Relationships Between Cognitive Impairments and Motor Learning After Stroke: A Scoping Review.
Caroline M Rajda, Katrina Desabrais, Mindy F Levin
PMID 39606925WHAT IT FOUND
Cognitive deficits often limit motor learning after stroke, particularly with explicit tasks and movement-quality feedback.
Patients with attention or memory issues may benefit more from implicit learning and result-focused feedback. Evidence is preliminary due to small studies and inconsistent testing methods.
Key findings
01Patients with cognitive deficits showed reduced gains in upper limb function and daily activities after robotic training, particularly if they had spatial attention or executive function issues.
02In reaching tasks, patients with better memory and executive function improved when given feedback about movement quality, while all patients improved when given feedback about movement outcome regardless of cognitive status.
03Most included studies did not test retention, meaning they measured immediate motor improvement rather than long-term motor learning.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTsWhat it means for SLPs
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What it does not show
Only 10 of 19 studies included retention testing, so most results describe immediate motor improvement rather than long-term motor learning. Sample sizes in individual studies were small (9 to 59 participants), and the overall evidence base is heterogeneous. Cognitive assessments varied widely, with some studies using only global screening tools (e.g., MoCA) that may miss specific deficits. The review did not account for lesion location, which can differentially affect implicit vs. explicit learning. Risk of bias was assessed by only one author, and the protocol was not prospectively registered.
Declared interests
The authors declared no potential conflicts of interest and received no financial support for the research.
The easy way to misread this
Do not assume that cognitive deficits prevent motor learning entirely. The evidence suggests they affect *how* learning occurs (e.g., struggling with explicit instruction) rather than blocking it, and many patients improved regardless of cognitive status when given appropriate feedback.