Background

There is significant variability in poststroke locomotor learning that is poorly understood and affects individual responses to rehabilitation interventions. Cognitive abilities relate to upper extremity motor learning in neurologically intact adults, but have not been studied in poststroke locomotor learning.

Objective

To understand the relationship between locomotor learning and retention and cognition after stroke.

Methods

Participants with chronic (>6 months) stroke participated in 3 testing sessions. During the first session, participants walked on a treadmill and learned a new walking pattern through visual feedback about their step length. During the second session, participants walked on a treadmill and 24-hour retention was assessed. Physical and cognitive tests, including the Fugl-Meyer-Lower Extremity (FM-LE), Fluid Cognition Composite Score (FCCS) from the NIH Toolbox -Cognition Battery, and Spatial Addition from the Wechsler Memory Scale-IV, were completed in the third session. Two sequential regression models were completed: one with learning and one with retention as the dependent variables. Age, physical impairment (ie, FM-LE), and cognitive measures (ie, FCCS and Spatial Addition) were the independent variables.

Results

Forty-nine and 34 participants were included in the learning and retention models, respectively. After accounting for age and FM-LE, cognitive measures explained a significant portion of variability in learning (R² = 0.17, P = .008; overall model R² = 0.31, P = .002) and retention (ΔR² = 0.17, P = .023; overall model R² = 0.44, P = .002).

Conclusions

Cognitive abilities appear to be an important factor for understanding locomotor learning and retention after stroke. This has significant implications for incorporating locomotor learning principles into the development of personalized rehabilitation interventions after stroke.

中文翻译：

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流畅的认知能力对于中风后个体学习和保持新的、明确学习的步行模式很重要

背景

中风后运动学习存在显着差异，人们对此知之甚少，并影响个体对康复干预的反应。认知能力与神经功能完好的成年人的上肢运动学习有关，但尚未在中风后运动学习中进行研究。

客观的

了解中风后运动学习与保留和认知之间的关系。

方法

患有慢性（> 6 个月）中风的参与者参加了 3 次测试。在第一次会议期间，参与者在跑步机上行走，并通过有关步长的视觉反馈学习了一种新的步行模式。在第二次会议期间，参与者在跑步机上行走并评估了 24 小时的保持力。身体和认知测试，包括 Fugl-Meyer-Lower Extremity (FM-LE)、来自 NIH Toolbox-Cognition Battery 的 Fluid Cognition Composite Score (FCCS) 和来自 Wechsler Memory Scale-IV 的空间加成，在第三阶段完成会议。完成了两种顺序回归模型：一种以学习为因变量，一种以保留为因变量。年龄、身体损伤（即 FM-LE）和认知测量（即 FCCS 和空间加成）是自变量。

结果

学习和保留模型分别包括 49 和 34 名参与者。在考虑了年龄和 FM-LE 后，认知测量解释了学习（R ² = 0.17，P = .008；整体模型R ² = 0.31，P = .002）和保留（Δ R ² = 0.17 ，P = .023；整体模型R ² = 0.44，P = .002）。

结论

认知能力似乎是了解中风后运动学习和保留的重要因素。这对于将运动学习原理纳入中风后个性化康复干预的发展具有重要意义。