Issue 1-22, 2023

Effect of Rehabilitation Interventions on Post-Stroke Upper Limb Dysfunction and Cognitive Functions: a Systematic Review and Meta-Analysis



1,2 ORCIDElena V. Kostenko, 1 ORCIDLyudmila V. Petrova, 1 ORCIDDmitry I. Nahrapov, 1 ORCIDIrena V. Pogonchenkova

1 Moscow Centre for Research and Practice in Medical Rehabilitation, Restorative and Sports Medicine of Moscow Healthcare Department, Moscow, Russian Federation
2 Pirogov Russian National Research Medical University, Moscow, Russian Federation


ABSTRACT

INTRODUCTION. The prevalence of upper limb dysfunction and cognitive impairments are frequently observed following stroke, but are often considered as distinct entities, and there is little evidence regarding how they are related, as well as rehabilitation methods are aimed at monodomain restoration of any of these impairments.

AIM. To analyze the data of recent years on the impact of rehabilitation interventions on cognitive and the upper limb (UL) motor functions in patients with stroke, and to establish how they are related.

MATERIAL AND METHODS. The search was carried out in the Medline, Web of Science, PubMed and Scopus sources in accordance with the PRISMA principles and initially revealed 2,841 records. Of these, 35 articles were included in the study with publication 2011–2022. Keywords were used: stroke, movement, motor, upper limb, cognition, cognitive, cognitive-motor, motor-cognitive function. The relationship between cognitive impairments and the degree of restoration of the UL motor function under the influence of various rehabilitation interventions was assessed.

RESULTS. Five studies were selected for meta-analysis with the inclusion of 180 stroke patients. It is shown that the improvement of cognitive tests (MoCA) is accompanied by an improvement in UL motor impairments (FMA, Jebsen-Taylor Hand Function Test), while hand dexterity (Box and blocks, NHPT, Minnesota manual dexterity test) remained without statistically significant changes during medical rehabilitation.

CONCLUSION. The meta-analysis provides evidence of the relationship and mutual influence of cognitive functions on motor recovery and manual dexterity. However, the small sample size and heterogeneity of available studies are still limiting factors for obtaining unambiguous conclusions.


KEYWORDS: stroke, movement, cognition, motor functions, rehabilitation, upper limb

FOR CITATION: Kostenko E.V., Petrova L.V., Nahrapov D.I., Pogonchenkova I.V. Effect of Rehabilitation Interventions on Post-Stroke Upper Limb Dysfunction and Cognitive Functions: a Systematic Review and Meta-Analysis. Bulletin of Rehabilitation Medicine. 2023; 22(1): 69–79. https://doi.org/10.38025/2078–1962–2023–22–1-69–79


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This is an open article under the CC BY 4.0 license. Published by the National Medical Research Center for Rehabilitation and Balneology.