Relationship between motor abilities and executive functions in patients after pediatric stroke
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Published on: September 1, 2023
Stephanie Abgottspon1,2, Leonie Steiner1, Nedelina Slavova3
1Division of Neuropaediatrics, Development and Rehabilitation, Department of Pediatrics, Inselspital, Bern University Hospital, University of Bern, Switzerland.
Insights
Pediatric stroke survivors show a strong link between upper limb function and executive functions. Rehabilitation should focus on complex motor skills to improve both cognitive and motor abilities.
Area of Science:
- Neuroscience
- Pediatric Neurology
- Rehabilitation Medicine
Background:
- Pediatric stroke often results in motor and cognitive impairments, frequently managed separately in rehabilitation.
- Evidence linking motor and cognitive functions in pediatric stroke survivors is limited.
Purpose of the Study:
- To investigate the association between motor abilities and executive functions in children with arterial ischemic stroke.
- To explore the relationship between upper limb performance, hand strength, and executive functions.
Main Methods:
- Study included 27 pediatric stroke patients (chronic phase) and 49 healthy controls.
- Executive functions (working memory, inhibition, shifting) assessed using standardized neuropsychological tests.
- Hand strength and upper limb performance evaluated with specific tasks.
Main Results:
- A significant association was found between upper limb performance and executive functions in pediatric stroke patients.
- The link between upper limb performance and executive functions was stronger than that of hand strength.
Conclusions:
- Upper limb performance and executive functions are closely interrelated in pediatric stroke survivors.
- Rehabilitation programs could benefit from integrating cognitively demanding upper limb training to enhance executive functions.
Abstract:
Patients after pediatric stroke typically experience varying extent of motor and cognitive impairments. During rehabilitation, these impairments are often treated as separate entities. While there is a notion claiming that motor and cognitive functions are interrelated to some degree in healthy children, a minimal amount of evidence exists regarding this issue in patients after pediatric stroke. The purpose of this study was to investigate the association between motor abilities and executive functions in patients after pediatric arterial ischemic stroke. Twenty-seven patients (6 - 23 years) diagnosed with pediatric arterial ischemic stroke in the chronic phase (≥ 2 years after diagnosis, diagnosed < 16 years) and 49 healthy controls (6 - 26 years) were included in this study. Participants completed six tasks from standardized neuropsychological tests assessing the dimensions of executive functions, namely working memory, inhibition, and shifting. Additionally, we assessed hand strength and upper limb performance with two tasks each. In the patient group, the association between upper limb performance and executive functions was stronger than between hand strength and executive functions. Our results point toward the idea of a close interrelation between upper limb performance and executive functions. Training more complex and cognitively engaging motor abilities involving upper limb performance rather than basic motor abilities such as hand strength during a rehabilitation program may have the power to foster executive function development and vice versa in patients after stroke.
