Abstract

Patients after pediatric stroke typically experience varying extent of motor and cognitive impairments. During rehabilitation, these impairments are often treated as separate entities. While there is a notion claiming that motor and cognitive functions are interrelated to some degree in healthy children, a minimal amount of evidence exists regarding this issue in patients after pediatric stroke. The purpose of this study was to investigate the association between motor abilities and executive functions in patients after pediatric arterial ischemic stroke. Twenty-seven patients (6 – 23 years) diagnosed with pediatric arterial ischemic stroke in the chronic phase (≥ 2 years after diagnosis, diagnosed < 16 years) and 49 healthy controls (6 – 26 years) were included in this study. Participants completed six tasks from standardized neuropsychological tests assessing the dimensions of executive functions, namely working memory, inhibition, and shifting. Additionally, we assessed hand strength and upper limb performance with two tasks each. In the patient group, the association between upper limb performance and executive functions was stronger than between hand strength and executive functions. Our results point toward the idea of a close interrelation between upper limb performance and executive functions. Training more complex and cognitively engaging motor abilities involving upper limb performance rather than basic motor abilities such as hand strength during a rehabilitation program may have the power to foster executive function development and vice versa in patients after stroke.

摘要

小儿卒中后的患者通常会经历不同程度的运动和认知障碍。在康复过程中，这些损伤通常被视为单独的实体。虽然有一种观点声称健康儿童的运动和认知功能在某种程度上是相互关联的，但在小儿卒中后的患者中，关于这个问题的证据很少。本研究的目的是调查小儿动脉缺血性卒中后患者运动能力与执行功能之间的关系。本研究纳入了 27 名（6-23 岁）慢性期（诊断后≥ 2 年，诊断 < 16 岁）诊断为小儿动脉缺血性卒中的患者和 49 名健康对照（6-26 岁）。参与者完成了来自标准化神经心理学测试的六项任务，这些测试评估了执行功能的维度，即工作记忆、抑制和转移。此外，我们通过两项任务分别评估了手部力量和上肢表现。在患者组中，上肢表现与执行功能之间的关联要强于手部力量与执行功能之间的关联。我们的结果指向上肢表现和执行功能之间密切相关的想法。在康复计划期间训练更复杂和认知参与的运动能力，包括上肢表现而不是手部力量等基本运动能力，可能有助于促进中风后患者的执行功能发展，反之亦然。