PMID- 36893079
OWN - NLM
STAT- MEDLINE
DCOM- 20230313
LR  - 20230418
IS  - 1932-6203 (Electronic)
IS  - 1932-6203 (Linking)
VI  - 18
IP  - 3
DP  - 2023
TI  - The impact of visuospatial and executive function on activity performance and 
      outcome after robotic or conventional gait training, long-term after stroke-as 
      part of a randomized controlled trial.
PG  - e0281212
LID - 10.1371/journal.pone.0281212 [doi]
LID - e0281212
AB  - INTRODUCTION: Visuospatial and executive impairments have been associated with 
      poor activity performance sub-acute after stroke. Potential associations 
      long-term and in relation to outcome of rehabilitation interventions need further 
      exploration. AIMS: To explore associations between visuospatial and executive 
      function and 1) activity performance (mobility, self-care and domestic life) and 
      2) outcome after 6 weeks of conventional gait training and/or robotic gait 
      training, long term (1-10 years) after stroke. METHODS: Participants (n = 45), 
      living with stroke affecting walking ability and who could perform the items 
      assessing visuospatial/executive function included in the Montreal Cognitive 
      Assessment (MoCA Vis/Ex) were included as part of a randomized controlled trial. 
      Executive function was evaluated using ratings by significant others according to 
      the Dysexecutive Questionnaire (DEX); activity performance using 6-minute walk 
      test (6MWT), 10-meter walk test (10MWT), Berg balance scale, Functional 
      Ambulation Categories, Barthel Index and Stroke Impact Scale. RESULTS: MoCA 
      Vis/Ex was significantly associated with baseline activity performance, long-term 
      after stroke (r = .34-.69, p < .05). In the conventional gait training group, 
      MoCA Vis/Ex explained 34% of the variance in 6MWT after the six-week intervention 
      (p = 0.017) and 31% (p = 0.032) at the 6 month follow up, which indicate that a 
      higher MoCA Vis/Ex score enhanced the improvement. The robotic gait training 
      group presented no significant associations between MoCA Vis/Ex and 6MWT 
      indicating that visuospatial/executive function did not affect outcome. Rated 
      executive function (DEX) presented no significant associations to activity 
      performance or outcome after gait training. CONCLUSION: Visuospatial/executive 
      function may significantly affect activity performance and the outcome of 
      rehabilitation interventions for impaired mobility long-term after stroke and 
      should be considered in the planning of such interventions. Patients with 
      severely impaired visuospatial/executive function may benefit from robotic gait 
      training since improvement was seen irrespective of visuospatial/executive 
      function. These results may guide future larger studies on interventions 
      targeting long-term walking ability and activity performance. TRIAL REGISTRATION: 
      clinicaltrials.gov (NCT02545088) August 24, 2015.
CI  - Copyright: (c) 2023 Bergqvist et al. This is an open access article distributed 
      under the terms of the Creative Commons Attribution License, which permits 
      unrestricted use, distribution, and reproduction in any medium, provided the 
      original author and source are credited.
FAU - Bergqvist, Maria
AU  - Bergqvist M
AD  - Department of Rehabilitation Medicine, Danderyd University Hospital, Stockholm, 
      Sweden.
FAU - Moller, Marika C
AU  - Moller MC
AUID- ORCID: 0000-0001-8700-5186
AD  - Department of Rehabilitation Medicine, Danderyd University Hospital, Stockholm, 
      Sweden.
AD  - Department of Clinical Sciences, Danderyd Hospital, Karolinska Institutet, 
      Stockholm, Sweden.
FAU - Bjorklund, Martin
AU  - Bjorklund M
AD  - Department of Community Medicine and Rehabilitation Physiotherapy, Umea 
      University, Umea, Sweden.
FAU - Borg, Jorgen
AU  - Borg J
AD  - Department of Rehabilitation Medicine, Danderyd University Hospital, Stockholm, 
      Sweden.
AD  - Department of Clinical Sciences, Danderyd Hospital, Karolinska Institutet, 
      Stockholm, Sweden.
FAU - Palmcrantz, Susanne
AU  - Palmcrantz S
AUID- ORCID: 0000-0001-5337-2092
AD  - Department of Rehabilitation Medicine, Danderyd University Hospital, Stockholm, 
      Sweden.
AD  - Department of Clinical Sciences, Danderyd Hospital, Karolinska Institutet, 
      Stockholm, Sweden.
LA  - eng
SI  - ClinicalTrials.gov/NCT02545088
PT  - Journal Article
PT  - Randomized Controlled Trial
PT  - Research Support, Non-U.S. Gov't
DEP - 20230309
PL  - United States
TA  - PLoS One
JT  - PloS one
JID - 101285081
SB  - IM
MH  - Humans
MH  - *Stroke Rehabilitation/methods
MH  - Executive Function
MH  - *Robotic Surgical Procedures
MH  - *Stroke/complications
MH  - Walking
MH  - Exercise Therapy/methods
MH  - Gait
MH  - Treatment Outcome
MH  - *Gait Disorders, Neurologic
PMC - PMC9997896
COIS- The authors have declared that no competing interests exist.
EDAT- 2023/03/10 06:00
MHDA- 2023/03/14 06:00
PMCR- 2023/03/09
CRDT- 2023/03/09 13:32
PHST- 2022/07/05 00:00 [received]
PHST- 2022/12/22 00:00 [accepted]
PHST- 2023/03/09 13:32 [entrez]
PHST- 2023/03/10 06:00 [pubmed]
PHST- 2023/03/14 06:00 [medline]
PHST- 2023/03/09 00:00 [pmc-release]
AID - PONE-D-22-18479 [pii]
AID - 10.1371/journal.pone.0281212 [doi]
PST - epublish
SO  - PLoS One. 2023 Mar 9;18(3):e0281212. doi: 10.1371/journal.pone.0281212. 
      eCollection 2023.