Cognitive Impairments After Stroke Do Not Attenuate Explicit Visuomotor Adaptation in Reaching and Savings With the Unaffected Arm.
Reut Binyamin-Netser, Noy Goldhamer, Inbar Avni and 2 others
PMID 37287311WHAT IT FOUND
Stroke participants using their unaffected arm adapted to a 40° reaching rotation and relearned it as well as age-matched controls, despite lower cognitive screening scores.
Both older groups were less accurate than young controls.
Key findings
01Stroke participants had lower MoCA scores (22.15) than age-matched controls who completed the MoCA (24.95).
02Using the unaffected arm, stroke and age-matched controls adapted similarly to a 40° clockwise rotation and showed similar savings across blocks.
03In the stroke group, explicit learning improvement across blocks was associated with MoCA scores and with attention, perception, and short-term memory.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTs
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What it does not show
The stroke group was chronic, with time after stroke onset at least 6 months and mean 12.37 months, so it may not apply to acute rehabilitation. Participants with stroke used the unaffected arm and had full motor and sensory FMA and ARAT scores, so it does not show what happens with the affected arm. The stroke sample was a convenience sample from one rehabilitation center, and only 27 stroke participants were tested instead of 30 planned. Ten age-matched controls did not complete the MoCA due to technical constraints, so the cognitive comparison used 21 age-matched controls. The young control group was not pre-registered, and the study did not test a treatment or clinical outcome. The separation of explicit and implicit learning relies on the assumption that all groups understood and responded to the color cue in the same way. The study used a laboratory reaching task with a 40° rotation, not a therapy program, so it cannot show that a clinical intervention improves learning.
Declared interests
The authors declared no potential conflicts of interest. Funding was from the United States-Israel Binational Science Foundation grant 2015327 and Israel Science Foundation grant 1244/22.
The easy way to misread this
Do not conclude that cognitive impairment after stroke has no effect on motor rehabilitation. The stroke group used the unaffected arm, was chronic, and the task was a laboratory reaching adaptation, not a therapy outcome.