Using standardized visuospatial tests to predict motor training responsiveness in older adults

摘要 该项目的总体目标是确定标准化认知测试是否可以用于运动测试。 康复，以更好地识别治疗无效的风险患者。年龄较大的患者通常表现为 与年轻患者相比，运动康复的收益较小，这可能是由于认知障碍 干扰他们在治疗中重新学习运动技能的能力。认知障碍已被证明会影响 对其他类型康复的反应。因此，我们建议使用标准化的视觉空间 预测正常衰老和中风后上肢特定任务训练的反应性的测试。 这种运动技能学习范例使用家用物品，并模仿特定于任务的功能性训练，即运动 一种被认为优于标准护理以提高上肢技能的康复方法 中风后。根据我们的初步工作，我们预计视觉空间得分较高的老年人将 在完成三次特定任务训练一个月后，与那些 视觉空间分数更低的人。这项研究的结果将提供现成的工具来帮助临床医生 确定接受上肢运动康复治疗的患者存在治疗反应性极低的风险。 研究结果还将确定哪些视觉空间测试具有最大的预测价值，因此应该 在时间或资源有限的情况下优先进行筛选。此外，如果视觉空间得分较低的患者 更有可能在给定的运动康复方案后表现出很少或没有改善，然后改善他们的 通过认知康复进行视觉空间评分可能是一种可行的、非侵入性的策略，可以最大限度地利用老年人 患者的运动康复反应性。

ABSTRACT The broad objective of this project is to determine whether standardized cognitive tests could be used in motor rehabilitation to better identify patients at risk for not responding to therapy. Older patients typically show smaller gains in motor rehabilitation than do younger patients, which may be due to cognitive impairments that interfere with their ability to relearn motor skills in therapy. Cognitive impairments have been shown to affect responsiveness to other types of rehabilitation. We therefore propose the use of standardized visuospatial tests for predicting responsiveness to upper extremity task-specific training in normal aging and after stroke. This motor skill learning paradigm uses household objects and mimics functional task-specific training, a motor rehabilitative approach that has been cited as superior to standard care for improving upper extremity skill post-stroke. Based on our preliminary work, we expect that older adults with better visuospatial scores will retain more motor skill one month after completing three sessions of task-specific training, compared to those with poorer visuospatial scores. Findings from this study will yield readily-available tools to help clinicians identify patients in upper extremity motor rehabilitation who are at risk for minimal treatment responsiveness. Findings will also determine which visuospatial tests have the most predictive value and should therefore be prioritized in screening when time or resources are limited. Further, if patients with lower visuospatial scores are more likely to show little to no improvement after a given motor rehabilitation protocol, then improving their visuospatial scores through cognitive rehabilitation could be a feasible, non-invasive strategy to maximize older patients’ motor rehabilitation responsiveness.