Relationships Between Cognitive Impairments and Motor Learning After Stroke: A Scoping Review.

Abstract

Background: Stroke is one of the leading causes of chronic disability worldwide. Sensorimotor recovery relies on principles of motor learning for the improvement of movement and sensorimotor function after stroke. Motor learning engages several cognitive processes to effectively learn and retain new motor skills. However, cognitive impairments are common and often coexist with motor impairments after stroke. The specific relationships between poststroke cognitive impairments and motor learning have not been determined.

Objectives: To summarize the existing evidence related to cognitive impairments and motor learning after stroke. Specific goals were to determine: (1) how motor learning is studied in individuals with poststroke cognitive impairments; (2) how cognitive impairments are assessed; (3) which cognitive domains impact motor learning.

Results: Over 400 studies were screened for specific inclusion criteria and 19 studies that related poststroke cognitive impairments to motor learning were included. Studies used a wide variety of experimental designs, sample sizes, and measures for cognitive evaluation. Cognitive impairments impacting motor improvement and learning capacity after stroke were reported in all but 4 studies. The most common domains impacting motor learning were attention, executive function, and memory.

Conclusion: Detailed cognitive assessments, retention testing, and a combination of clinical and kinematic outcomes are recommended for future studies. The presence of specific cognitive impairments measured with sensitive instruments should be considered when designing effective training interventions for patients with stroke to maximize sensorimotor recovery.