Working memory and mental practice outcomes after stroke

Abstract

Malouin F, Belleville S, Richards CL, Desrosiers J, Doyon J. Working memory and mental practice outcomes after stroke. Arch Phys Med Rehabil 2004;85:177–83. Objective To examine the relationship between working memory and motor improvement obtained after a single training session combining mental and physical practice. Design Before-after trial. Setting Laboratory of a university-affiliated research rehabilitation center. Participants A sample of 12 patients with stroke and 14 age- and gender-matched healthy subjects. Intervention In a single session, patients were trained with combined mental and physical practice to increase the loading on the affected leg while standing up and sitting down. Main outcome measures Motor improvement as measured by the percentage change in limb loading on the affected limb after training and 24 hours later (follow-up), and the relationship between working memory and percentage motor improvement. Results The loading on the affected leg was improved after training ( P<.01) and at follow-up ( P<.05), and working memory scores at follow-up correlated significantly ( P<.004 to P<.007) with the level of improvement. The visuospatial domain yielded the strongest correlation ( r=.83), followed by the verbal ( r=.62) and kinesthetic ( r=.59) domains. Conclusions These results suggest that the outcome (improved limb loading) of mental rehearsal with motor imagery depends on the ability to maintain and manipulate information in working memory.