deficits and upper-limb motor recovery, the practical implication of these relationships for rehabilitation is unclear. Using a structured review and meta-analyses, we examined the nature and strength of the associations between cognitive deficits and upper-limb motor recovery in studies of patients with stroke.

Methods: Motor recovery was defined using measures of upper limb motor impairment and/or activity limitations. Studies were included if they reported on at least one measure of cognitive function and one measure of upper limb motor impairment or function.

Results: Six studies met the selection criteria. There was a moderate association (r = 0.43; confidence interval; CI:0.09- 0.68, p = 0.014) between cognition and overall arm motor recovery. Separate meta-analyses showed a moderately strong association between executive function and motor recovery (r = 0.48; CI:0.26- 0.65; p < 0.001), a weak positive correlation between attention and motor recovery (r = 0.25; CI:0.04- 0.45; p = 0.023), and no correlation between memory and motor recovery (r = 0.42; CI:0.16- 0.79; p = 0.14).

Conclusion: These results imply that information on the presence of cognitive deficits should be considered while planning interventions for clients in order to design more personalized interventions tailored to the individual for maximizing upper-limb recovery.

Keywords: Motor learning; cognition; rehabilitation; upper limb.

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Figures

Fig.1
Fig.1
PRISMA Flow Diagram. *Reasons for exclusion: exclusion of persons with impaired cognition (n = 20); no baseline cognitive assessment (n = 16); no upper limb motor outcome (n = 9); no repetitive movement or motor rehabilitation intervention provided (n = 5); Dual task interventions (n = 2); hemispatial neglect was the only cognitive predictor (n = 2); upper limb intervention review paper (n = 1); non-stroke study sample (n = 1)  †Reasons for exclusion: statistical associations between baseline cognition and motor outcome scores were not done and could not be derived from the data provided (n = 5); no baseline cognitive assessment (n = 1); no motor intervention (n = 1).
Fig.2
Fig.2
Results of a meta-analysis examining the correlation between cognition and arm motor improvement. Larger squares represent larger study effect sizes. Diamonds indicate the pooled effects of results of individual studies. Diamond location indicates the estimated effect size and diamond width reflects the precision of the estimate.
Fig.3
Fig.3
Results of meta-analyses examining the correlation between arm motor improvement and (A) executive function, (B) attention and (C) memory. Larger squares represent larger study effect sizes. Diamonds indicate pooled effects of results of individual studies. Diamond location indicates the estimated effect size and diamond width reflects the precision of the estimate.
See this image and copyright information in PMC

References

    1. Barker-Collo S, Feigin V. The impact of neuropsychological deficits on functional stroke outcomes. Neuropsychol Rev. 2006;16(2):53–64. - PubMed
    1. Barker-Collo S, Starkey N, Lawes CM, Feigin V, Senior H, Parag V. Neuropsychological profiles of 5-year ischemic stroke survivors by Oxfordshire stroke classification and hemisphere of lesion. Stroke. 2012;43(1):50–55. - PubMed
    1. Barreca SR, Finlayson AM, Gowland CA, Basmajian JV. Use of the Halstead Category Test as a cognitive predictor of functional recovery in the hemiplegic upper limb: A cross-validation study. Clin Neuropsychol. 1999;13(2):171–181. - PubMed
    1. Boe EW, Pedersen AD, Pedersen AR, Nielsen JF, Blicher JU. Cognitive status does not predict motor gain from post stroke constraint-induced movement therapy. NeuroRehabilitation. 2014;34(1):201–207. - PubMed
    1. Carter LT, Oliveira DO, Duponte J, Lynch SV. The relationship of cognitive skills performance to activities of daily living in stroke patients. Am J Occup Ther. 1988;42(7):449–455. - PubMed

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