Combined cognitive and motor training improves the outcome in the early phase after stroke and prevents a decline of executive functions: A pilot study.

BACKGROUND The negative impact of cognitive dysfunction on motor rehabilitation as a relearning-process is well known in stroke patients. However, evidence for combined cognitive and motor training (CMT) is lacking. OBJECTIVE To evaluate the effects of combined CMT in early stroke rehabilitation. METHODS In a controlled pilot study, 29 moderately affected stroke patients with low-level motor performance and cognitive impairment received motor therapy plus either cognitive (experimental group, EG) or low-frequency ergometer training (control group, CG) for eight days. RESULTS Both groups improved their motor functioning significantly. After training, between-group comparison revealed significant differences for cognitive flexibility and trends for set-shifting, working memory, and reaction control in favor of the EG. Within-group effects showed improvement across all cognitive domains in the EG, which correlated with gains in bed-mobility, while the CG showed no significant improvement in cognition. Rather, a trend towards reaction control decline was observed, which correlated with less functional progression and recovery. Furthermore, a decline in cognitive flexibility, set-shifting, and working memory was descriptively observed. CONCLUSIONS Combined CMT may enhance cognition and motor relearning early after stroke and is superior to single motor training. Further studies are needed to replicate these results and investigate long-term benefits.