Tasks that require adaptability, self-monitoring, and responsiveness — skills integral to rehabilitation — become significantly harder for stroke survivors.

By Pesach Benson, TPS

Although it is known that cognitive impairments impact stroke survivors, an Israeli study released on Wednesday specifically identifies the ability to understand and follow instructions as a foundational element for motor recovery and rehabilitation success.

The findings are expected to lead to more personalized treatment and integration of technology into rehabilitation.

A stroke occurs when the blood supply to the brain is interrupted or significantly reduced, depriving brain cells of oxygen and nutrients, usually the result of a clot or bleeding.

This can result in the death of brain cells within minutes, leading to potentially severe and lasting physical and cognitive damage.

According to the World Stroke Organization, in 2019, there were approximately 12.2 million new stroke cases globally, while 101 million survivors were living with the aftermath of one.

A team of researchers from the Joint Laboratory for Neurological Rehabilitation Research at Ben-Gurion University of the Negev and the Negev Nahalat Eran Hospital uncovered new insights into the interplay between cognitive impairments and motor recovery after a stroke.

The findings were recently published in the peer-reviewed journal, Neuropsychology.

Dr. Reut Binyamin-Netzer and Prof. Lior Shmuelof from Ben-Gurion University’s Department of Cognitive and Brain Sciences led the study, which sought to understand how stroke affects the ability to follow instructions and identify the cognitive skills that underpin this capability.

They focused on the cognitive processes that enable patients to learn and execute therapeutic tasks.

According to the study, cognitive impairments — such as memory deficits, attention problems, and reduced executive function — affect 72% of stroke survivors.

These challenges not only impair daily functioning but also hinder participation in rehabilitation programs.

One particularly troubling consequence of cognitive impairment is the difficulty in learning and following instructions.

Tasks that require adaptability, self-monitoring, and responsiveness — skills integral to rehabilitation — become significantly harder for stroke survivors.

Recognizing the importance of these abilities, the researchers focused their investigation on the link between cognitive deficits and motor recovery.

The study involved 31 stroke survivors and 36 age-matched control participants aged 55-75.

All participants completed a series of computerized tasks designed to evaluate their ability to respond to stimuli based on color and location, as well as their capacity for delayed response and symbol-based information processing.

The results revealed a notable decline in accuracy and reaction times among stroke survivors compared to the control group. Additionally, the stroke group exhibited slower information processing and reduced ability to delay responses.

Importantly, the researchers found a direct correlation between the ability to delay a response and the capacity to follow instructions.

“The ability to delay a response has a significant impact on patients’ participation in the rehabilitation process,” explained Binyamin-Netzer. “Understanding instructions is fundamental to motor recovery because rehabilitation relies on following structured tasks.”

The researchers advocate for early, intensive rehabilitation programs that leverage computerized technologies to enhance recovery. These interventions should focus on improving cognitive abilities, which are intricately linked to motor recovery.

Said Shmuelof, “In an era where video games and other technologies are central to rehabilitation, understanding the connection between cognitive functions and recovery is critical.”

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