Cognitive strategy use to enhance motor skill acquisition post-stroke: a critical review.
OBJECTIVE
The objective of this critical review was to examine the literature regarding the use of cognitive strategies to acquire motor skills in people who have had a stroke, to determine which strategies are in use and to compile evidence of their effectiveness. SEARCH TERMS: A computerized search of a range of databases was conducted using the following search terms: stroke, cerebrovascular accident; combined with strategy training, learning strateg*, cognitive strateg*, metacognitive strateg*, goal setting, goal planning, goal attainment, goal direct*, goal orient*, self talk, imagery, mental practice, self evaluat*, ready*, attentional focus*, problem solv*, goal management; combined with motor, mobility, activit*, skill, task, function, ADL.


RESULTS
Twenty-six articles were reviewed. Seven studies investigated general cognitive strategies and 19 investigated task-specific strategies. The most commonly studied task-specific strategy was motor imagery. Findings suggest that general strategy training improves performance in both trained and untrained activities compared to traditional therapy; and that a specific motor imagery protocol can improve mobility and recovery in the affected upper extremity in people living with the chronic effects of stroke.


CONCLUSIONS
This foundational evidence supports the further development of novel cognitive strategy-based interventions with the intention of improving long-term stroke outcomes.
McEwen
Sara E
SE
Graduate Department of Rehabilitation Science, University of Toronto, Toronto, Ontario, Canada. sara.mcewen@utoronto.ca
Huijbregts
Maria P J
MP
Ryan
Jennifer D
JD
Polatajko
Helene J
HJ
D000203:Activities of Daily Living; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002675:Child, Preschool; D003071:Cognition; D019317:Evidence-Based Medicine; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009048:Motor Skills; D009788:Occupational Therapy / Q000379:methods*; D026741:Physical Therapy Modalities; D020127:Recovery of Function; D000071939:Stroke Rehabilitation; D016896:Treatment Outcome