Over-focused? The relation between patients’ inclination for conscious control and single- and dual-task motor performance after stroke

Background: Many stroke patients are inclined to consciously control their movements. This is thought to negatively affect patients’ motor performance, as it disrupts movement automaticity. However, it has also been argued that conscious control may sometimes benefit motor performance, depending on the task or patientś motor or cognitive capacity. Aim: To assess whether stroke patients’ inclination for conscious control is associated with motor performance, and explore whether the putative association differs as a function of task (single- vs dual) or patientś motor and cognitive capacity. Methods: Univariate and multivariate linear regression analysis were used to assess associations between patients’ disposition to conscious control (i.e., Conscious Motor Processing subscale of Movement-Specific Reinvestment Scale; MSRS-CMP) and single-task (Timed-up-and-go test; TuG) and motor dual-task costs (TuG while tone counting; motor DTC%). We determined whether these associations were influenced by patients’ walking speed (i.e., 10-m-walk test) and cognitive capacity (i.e., working memory, attention, executive function). Results: Seventy-eight clinical stroke patients (<6 months post-stroke) participated. Patients’ conscious control inclination was not associated with single-task TuG performance. However, patients with a strong inclination for conscious control showed higher motor DTC%. These associations were irrespective of patients’ motor and cognitive abilities. Conclusion: Patients’ disposition for conscious control was not associated with single task motor performance, but was associated with higher motor dual task costs, regardless of patients’ motor or cognitive abilities. Clinical relevance: Therapists should be aware that patients’ conscious control inclination can influence their dual-task performance while moving. Longitudinal studies are required to test whether reducing patients’ disposition for conscious control would improve dual-tasking post-stroke.