Visuospatial Working Memory Predicts Strategic Motor Learning With Visual Feedback During Gait After Stroke

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BACKGROUND: Strategic motor learning, guided by visual feedback (VF), is commonly used in post-stroke gait rehabilitation. While visuospatial working memory (VSWM) has been shown to support VF-guided motor correction in upper limb motor learning tasks, its role in locomotor learning after stroke remains unclear. OBJECTIVE: We examined whether VSWM is related to strategic learning by examining the overall accuracy and improvement in accuracy over time with VF-guided locomotor learning in individuals with chronic stroke. METHODS: Seventy-seven individuals >6 months post-stroke (41 males and 36 females; mean age = 66.3 ± 10.9 years) adapted walking on a split-belt treadmill (2:1 ratio) with real-time VF of step lengths. Feedback was displayed as visual targets on a screen and participants were instructed to use the visual cues to counteract the split-belt perturbation and restore their pre-perturbation step lengths. Strategic learning was assessed using 2 outcomes: overall accuracy and improvement in accuracy over strides during the VF phase. VSWM was assessed with the Spatial Addition subtest of the Wechsler Memory Scale-IV. RESULTS: < .001). CONCLUSION: Our findings suggest that VSWM may be important for strategic locomotor learning with VF in people with chronic stroke, highlighting its potential relevance as a key consideration in designing walking rehabilitation strategies for people after stroke.

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