Combined cognitive and motor training improves the outcome in the early phase after stroke and prevents a decline of executive functions: A pilot study

NeuroRehabilitation. 2021;48(1):97-108. doi: 10.3233/NRE-201583.

Abstract

Background: The negative impact of cognitive dysfunction on motor rehabilitation as a relearning-process is well known in stroke patients. However, evidence for combined cognitive and motor training (CMT) is lacking.

Objective: To evaluate the effects of combined CMT in early stroke rehabilitation.

Methods: In a controlled pilot study, 29 moderately affected stroke patients with low-level motor performance and cognitive impairment received motor therapy plus either cognitive (experimental group, EG) or low-frequency ergometer training (control group, CG) for eight days.

Results: Both groups improved their motor functioning significantly. After training, between-group comparison revealed significant differences for cognitive flexibility and trends for set-shifting, working memory, and reaction control in favor of the EG. Within-group effects showed improvement across all cognitive domains in the EG, which correlated with gains in bed-mobility, while the CG showed no significant improvement in cognition. Rather, a trend towards reaction control decline was observed, which correlated with less functional progression and recovery. Furthermore, a decline in cognitive flexibility, set-shifting, and working memory was descriptively observed.

Conclusions: Combined CMT may enhance cognition and motor relearning early after stroke and is superior to single motor training. Further studies are needed to replicate these results and investigate long-term benefits.

Keywords: Cerebrovascular event; cognition recovery of function; physiotherapy; rehabilitation.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Cognition / physiology
  • Cognitive Behavioral Therapy / methods*
  • Cognitive Dysfunction / physiopathology
  • Cognitive Dysfunction / psychology
  • Cognitive Dysfunction / therapy*
  • Combined Modality Therapy / methods
  • Combined Modality Therapy / psychology
  • Executive Function / physiology*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Motor Skills / physiology
  • Physical Therapy Modalities* / psychology
  • Pilot Projects
  • Stroke / physiopathology
  • Stroke / psychology
  • Stroke / therapy*
  • Stroke Rehabilitation / methods*
  • Stroke Rehabilitation / psychology
  • Treatment Outcome