title: Effects of problem-oriented willed-movement therapy on motor abilities for people with poststroke cognitive deficits.
abstract: 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.
authors.affiliation: Department of Neurology, Xiangya Hospital, Central South University, Changsha, Hunan, China. tqingping1111@126.com
authors.forename: Qing Ping
authors.initials: QP
authors.lastname: Tang
authors.forename: Qi Dong
authors.initials: QD
authors.lastname: Yang
authors.forename: Ying Hua
authors.initials: YH
authors.lastname: Wu
authors.forename: Gai Qing
authors.initials: GQ
authors.lastname: Wang
authors.forename: Zhi Ling
authors.initials: ZL
authors.lastname: Huang
authors.forename: Zun Jing
authors.initials: ZJ
authors.lastname: Liu
authors.forename: Xiao Song
authors.initials: XS
authors.lastname: Huang
authors.forename: Lin
authors.initials: L
authors.lastname: Zhou
authors.forename: Pei Ming
authors.initials: PM
authors.lastname: Yang
authors.forename: Zhen Yong
authors.initials: ZY
authors.lastname: Fan
mesh_terms: 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