Association Between Turning Mobility and Cognitive Function in Chronic Poststroke

Abstract

Turning difficulties are common in patients with stroke. The detrimental effects of dual tasks on turning indicate a correlation between turning and cognition. Cognitive impairment is prevalent after stroke, and stroke patients with mild cognitive impairment had a poorer turning performance than did stroke patients with intact cognitive abilities. Therefore, we investigated the association between turning mobility and cognitive function in patients with chronic poststroke. Ninety patients with chronic stroke (>6 months post-stroke) were recruited. Angular velocity was assessed using wearable sensors during 180° walking turns and 360° turning on the spot from both sides. Global cognition and distinct cognitive domains were assessed using the Mini-Mental State Examination. In patients with stroke, turning mobility was significantly associated with global cognitive function and distinct cognitive domains, such as visuospatial ability and language. The balance function and lower limbs strength were mediators of the association between cognition and turning. The association highlights the complexity of the turning movement and dynamic motor and cognitive coordination necessary to safely complete a turn. However, our findings should be regarded as preliminary, and a thorough neuropsychological assessment to provide a valid description of distinct cognitive domains is required.

Beyond timing and step counting in 360° turning-in-place assessment: a scoping review

“…Six studies out of 21 investigated solely one subjects' group [ 57 , 59 , 64 , 69 , 70 , 77 ]. Other studies included two [ 58 , 61 , 62 , 66 , 71 , 72 ] or three subjects’ groups [ 60 , 63 , 65 , 67 , 68 , 73 – 76 ].…”

“…Other studies included two [ 58 , 61 , 62 , 66 , 71 , 72 ] or three subjects’ groups [ 60 , 63 , 65 , 67 , 68 , 73 – 76 ]. Included groups were PD patients [ 57 – 68 ], stroke patients [ 69 – 72 ], people with multiple sclerosis [ 75 ], older adults [ 58 , 60 , 62 , 63 , 65 , 67 , 68 , 71 – 76 ], frail and pre-frail older adult [ 73 ], older adult fallers [ 76 ], middle-aged adults [ 74 , 75 ], and young adults [ 74 , 77 ] (Table 1 ). In total, the studied population amounted to 1193 subjects (664 males, 510 females).…”

“…All studies (i.e. 13 studies) involving turning limited by the number of turns utilised a single turn in the turning task [ 58 , 59 , 65 , 67 , 69 – 77 ]. Eight studies limited turning by the total time of 1 min [ 61 – 63 , 66 , 68 ], 2 min [ 60 , 64 ], or 80 s [ 57 ].…”

“…Only four studies included instructions to turn quickly [ 58 , 62 , 64 , 66 ]. Other studies instructed participants to turn at a self-selected speed of turn [ 57 , 60 , 63 , 67 , 69 – 72 , 76 , 77 ].…”

Dual-task turn velocity – a novel digital biomarker for mild cognitive impairment and dementia

“…However, only a few studies that have indirectly analyzed the association between turning function and cognitive impairment. A recent study found that turning function in patients with chronic stroke was associated with cognitive impairment ( Kuan et al, 2022 ). Mirelman et al (2014) also discovered that individuals with MCI had lower trunk angular velocity during turning.…”