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. 2021 Apr 30;11(5):587.
doi: 10.3390/brainsci11050587.

Influence of Cognitive Impairment on the Recovery of Subjects with Subacute Stroke Undergoing Upper Limb Robotic Rehabilitation

Irene Aprile  1 , Giulia Guardati  1 , Valeria Cipollini  1 , Dionysia Papadopoulou  1 , Serena Monteleone  2 , Alessandra Redolfi  2 , Romina Garattini  2 , Gianluigi Sacella  2 , Fulvia Noro  2 , Silvia Galeri  2 , Maria Chiara Carrozza  2   3 , Marco Germanotta  1
Affiliations

Influence of Cognitive Impairment on the Recovery of Subjects with Subacute Stroke Undergoing Upper Limb Robotic Rehabilitation

Irene Aprile et al. Brain Sci. .

Abstract

Cognitive decline is often present in stroke survivors, with a significant impact on motor recovery. However, how specific cognitive domains could impact motor recovery after robotic rehabilitation in patients with stroke is still not well understood. In this study, we analyzed the relationship between cognitive impairment and the outcome of a robot-mediated upper limb rehabilitation intervention in a sample of 51 subacute stroke patients. Participants were enrolled and treated with a set of robotic and sensor-based devices. Before the intervention, patients underwent a cognitive assessment by means of the Oxford Cognitive Screen. To assess the effect of the 30-session rehabilitation intervention, patients were assessed twice with the following outcome measures: the Fugl-Meyer Assessment for Upper Extremity (FMA-UE), to evaluate motor function; the Upper limb Motricity Index (MI), to evaluate upper limb muscle strength; the Modified Barthel Index (mBI), to evaluate activities of daily living and mobility. We found that deficits in spatial attention and executive functions impacted the mBI improvement, while language, number processing, and spatial attention deficits reduced the gains in the FMA-UE. These results suggest the importance to evaluate the cognitive functions using an adequate tool in patients with stroke undergoing a robotic rehabilitation intervention.

Keywords: attention; executive function; memory; rehabilitation; robotics; stroke.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Robotic and sensor-based devices used to treat the upper limb: (A) Amadeo (Tyromotion); (B) Motore (Humanware); (C) Diego (Tyromotion); and (D) Pablo (Tyromotion).
Figure 2
Figure 2
Oxford Cognitive Screen (OCS) scores impacting on the recovery in the activity of daily living, as measured by the change from baseline of modified Barthel Index (ΔBI). The asterisks indicate a statistically significant difference (** p < 0.01). Finally, Cohen’s d is reported.
Figure 3
Figure 3
Oxford Cognitive Screen (OCS) scores impacting motor recovery, as measured by the change from baseline of Fugl-Meyer Assessment for the Upper limb (ΔFMA-UE). The asterisks indicate a statistically significant difference (* p < 0.05; ** p < 0.01). Finally, Cohen’s d is reported.
See this image and copyright information in PMC

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