The impact of visuospatial and executive function on activity performance and outcome after robotic or conventional gait training, long-term after stroke—as part of a randomized controlled trial
<h4>Introduction</h4> Visuospatial and executive impairments have been associated with poor activity performance sub-acute after stroke. Potential associations long-term and in relation to outcome of rehabilitation interventions need further exploration. <h4>Aims</h4> To expl...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
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Public Library of Science (PLoS)
2023-01-01
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| Series: | PLoS ONE |
| Online Access: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9997896/?tool=EBI |
| _version_ | 1811154323503054848 |
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| author | Maria Bergqvist Marika C Möller Martin Björklund Jörgen Borg Susanne Palmcrantz |
| author_facet | Maria Bergqvist Marika C Möller Martin Björklund Jörgen Borg Susanne Palmcrantz |
| author_sort | Maria Bergqvist |
| collection | DOAJ |
| description | <h4>Introduction</h4> Visuospatial and executive impairments have been associated with poor activity performance sub-acute after stroke. Potential associations long-term and in relation to outcome of rehabilitation interventions need further exploration. <h4>Aims</h4> To explore associations between visuospatial and executive function and 1) activity performance (mobility, self-care and domestic life) and 2) outcome after 6 weeks of conventional gait training and/or robotic gait training, long term (1–10 years) after stroke. <h4>Methods</h4> Participants (n = 45), living with stroke affecting walking ability and who could perform the items assessing visuospatial/executive function included in the Montreal Cognitive Assessment (MoCA Vis/Ex) were included as part of a randomized controlled trial. Executive function was evaluated using ratings by significant others according to the Dysexecutive Questionnaire (DEX); activity performance using 6-minute walk test (6MWT), 10-meter walk test (10MWT), Berg balance scale, Functional Ambulation Categories, Barthel Index and Stroke Impact Scale. <h4>Results</h4> MoCA Vis/Ex was significantly associated with baseline activity performance, long-term after stroke (r = .34-.69, p < .05). In the conventional gait training group, MoCA Vis/Ex explained 34% of the variance in 6MWT after the six-week intervention (p = 0.017) and 31% (p = 0.032) at the 6 month follow up, which indicate that a higher MoCA Vis/Ex score enhanced the improvement. The robotic gait training group presented no significant associations between MoCA Vis/Ex and 6MWT indicating that visuospatial/executive function did not affect outcome. Rated executive function (DEX) presented no significant associations to activity performance or outcome after gait training. <h4>Conclusion</h4> Visuospatial/executive function may significantly affect activity performance and the outcome of rehabilitation interventions for impaired mobility long-term after stroke and should be considered in the planning of such interventions. Patients with severely impaired visuospatial/executive function may benefit from robotic gait training since improvement was seen irrespective of visuospatial/executive function. These results may guide future larger studies on interventions targeting long-term walking ability and activity performance. <h4>Trial registration</h4> clinicaltrials.gov (NCT02545088) August 24, 2015. |
| first_indexed | 2024-04-10T04:13:49Z |
| format | Article |
| id | doaj.art-6dee17cc387342f6a6f581947e50d2d2 |
| institution | Directory Open Access Journal |
| issn | 1932-6203 |
| language | English |
| last_indexed | 2024-04-10T04:13:49Z |
| publishDate | 2023-01-01 |
| publisher | Public Library of Science (PLoS) |
| record_format | Article |
| series | PLoS ONE |
| spelling | doaj.art-6dee17cc387342f6a6f581947e50d2d22023-03-12T05:32:29ZengPublic Library of Science (PLoS)PLoS ONE1932-62032023-01-01183The impact of visuospatial and executive function on activity performance and outcome after robotic or conventional gait training, long-term after stroke—as part of a randomized controlled trialMaria BergqvistMarika C MöllerMartin BjörklundJörgen BorgSusanne Palmcrantz<h4>Introduction</h4> Visuospatial and executive impairments have been associated with poor activity performance sub-acute after stroke. Potential associations long-term and in relation to outcome of rehabilitation interventions need further exploration. <h4>Aims</h4> To explore associations between visuospatial and executive function and 1) activity performance (mobility, self-care and domestic life) and 2) outcome after 6 weeks of conventional gait training and/or robotic gait training, long term (1–10 years) after stroke. <h4>Methods</h4> Participants (n = 45), living with stroke affecting walking ability and who could perform the items assessing visuospatial/executive function included in the Montreal Cognitive Assessment (MoCA Vis/Ex) were included as part of a randomized controlled trial. Executive function was evaluated using ratings by significant others according to the Dysexecutive Questionnaire (DEX); activity performance using 6-minute walk test (6MWT), 10-meter walk test (10MWT), Berg balance scale, Functional Ambulation Categories, Barthel Index and Stroke Impact Scale. <h4>Results</h4> MoCA Vis/Ex was significantly associated with baseline activity performance, long-term after stroke (r = .34-.69, p < .05). In the conventional gait training group, MoCA Vis/Ex explained 34% of the variance in 6MWT after the six-week intervention (p = 0.017) and 31% (p = 0.032) at the 6 month follow up, which indicate that a higher MoCA Vis/Ex score enhanced the improvement. The robotic gait training group presented no significant associations between MoCA Vis/Ex and 6MWT indicating that visuospatial/executive function did not affect outcome. Rated executive function (DEX) presented no significant associations to activity performance or outcome after gait training. <h4>Conclusion</h4> Visuospatial/executive function may significantly affect activity performance and the outcome of rehabilitation interventions for impaired mobility long-term after stroke and should be considered in the planning of such interventions. Patients with severely impaired visuospatial/executive function may benefit from robotic gait training since improvement was seen irrespective of visuospatial/executive function. These results may guide future larger studies on interventions targeting long-term walking ability and activity performance. <h4>Trial registration</h4> clinicaltrials.gov (NCT02545088) August 24, 2015.https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9997896/?tool=EBI |
| spellingShingle | Maria Bergqvist Marika C Möller Martin Björklund Jörgen Borg Susanne Palmcrantz The impact of visuospatial and executive function on activity performance and outcome after robotic or conventional gait training, long-term after stroke—as part of a randomized controlled trial PLoS ONE |
| title | The impact of visuospatial and executive function on activity performance and outcome after robotic or conventional gait training, long-term after stroke—as part of a randomized controlled trial |
| title_full | The impact of visuospatial and executive function on activity performance and outcome after robotic or conventional gait training, long-term after stroke—as part of a randomized controlled trial |
| title_fullStr | The impact of visuospatial and executive function on activity performance and outcome after robotic or conventional gait training, long-term after stroke—as part of a randomized controlled trial |
| title_full_unstemmed | The impact of visuospatial and executive function on activity performance and outcome after robotic or conventional gait training, long-term after stroke—as part of a randomized controlled trial |
| title_short | The impact of visuospatial and executive function on activity performance and outcome after robotic or conventional gait training, long-term after stroke—as part of a randomized controlled trial |
| title_sort | impact of visuospatial and executive function on activity performance and outcome after robotic or conventional gait training long term after stroke as part of a randomized controlled trial |
| url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9997896/?tool=EBI |
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