Motor-cognitive intervention concepts can improve gait in chronic stroke, but their effect on cognitive functions is unclear: A systematic review with meta-analyses

Simone K Huber; Ruud H Knols; Patrick Arnet; Eling D de Bruin

doi:10.1016/j.neubiorev.2021.11.013

Motor-cognitive intervention concepts can improve gait in chronic stroke, but their effect on cognitive functions is unclear: A systematic review with meta-analyses

Neurosci Biobehav Rev. 2022 Jan:132:818-837. doi: 10.1016/j.neubiorev.2021.11.013. Epub 2021 Nov 20.

Authors

Simone K Huber¹, Ruud H Knols², Patrick Arnet³, Eling D de Bruin⁴

Affiliations

¹ Physiotherapy and Occupational Therapy Research Center, Directorate of Research and Education, University Hospital Zurich, Zurich, Switzerland; Institute of Human Movement Sciences and Sport, Department of Health Sciences and Technology, ETH Zurich, Zurich, Switzerland. Electronic address: simone.huber@usz.ch.
² Physiotherapy and Occupational Therapy Research Center, Directorate of Research and Education, University Hospital Zurich, Zurich, Switzerland; Institute of Human Movement Sciences and Sport, Department of Health Sciences and Technology, ETH Zurich, Zurich, Switzerland; Physiotherapy Occupational Therapy, Nursing and Allied Health Professions Office, University Hospital Zurich, Zurich, Switzerland.
³ Physiotherapy and Occupational Therapy Research Center, Directorate of Research and Education, University Hospital Zurich, Zurich, Switzerland; Institute of Human Movement Sciences and Sport, Department of Health Sciences and Technology, ETH Zurich, Zurich, Switzerland.
⁴ Institute of Human Movement Sciences and Sport, Department of Health Sciences and Technology, ETH Zurich, Zurich, Switzerland; Division of Physiotherapy, Department of Neurobiology, Care Sciences and Society, Karolinska Institute, Stockholm, Sweden; OST - Eastern Swiss University of Applied Sciences, Department of Health, St.Gallen, Switzerland.

PMID: 34815131
DOI: 10.1016/j.neubiorev.2021.11.013

Abstract

Motor-cognitive intervention concepts are promising to counteract residual gait and cognitive impairments in chronic stroke. There is, however, considerable variation in motor-cognitive intervention types, which may lead to different effects. This systematic review strived to summarize and compare the effects of different motor-cognitive intervention concepts on gait and cognitive functions in chronic stroke. The systematic search identified twenty-nine articles, which were allocated to three types of motor-cognitive training concepts; SEQUENTIAL, SIMULTANEOUS-ADDITIONAL, and SIMULTANEOUS-INCORPORATED. Random-effects meta-analyses revealed that motor-cognitive interventions may be better than non-combined training approaches for improving gait function in chronic stroke (e.g. gait speed: g = 0.43, 95 % CI [0.22, 0.64], p < 0.0001). SIMULTANEOUS-INCORPORATED motor-cognitive training seems the most promising concept. As very few articles measured both, spatiotemporal gait parameters and cognitive outcomes, future studies are warranted to investigate the effects of motor-cognitive intervention concepts on gait control and cognitive functions in chronic stroke.

Keywords: Chronic stroke; Cognition; Exercise; Exergaming; Gait; Mobility; Motor-Cognitive; Rehabilitation; Systematic review; Training.

Publication types

Meta-Analysis
Review
Systematic Review

MeSH terms

Cognition
Exercise Therapy
Gait
Humans
Stroke Rehabilitation*
Stroke* / complications
Stroke* / therapy
Walking Speed