Over-focused? The relation between patients’ inclination for conscious control and single- and dual-task motor performance after stroke

Background: Many stroke patients are inclined to consciously control their movements. This is thought to negatively affect patients’ motor performance, as it disrupts movement automaticity. However, it has also been argued that conscious control may sometimes benefit motor performance, depending on the task or patientś motor or cognitive capacity. Aim: To assess whether stroke patients’ inclination for conscious control is associated with motor performance, and explore whether the putative association differs as a function of task (single- vs dual) or patientś motor and cognitive capacity. Methods: Univariate and multivariate linear regression analysis were used to assess associations between patients’ disposition to conscious control (i.e., Conscious Motor Processing subscale of Movement-Specific Reinvestment Scale; MSRS-CMP) and single-task (Timed-up-and-go test; TuG) and motor dual-task costs (TuG while tone counting; motor DTC%). We determined whether these associations were influenced by patients’ walking speed (i.e., 10-m-walk test) and cognitive capacity (i.e., working memory, attention, executive function). Results: Seventy-eight clinical stroke patients (<6 months post-stroke) participated. Patients’ conscious control inclination was not associated with single-task TuG performance. However, patients with a strong inclination for conscious control showed higher motor DTC%. These associations were irrespective of patients’ motor and cognitive abilities. Conclusion: Patients’ disposition for conscious control was not associated with single task motor performance, but was associated with higher motor dual task costs, regardless of patients’ motor or cognitive abilities. Clinical relevance: Therapists should be aware that patients’ conscious control inclination can influence their dual-task performance while moving. Longitudinal studies are required to test whether reducing patients’ disposition for conscious control would improve dual-tasking post-stroke

Riding waves to improve functioning: a quantitative evaluation of a Surf Week in individuals with chronic phase brain injury with six months follow-up

Supplemental material is available online at: https://www.tandfonline.com/doi/full/10.1080/09638288.2024.2320265#supplemental-material-section .Purpose: Environmental enrichment seems to enable people in the chronic phase of acquired brain injury (ABI) to experience new functional abilities and motor/coping strategies and consequently to become more adaptable which might prevent/reverse functional decline. This study describes the influence of a five-days Surf Week program on participants on physical function, self-efficacy, functional balance performance and self-perceived recovery. Materials and methods: A multiple-baseline single-case design was used. Adults participating in the Surf Week in chronic phase of ABI were eligible to participate. Participants completed a battery of tests monitoring physical function, self-efficacy, functional balance performance and self-perceived recovery. This battery was repeated 5 times over a 1-year period, two times pre-Surf Week, three times post-Surf Week. Visual data inspection with two non-overlap methods were used to determine if patients showed sustained improvement in outcomes post-intervention. Results: A moderate to strong indication for improvements on physical function, functional balance performance and self-perceived recovery exists till six months follow-up. No indication was observed on self-efficacy till six months follow-up. Conclusions: A five-days Surf Week is a physically, cognitively and socially intensive stimulating activity that can positively challenge individuals after ABI and seems to improve physical functioning, functional balance performance and self-perceived recovery.Fontys University of Applied Sciences, Department of Health Innovation and Technology