Mode of locomotion and other determinants of navigation ability post-stroke

ABSTRACTMaintaining the ability to navigate through one's environment is an important component of quality of life after cerebrovascular accidents (CVA). Yet, navigation ability is not commonly assessed in post-CVA rehabilitation, and when it is, assessment methods are quite varied. Here, we assessed navigation impairment in thirty-four individuals with left and right CVA compared to sixteen neurotypical controls. We had three primary aims, (1) to confirm the presence of route and survey learning impairment post-stroke as assessed by a real-world task, (2) to assess whether navigation impairments are more likely to be detected when assessment is performed in certain locomotion conditions (walking, wheelchair, and video), and (3) to evaluate potential underlying causes of navigation impairment. Results reveal an impairment for individuals with CVA relative to controls on the route memory task. We also observed a benefit of real-world navigation, as individuals with CVA were particularly impaired in the video condition. Heading sensitivity and, to a lesser degree, lateralized attention were two underlying abilities contributing to route memory when walking. Together these results are consistent with the importance of real-world methods of assessing navigation in stroke, and suggest the possibility that treatment of deficits in heading sensitivity may improve spatial navigation.