Effects of problem-oriented willed-movement therapy on motor abilities for people with poststroke cognitive deficits.
OBJECTIVE
Cognitive deficits after stroke are common and interfere with recovery. One purpose of this study was to determine whether the motor abilities of subjects who have poststroke cognitive deficits and who have received problem-oriented willed-movement (POWM) therapy will improve more than the motor abilities of subjects in the reference group who have received neurodevelopmental treatment (NDT). Another purpose of this study was to identify the relationship between cognitive function and motor abilities for both groups.


METHODS
The subjects recruited for this study were 36 men and 11 women with various degrees of poststroke cognitive deficits.


METHODS
A randomized block design was used to assign the subjects to 2 groups. Cognitive function and motor ability were evaluated with the Mini-Mental State Examination and the Stroke Rehabilitation Assessment of Movement (STREAM). Both groups received physical therapy 5 or 6 times per week in 50-minute sessions.


RESULTS
The STREAM scores improved after treatment in both groups. Main group effects were found for the lower-extremity (F=4.58, P< .05) and basic mobility (F=27.49, P< .01) subscales of the STREAM. Pretest cognitive function showed a positive relationship with posttest motor ability in the NDT group (r = .446, P< .05). However, the relationship between pretest cognitive function and posttest motor ability had no statistical significance in the POWM group (r = .101, P= .630).


CONCLUSIONS
These findings suggest that, regardless of a person's cognitive function, POWM intervention is effective in improving lower-extremity and basic mobilities and indicates the need to use relatively intact cognitive function or perceptual function, or both, to improve motor rehabilitation for people with cognitive function deficits.
Tang
Qing Ping
QP
Department of Neurology, Xiangya Hospital, Central South University, Changsha, Hunan, China. tqingping1111@126.com
Yang
Qi Dong
QD
Wu
Ying Hua
YH
Wang
Gai Qing
GQ
Huang
Zhi Ling
ZL
Liu
Zun Jing
ZJ
Huang
Xiao Song
XS
Zhou
Lin
L
Yang
Pei Ming
PM
Fan
Zhen Yong
ZY
D000328:Adult; D000368:Aged; D002681:China; D003072:Cognition Disorders / Q000209:etiology / Q000534:rehabilitation*; D006233:Persons with Disabilities / Q000534:rehabilitation*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008124:Locomotion; D008297:Male; D008875:Middle Aged; D009048:Motor Skills; D026741:Physical Therapy Modalities / Q000592:standards*; D020127:Recovery of Function; D012720:Severity of Illness Index; D020521:Stroke / Q000150:complications; D000071939:Stroke Rehabilitation; D013997:Time Factors; D014836:Volition