Brain Neurorehabil.  2011 Sep;4(2):103-109. 10.12786/bn.2011.4.2.103.

Impact of Cognitive Function on Functional Recovery during Rehabilitation in Patients with Stroke

• Lee YN
• Kwon HK
• Kang YK
• Pyun SB

• KMID: 2048463
• DOI: http://doi.org/10.12786/bn.2011.4.2.103

Abstract

OBJECTIVE
Cognitive dysfunction is an important factor on functional recovery after stroke. This study investigated the relationship between functional outcome and cognitive status during rehabilitation after stroke. METHOD: This retrospective study included 80 patients with rehabilitation program after first-ever stroke. The independent variables were mini-mental status examination (MMSE) and computerized neurocognitive function test (CNT). The dependent variables were modified Barthel index (MBI), Berg balance scale (BBS), National Institute of Health Stroke Scale (NIHSS) and discharge destination. The correlation analysis was applied.
RESULTS
Mean interval from onset to rehabilitation program was 29.5 days and duration of inpatient rehabilitation program was 31.1 days. Mean score of initial MMSE was 20.5 and CNT showed abnormal performance in at least one of the domain specific tests in all patients. The scores of MMSE, MBI, NIHSS and BBS were improved after rehabilitation program (p<0.05). Cognitive improvement contributing to the functional recovery were significant in the early participants in rehabilitation and in older patients (p<0.05). The home-discharge group demonstrated higher scores in executive function tests (p<0.001). Visual attention, visual working memory and reasoning revealed significant correlation with the MBI score at discharge.
CONCLUSION
The results of present study suggest that cognitive function, especially attention and working memory, is a predictor of functional outcome after stroke rehabilitation.

Keyword

cognition; function recovery; rehabilitation; stroke

MeSH Terms

Cognition
Executive Function
Humans
Inpatients
Memory, Short-Term
Recovery of Function
Retrospective Studies
Stroke

Figure

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  Fig. 1 Correlation between cognitive tests and functional outcome after rehabilitation program. There are significant correlation between cognitive function and primary functional outcome only in the tests for visual attention and memory (VSB) and auditory vigilance. The results of tests for general cognition (K-MMSE) and emotion (BDI) do not showed any correlation-ship with primary functional outcomes. (*p<0.05, †p<0.01, MBI: Modified Barthel index, ΔMBI: changes in MBI (total score) between beginning of rehabilitation program and discharge, K-MMSEi: Korean version mini-mental status examination at beginning of rehabilitation program, ΔK-MMSE: changes in K-MMSE between beginning of rehabilitation program and discharge, BDI: Beck depression inventory, VSB: visual span backward test, ACPT: auditory continuous performance test, NIHSSdc: National Institute of Health Stroke Scale at discharge, ΔNIHSS: changes in NIHSS between beginning of rehabilitation program and discharge, BBSdc: Berg balance scale at discharge, ΔBBS: changes in BBS between beginning of rehabilitation program and discharge.

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