Cognition and Motor Learning Post-stroke

Study Overview
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Brief Summary
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This project seeks to determine how post-stroke cognitive impairment moderates motor learning during walking in older adults with chronic stroke and identify brain structural markers that mediate this relationship. The chosen experimental design integrates biomechanical analyses, neuropsychological assessments, and brain imaging techniques to determine the impact of post-stroke cognitive impairment severity on two forms of motor learning (explicit and implicit) and examine the role of the dorsolateral prefrontal cortex in the relationship between cognition and explicit motor learning. Ultimately, this work may lead to the development of a more comprehensive, effective treatment approach to improve walking dysfunction in older adults post-stroke.

Official Title
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Cognition as a Moderator of Motor Learning Post-stroke

Conditions
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Stroke, CVA (Cerebrovascular Accident)

Intervention / Treatment
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* Behavioral: Explicit motor learning
* Behavioral: Implicit motor learning


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Unilateral stroke Stroke occurred more than 6 months prior Paresis confined to one side Independently ambulatory (including the use of assistive devices) Able to walk for 5 minutes without stopping Answers no to all general health questions on the PAR-Q+ Willingness to complete study procedures Exclusion Criteria: Brainstem or cerebellar stroke Aphasia (expressive, receptive, or global) Any major musculoskeletal or non-stroke neurological condition that interferes with the assessment of sensorimotor or cognitive function Metal in the head (except in the mouth), implanted cranial or thoracic devices that violate MRI safety regulations Uncontrolled hypertension (>160/110mmHg) Concurrent physical therapy Claustrophobia Significant cognitive deficit or dementia (<20 on MoCA) Inability to give informed consent

Ages Eligible for Study
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Minimum Age: 45 Years
Maximum Age: 85 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Basic Science
Intervention Model: Single Group Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Evaluating motor learning and brain structures post-stroke<br>We will use a single arm design to determine the impact of post-stroke cognitive impairment on two forms of motor learning (implicit and explicit) and evaluate the structural integrity of relevant brain structures in 65 individuals post stroke | Behavioral: Explicit motor learning<br>* Participants will be provided with visual feedback of their right and left step lengths on a screen in front of a treadmill.<br>Behavioral: Implicit motor learning<br>* Participants will walk on a treadmill that drives their right and left legs to move at two different speeds.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| step length asymmetry - change in performance | characterized as a comparison between the right and left step lengths; captured to quantify change in performance with biofeedback or split belt walking | Measured at three timepoints of interest within each testing session: baseline and at the beginning and end of the interventions; participants will complete 2 testing sessions over approximately 1 months | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| step length asymmetry - immediate retention | characterized as a comparison between the right and left step lengths; captured to quantify the retention of a newly learned walking pattern | Measured after motor learning in each testing session; participants will complete 2 testing sessions over approximately 1 months | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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stroke, walking, rehabilitation, cognition