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

2020 ◽  
pp. 1-12
Author(s):  
Mareike Eschweiler ◽  
Lara Bohr ◽  
Josef Kessler ◽  
Gereon R. Fink ◽  
Elke Kalbe ◽  
...  
Keyword(s):  
Working Memory ◽  
Pilot Study ◽  
Cognitive Flexibility ◽  
Negative Impact ◽  
Low Frequency ◽  
Control Group ◽  
Motor Training ◽  
Set Shifting ◽  
Stroke Patients ◽  
Motor Functioning

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.

scholarly journals Effects of Cervical Spine Mobilization on Respiratory Function and Cervical Angles of Stroke Patients: A Pilot Study

Healthcare ◽  
2021 ◽  
Vol 9 (4) ◽  
pp. 377
Author(s):  
Ho Jung An ◽  
Shin Jun Park
Keyword(s):  
Cervical Spine ◽  
Pilot Study ◽  
Respiratory Function ◽  
Negative Impact ◽  
Small Sample ◽  
Control Group ◽  
Stroke Patients ◽  
Number Of Patients ◽  
Significant Difference ◽  
Experimental Group

The forward head posture (FHP) of stroke patients has a negative impact on respiratory function. Cervical spine mobilization is a manual therapy technique that used to prevent and treat FHP and respiratory function. This pilot study investigated whether cervical spine mobilization can effectively improve outcomes following FHP and respiratory function of stroke patients. Twenty-four patients participated in our assessor-blinded randomized controlled trial. All the participants received neurodevelopmental treatments (gait training and trunk rehabilitation). The experimental group additionally received 15-min sessions of cervical spine mobilization three times per week for 4 weeks. The control group received cervical spine sham mobilization during the same period. For the cervical angles, the cranial vertebral angle (CVA) and cranial rotation angle (CRA) were measured. A respiratory function test was performed to measure the forced vital capacity (FVC), forced expiratory volume in 1 s (FEV1), peak expiratory flow (PEF), maximal inspiratory pressure (MIP), maximal expiratory pressure (MEP), and chest circumferences (upper and lower chest sizes). Except for MIP, there was no significant difference between the experimental group and the control group. The CVA and CRA were significantly increased in the experimental group only. Cervical spine mobilization improved cervical angles and inspiratory function of the stroke patients in this study. However, a comparative study with a larger number of patients is needed to confirm this finding from our pilot study, which had a small sample size.

scholarly journals Benefits of a Mindfulness-Based Intervention upon School Entry: A Pilot Study

2021 ◽  
Vol 18 (23) ◽  
pp. 12630
Author(s):  
Adam Koncz ◽  
Ferenc Köteles ◽  
Zsolt Demetrovics ◽  
Zsofia K. Takacs
Keyword(s):  
Working Memory ◽  
Academic Performance ◽  
Pilot Study ◽  
Executive Functioning ◽  
Short Story ◽  
First Graders ◽  
School Entry ◽  
Control Group ◽  
Mindfulness Intervention ◽  
Cortisol Levels

Background: mindfulness meditation is effective at fostering the executive functioning of children, i.e., the skills that play important roles in academic performance and social–emotional wellbeing. One possible mechanism for such an effect might be that meditation practices can decrease stress, especially if someone is at a risk for elevated cortisol levels, for instance, due to a stressful life event, such as starting school. Participants and methods: the present pilot study tested the effects of a six-session mindfulness intervention applied right after school entry compared to a passive control group. In total 61 first graders participated (Mage = 84.95 months, SD = 5.21) in this study from four classes of a primary school in Budapest. Repeated-measures ANOVA were performed to explore the effects on executive functioning skills and cortisol levels. Results: no effect was found on morning salivary cortisol levels, but the working memory capacities of girls significantly improved as a result of the intervention. Conclusions: a relatively short, story-based mindfulness intervention can improve the working memory capacities of first-graders; thus, it could potentially contribute to the academic performance and adaptation of children in schools.

The Effect of an 8-Week Aerobic Dance Program on Executive Function in Children

2021 ◽  
pp. 003151252110580
Author(s):  
Khawla Zinelabidine ◽  
Yousri Elghoul ◽  
Ghada Jouira ◽  
Sonia Sahli
Keyword(s):  
Working Memory ◽  
Primary School ◽  
Cognitive Flexibility ◽  
Repeated Measures ◽  
Mixed Model ◽  
Primary School Children ◽  
Control Group ◽  
Aerobic Dance ◽  
Digit Recall ◽  
Dance Intervention

In the current study, we examined the effect of an aerobic dance program as part of physical education (PE) classes on aspects of primary school children’s executive functions (EFs) (inhibition, working memory, and cognitive flexibility). Participants were 41 children (21 boys and 20 girls; M age =10.30, SD = 0.50 years, M height = 134.09, SD= 3.9 cm; M weight = 35.61, SD = 7.85 kg) who were divided into an experimental group (EG) and a no-PE control group (CG). The EG followed an aerobic dance intervention as part of their PE program (45 minute sessions two days per week over eight weeks). Participants in both groups performed EF tests before and after the intervention period to evaluate their mental flexibility, inhibition, and working memory. A two-way mixed model repeated measures ANOVA revealed a significant effect of the aerobic dance program on participants’ cognitive flexibility (i.e., on Trails Making Tests B-A times and committed errors) ( p <0.001), and on Stroop measures of inhibition (corrected number of words and corrected errors) ( p <0.001 and p <0.01, respectively), with post-hoc analyses showing an improved performance by the EG in working memory (digit recall score) from pre-test to post-test and in comparsion to the CG ( p < 0.001). Thus, this 8-week aerobic dance program promoted EF development among primary school children.

Motor Training of Upper Extremity With Functional Electrical Stimulation in Early Stroke Rehabilitation

2008 ◽  
Vol 23 (2) ◽  
pp. 184-190 ◽  
Author(s):  
Sabine Mangold ◽  
Corina Schuster ◽  
Thierry Keller ◽  
Andrea Zimmermann-Schlatter ◽  
Thierry Ettlin
Keyword(s):  
Electrical Stimulation ◽  
Upper Extremity ◽  
Shoulder Pain ◽  
Functional Electrical Stimulation ◽  
Intervention Group ◽  
Passive Movement ◽  
Control Group ◽  
Motor Training ◽  
Stroke Patients ◽  
Subacute Stroke

Background. Functional electrical stimulation (FES) allows active exercises in stroke patients with upper extremity paralysis. Objective. To investigate the effect of motor training with FES on motor recovery in acute and subacute stroke patients with severe to complete arm and/or hand paralysis. Methods. For this pilot study, 23 acute and subacute stroke patients were randomly assigned to the intervention (n = 12) and control group (n = 11). Distributed over 4 weeks, FES training replaced 12 conventional training sessions in the intervention group. An Extended Barthel Index (EBI) subscore assessed the performance of activities of daily living (ADL). The Chedoke McMaster Stroke Assessment (CMSA) measured hand and arm function and shoulder pain. The Modified Ashworth Scale (MAS) assessed resistance to passive movement. Unblinded assessments were performed prior to and following the end of the training period. Results. The EBI subscore and CMSA arm score improved significantly in both groups. The CMSA hand function improved significantly in the FES group. Resistance to passive movement of finger and wrist flexors increased significantly in the FES group. Shoulder pain did not change significantly. None of the outcome measures, however, demonstrated significant gain differences between the groups. Conclusions. We did not find clear evidence for superiority or inferiority of FES. Our findings, and those of similar trials, suggest that the number of sessions should be at least doubled to test for superiority of FES in these highly impaired patients and approximately 50 participants would have to be assigned to each therapeutic intervention to find significant differences.

scholarly journals Early bilingual immersion school program and cognitive development in French-speaking children: Effect of the second language learned (English vs. Dutch) and exposition duration (2 vs. 5 years)

PLoS ONE ◽  
2021 ◽  
Vol 16 (10) ◽  
pp. e0258458
Author(s):  
Sophie Gillet ◽  
Cristina Barbu ◽  
Martine Poncelet
Keyword(s):  
Working Memory ◽  
Second Language ◽  
Cognitive Flexibility ◽  
Fifth Grade ◽  
Second Grade ◽  
Control Group ◽  
Language Groups ◽  
Executive Skills ◽  
French Speaking ◽  
The Impact

The results of studies targeting cognitive and academic advantages in children frequenting early bilingual immersion school programs (CLIL) have been contradictory. While the impact of the amount of CLIL experience has already been studied, the role of the second language learned has been little studied to account for differences among study findings. The link between executive skills (EF) and scholar abilities (e.g., mathematics) in the CLIL context has also been little investigated. The purpose of the present study was to determine if the impact of CLIL on EF and academic performances varies depending on the immersion language and the duration of CLIL experience. The sample included a total of 230 French-speaking children attending second (141) and fifth (89) grade classes. Within each grade, there were three matched language groups composed of children respectively immersed in English, immersed in Dutch, and non-immersed controls. The children were administered tasks assessing executive functions [alerting, cognitive flexibility, and working memory], as well as arithmetic abilities. In second grade, we detected no difference in EF between the language groups. On the other hand, in fifth grade, the two immersed groups outperformed the non-immersed group on the cognitive flexibility task but did not differ between them. Moreover, only the Dutch immersed group outperformed the control group on the working memory task. Arithmetic performances also differed depending on the language learned; in second grade, Dutch learners performed better than the monolingual group. In fifth grade, Dutch learners outperformed the two other groups. These results suggest that the impact of CLIL on executive skills and arithmetic performances might be modulated by the amount of CLIL experience and the second language learned in immersion.

scholarly journals Post-Stroke Working Memory Dysfunction: A Meta-Analysis and Systematic Review

2020 ◽  
Author(s):  
Selma Lugtmeijer ◽  
Nikki A. Lammers ◽  
Edward H. F. de Haan ◽  
Frank-Erik de Leeuw ◽  
Roy P. C. Kessels
Keyword(s):  
Working Memory ◽  
Memory Deficits ◽  
High Load ◽  
Effect Sizes ◽  
Control Group ◽  
Separate Analysis ◽  
Stroke Patients ◽  
Chronic Stage ◽  
Post Stroke ◽  
Low Load

AbstractThis review investigates the severity and nature of post-stroke working memory deficits with reference to the multi-component model of working memory. We conducted a systematic search in PubMed up to March 2019 with search terms for stroke and memory. Studies on adult stroke patients, that included a control group, and assessed working memory function, were selected. Effect sizes (Hedges’ g) were extracted from 50 studies (in total 3,084 stroke patients) based on the sample size, mean and standard deviation of patients and controls. Performance of stroke patients was compared to healthy controls on low-load (i.e. capacity) and high-load (executively demanding) working memory tasks, grouped by modality (verbal, non-verbal). A separate analysis compared patients in the sub-acute and the chronic stage. Longitudinal studies and effects of lesion location were systematically reviewed. Stroke patients demonstrated significant deficits in working memory with a moderate effect size for both low-load (Hedges’ g = -.58 [-.82 to -.43]) and high-load (Hedges’ g = -.59 [-.73 to -.45]) tasks. The effect sizes were comparable for verbal and non-verbal material. Systematically reviewing the literature showed that working memory deficits remain prominent in the chronic stage of stroke. Lesions in a widespread fronto-parietal network are associated with working memory deficits. Stroke patients show decrements of moderate magnitude in all subsystems of working memory. This review clearly demonstrates the global nature of the impairment in working memory post-stroke.

Executive Function and Attention in Children Born Prematurely

2018 ◽  
Vol 2 ◽  
pp. 150-156
Author(s):  
Celeste Beaudoin ◽  
Roxanne Bélanger
Keyword(s):  
Working Memory ◽  
Executive Functioning ◽  
Inhibitory Control ◽  
Cognitive Flexibility ◽  
Premature Infants ◽  
Economic Status ◽  
Control Group ◽  
Socio Economic Status ◽  
Premature Children ◽  
The Impact

Aim - The aim of this study is to measure the abilities of premature school-aged children in tasks of attention, working memory and executive functioning in order to determine if premature newborns are more at risk to develop delays compared to children born at term. Method - The sampling will be based on a previous study where five school-age premature children from Northern Ontario will be assessed using standardized tests. Each parent will be given a standardized questionnaire designed to measure the executive functioning of his or her child. The results will be then compared to those of a control group born at term without any neonatal complications. Participants will be matched according to gender, age, language status and socio-economic status. Preliminary analysis has shown that premature infants have reduced performance in tasks such as attention and executive functioning (inhibitory control, working memory, and cognitive flexibility). The influence of gestational age, birth weight and socio-economic status will be explained. Importance of the Study - Premature children are more vulnerable to developmental and behavioural delays (Taheri, Goudarzi, Shariat, Nariman, & Martin, 2017). Several studies have shown that delays in executive functions are associated with lower academic achievement (Hüning et al., 2017). This study will help us determine the nature of the impact on non-language skills in premature infants. Preliminary results will allow us to better understand the impact of prematurity on the development of attention and executive functioning (inhibitory control, working memory, and cognitive flexibility), as it relates to language.

scholarly journals Efficacy of Myofunctional Therapy Associated with Voice Therapy in the Rehabilitation of Neurogenic Oropharyngeal Dysphagia: a pilot study

2017 ◽  
Vol 22 (03) ◽  
pp. 225-230 ◽  
Author(s):  
Bruno Fraga ◽  
Sheila Almeida ◽  
Márcia Santana ◽  
Mauriceia Cassol
Keyword(s):  
Pilot Study ◽  
Oropharyngeal Dysphagia ◽  
Oral Intake ◽  
Control Group ◽  
Stroke Patients ◽  
Swallowing Rehabilitation ◽  
Significant Difference ◽  
Vocal Exercises ◽  
Experimental Group ◽  
Post Therapy

Introduction Dysphagia causes changes in the laryngeal and stomatognathic structures; however, the use of vocal exercises is poorly described. Objective To verify whether the therapy consisting of myofunctional exercises associated with vocal exercises is more effective in rehabilitating deglutition in stroke patients. Methods This is a pilot study made up of two distinct groups: a control group, which performed only myofunctional exercises, and an experimental group, which performed myofunctional and vocal exercises. The assessment used for oral intake was the functional oral intake scale (FOIS). Results The FOIS levels reveal that the pre-therapy median of the experimental group was 4, and increased to 7 after therapy, while in the control group the values were 5 and 6 respectively. Thus, the experimental group had a statistically significant difference between the pre- and post-therapy assessments (p = 0.039), which indicates that the combination of myofunctional and vocal exercises was more effective in improving the oral intake levels than the myofunctional exercises alone (p = 0.059). On the other hand, the control group also improved, albeit at a lower rate compared with the experimental group; hence, there was no statistically significant difference between the groups post-therapy (p = 0.126). Conclusion This pilot study showed indications that using vocal exercises in swallowing rehabilitation in stroke patients was able to yield a greater increase in the oral intake levels. Nevertheless, further controlled blind clinical trials with larger samples are required to confirm such evidence, as this study points to the feasibility of conducting this type of research.

Executive function training in children with SLI: A pilot study

2016 ◽  
Vol 33 (1) ◽  
pp. 47-66 ◽  
Author(s):  
Brigitte Vugs ◽  
Harry Knoors ◽  
Juliane Cuperus ◽  
Marc Hendriks ◽  
Ludo Verhoeven
Keyword(s):  
Working Memory ◽  
Executive Function ◽  
Pilot Study ◽  
Cognitive Flexibility ◽  
Specific Language Impairment ◽  
Externalizing Behavior ◽  
Verbal Working Memory ◽  
Medium Effect ◽  
Positive Trend

The aim of this study was to evaluate the effectiveness of a computer-based executive function (EF) training in children with specific language impairment (SLI). Ten children with SLI, ages 8 to 12 years, completed a 25-session training of visuospatial working memory, inhibition and cognitive flexibility over a 6-week period. Treatment outcome was examined directly after training and at 6 months follow-up by tasks of the three trained EF, tasks of untrained neurocognitive functions (verbal working memory, attention, planning and fluency), and ratings of EF and behavioral problems by parents and teachers. Directly after training, results showed significant improvement on cognitive flexibility and a positive trend for visuospatial storage and inhibition. At 6 months follow-up, the children performed significantly better on tasks of all three trained EFs. Furthermore, the results showed significant improvement on sustained attention, attention control, parent- and teacher-rated attention behavior and parent-rated EF and externalizing behavior with medium effect sizes. The results of this pilot study highlight the importance of a large-scale, randomized controlled trial examining the possible effects of EF training in children with SLI.

Low-frequency rTMS inhibits the anti-depressive effect of ECT. A pilot study

2020 ◽  
Vol 32 (6) ◽  
pp. 328-338
Author(s):  
Poul Erik Buchholtz ◽  
Mahmoud Ashkanian ◽  
Simon Hjerrild ◽  
Line Kirstine Hauptmann ◽  
Torben Albert Devantier ◽  
...  
Keyword(s):  
Placebo Group ◽  
Pilot Study ◽  
Major Depression ◽  
Negative Impact ◽  
Repetitive Transcranial Magnetic Stimulation ◽  
Low Frequency ◽  
Double Blind Study ◽  
Depressant Effect ◽  
Significant Difference ◽  
Low Frequency Rtms

AbstractObjective:Low-frequency repetitive transcranial magnetic stimulation (rTMS) of the prefrontal cortex has been shown to have a statistically and clinically significant anti-depressant effect. The present pilot study was carried out to investigate if right prefrontal low-frequency rTMS as an add-on to electroconvulsive therapy (ECT) accelerates the anti-depressant effect and reduces cognitive side effects.Methods:In this randomised, controlled, double-blind study, thirty-five patients with major depression were allocated to ECT+placebo or ECT+low-frequency right prefrontal rTMS. The severity of depression was evaluated during the course using the Hamilton scale for depression (the 17-item as well as the 6-item scale) and the major depression inventory (MDI). Furthermore, neuropsychological assessment of cognitive function was carried out.Results:The study revealed no significant difference between the two groups for any of the outcomes, but with a visible trend to lower scores for MDI after treatment in the placebo group. The negative impact of ECT on neurocognitive functions was short-lived, and scores on logical memory were significantly improved compared to baseline 4 weeks after last treatment. The ECT-rTMS group revealed generally less impairment of cognitive functions than the ECT-placebo group.Conclusion:The addition of low-frequency rTMS as an add-on to ECT treatment did not result in an accelerated response. On the contrary, the results suggest that low-frequency rTMS could inhibit the anti-depressant effect of ECT.

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