Abstract
Background: Many stroke patients have an inclination to consciously guide their movements, a phenomenon that is often referred to as reinvestment. It is generally thought that reinvestment may delay motor recovery, because it requires a part of the inherently limited capacity of working memory, and hence results in less automatic
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performance. However, stroke patients’ inclination to reinvest may be necessary for executing motor and dual-task performance. Because of the contradictory findings, it is unclear whether physical therapists should promote or reduce reinvestment.
Aim: This study aims to assess whether stroke patients’ inclination for reinvestment is associated with single- and dual-task motor performance, and whether this association is related to patient’s general walking ability and working memory capacity.
Methods: Univariate and multivariate linear regression analysis were used to assess cross-sectional associations between an inclination to reinvest and respectively single- and dual-task motor performance. Working memory capacity and general walking ability were simultaneously added to the multivariate regression model as possible confounding factors and subsequently added apart as interaction term with reinvestment.
Results: Nineteen clinical stroke patients (<6 months post-stroke) were analysed. Patient’s inclination to reinvest was not significantly associated with single- and dual-task motor performance. These findings remained when general walking ability and working memory capacity were added into the model as possible confounders and moderators. Working memory capacity and general walking ability were independently positive associated to motor dual-task costs% and cognitive dual-task costs%.
Conclusion: This study did not find associations between an inclination to reinvest and single- and dual-task motor performance in clinical stroke patients. These findings seems not being different for patients with better or worse general walking ability or working memory capacity, although, this should interpret with care because of the low power of this study.
Clinical Relevance: Patient’s inclination to reinvest seems not influence single- and dual-task motor performance, regardless patient’s motor or cognitive capacity. For giving a good advice to physical therapists regarding to facilitating or discouraging reinvestment in clinical rehabilitation, future research with more power needs to establish whether motor or cognitive capacity influences the relationship between reinvestment and performance in clinical stroke patients.
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