Rajda Caroline M, Desabrais Katrina, Levin Mindy F
Integrated Program in Neuroscience, McGill University, Montreal, QC, Canada.
Feil-Oberfield Research Site of the Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal, Laval, QC, Canada.
Neurorehabil Neural Repair. 2025 Feb;39(2):142-156. doi: 10.1177/15459683241300458. Epub 2024 Nov 28.
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.
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.
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.
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.
中风是全球慢性残疾的主要原因之一。感觉运动功能的恢复依赖于运动学习原理，以改善中风后的运动和感觉运动功能。运动学习涉及多个认知过程，以有效地学习和保留新的运动技能。然而，认知障碍很常见，并且在中风后常与运动障碍共存。中风后认知障碍与运动学习之间的具体关系尚未确定。
总结与中风后认知障碍和运动学习相关的现有证据。具体目标是确定：（1）如何在中风后认知障碍患者中研究运动学习；（2）如何评估认知障碍；（3）哪些认知领域会影响运动学习。
根据特定纳入标准筛选了400多项研究，纳入了19项将中风后认知障碍与运动学习相关联的研究。研究采用了各种各样的实验设计、样本量和认知评估方法。除4项研究外，所有研究均报告了影响中风后运动改善和学习能力的认知障碍。影响运动学习最常见的领域是注意力、执行功能和记忆。
建议未来的研究进行详细的认知评估、保留测试，并结合临床和运动学结果。在为中风患者设计有效的训练干预措施以最大限度地提高感觉运动恢复时，应考虑使用敏感仪器测量的特定认知障碍的存在。
