The impact of cognitive function deficits and their recovery on functional outcome in subjects affected by ischemic subacute stroke: results from the Italian multicenter longitudinal study CogniReMo.
Journal
European journal of physical and rehabilitation medicine
ISSN: 1973-9095
Titre abrégé: Eur J Phys Rehabil Med
Pays: Italy
ID NLM: 101465662
Informations de publication
Date de publication:
Jun 2023
Jun 2023
Historique:
medline:
13
6
2023
pubmed:
15
5
2023
entrez:
15
5
2023
Statut:
ppublish
Résumé
The recovery of independence in activities of daily living is a fundamental goal of rehabilitation programs in subjects affected by subacute stroke. Rehabilitation is focused both on motor and cognitive aspects, and some evidence has reported cognitive deficits as prognostic factors of motor recovery. However, rehabilitation is a dynamic process during which executive functions and motor functions should be improved. The aim of the study is to evaluate the relationships between impairments in cognitive functions and recovery of functional independence in stroke patients during the subacute phase. Multicenter observational study. Intensive rehabilitation units. A sample of 319 stroke patients in subacute phase (70.6±11.6 years, 40.4% females), consecutively admitted from November 2019 to July 2021 at sixteen rehabilitation centers were enrolled in this observational, prospective and multicentric study with longitudinal assessments. Cognitive and functional assessments were performed at hospital admission and discharge, including Oxford Cognitive Screen, modified Barthel Index, Functional Independent Measure, Fugl-Meyer assessment scale and National Institutes of Health Stroke Scale. A regression analysis identified five predictors (out of about 200 tested variables) of functional recovery related to four aspects assessed at admission: functional status (P<0.001), lower limb functioning (P=0.002), attention (P=0.011), and executive functions (P=0.017). Furthermore, patients who recovered deficits in executive functions had the same recovery of those without deficits, whereas those who maintained deficits had a smaller recovery (P=0.019). The relationship between cognitive and motor deficits is increasingly highlighted and the recovery of executive functions deficits seems to contribute to motor recovery. Our results suggest that the recovery of executive functions may promote the recovery of the functional outcome of the patient with subacute stroke. Future treatment protocols may benefit from paying more attention to the recovery of executive functions.
Sections du résumé
BACKGROUND
BACKGROUND
The recovery of independence in activities of daily living is a fundamental goal of rehabilitation programs in subjects affected by subacute stroke. Rehabilitation is focused both on motor and cognitive aspects, and some evidence has reported cognitive deficits as prognostic factors of motor recovery. However, rehabilitation is a dynamic process during which executive functions and motor functions should be improved.
AIM
OBJECTIVE
The aim of the study is to evaluate the relationships between impairments in cognitive functions and recovery of functional independence in stroke patients during the subacute phase.
DESIGN
METHODS
Multicenter observational study.
SETTING
METHODS
Intensive rehabilitation units.
POPULATION
METHODS
A sample of 319 stroke patients in subacute phase (70.6±11.6 years, 40.4% females), consecutively admitted from November 2019 to July 2021 at sixteen rehabilitation centers were enrolled in this observational, prospective and multicentric study with longitudinal assessments.
METHODS
METHODS
Cognitive and functional assessments were performed at hospital admission and discharge, including Oxford Cognitive Screen, modified Barthel Index, Functional Independent Measure, Fugl-Meyer assessment scale and National Institutes of Health Stroke Scale.
RESULTS
RESULTS
A regression analysis identified five predictors (out of about 200 tested variables) of functional recovery related to four aspects assessed at admission: functional status (P<0.001), lower limb functioning (P=0.002), attention (P=0.011), and executive functions (P=0.017). Furthermore, patients who recovered deficits in executive functions had the same recovery of those without deficits, whereas those who maintained deficits had a smaller recovery (P=0.019).
CONCLUSIONS
CONCLUSIONS
The relationship between cognitive and motor deficits is increasingly highlighted and the recovery of executive functions deficits seems to contribute to motor recovery.
CLINICAL REHABILITATION IMPACT
CONCLUSIONS
Our results suggest that the recovery of executive functions may promote the recovery of the functional outcome of the patient with subacute stroke. Future treatment protocols may benefit from paying more attention to the recovery of executive functions.
Identifiants
pubmed: 37184413
pii: S1973-9087.23.07716-X
doi: 10.23736/S1973-9087.23.07716-X
pmc: PMC10266259
doi:
Types de publication
Observational Study
Multicenter Study
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
284-293Investigateurs
Laura Abbruzzese
(L)
Federica Alpegiani
(F)
Giordano Ambiveri
(G)
Gabriella Antonucci
(G)
Marco Bacci
(M)
Michela Baldrighi
(M)
Silvia Baudo
(S)
Federica Bariselli
(F)
Adonella Benedetti
(A)
Clarissa Biagioni
(C)
Matteo Bigoni
(M)
Loredana Cavalli
(L)
Francesca Ceriani
(F)
Elena Chinosi
(E)
Irene Ciancarelli
(I)
Michela Coccia
(M)
Filippo Codazzi
(F)
Tatiana Costa
(T)
Alessio Damora
(A)
Lucia Daturi
(L)
Rachele DI Giovanni
(R)
Giuseppe Falcone
(G)
Rosanna Falcone
(R)
Cristina Fonte
(C)
Ylenia Gallinaro
(Y)
Carmen Gambarelli
(C)
Giulia Gamberini
(G)
Sara Guglieri
(S)
Erica Grange
(E)
Antonino Greco
(A)
Marco Iosa
(M)
Sabrina Lecis
(S)
Roberta Maggi
(R)
Alessandra Maietti
(A)
Mauro Mancuso
(M)
Vanessa Maruccia
(V)
Giulia Martinelli
(G)
Alessandro Matano
(A)
Marisa Megna
(M)
Laura Montanari
(L)
Massimiliano Mori
(M)
Giovanni Morone
(G)
Chiara Mulè
(C)
Aleksandra Podgorska
(A)
Roberta Ricci
(R)
Maria L Rinaldesi
(ML)
Laura B Rizzo
(LB)
Giulia Rossi
(G)
Giuliana Rosso
(G)
Barbara Rubbuoli
(B)
Paola Russi
(P)
Livia Russo
(L)
Giulia Salti
(G)
Gian G Scaglia
(GG)
Annalisa Secchi
(A)
Nicola Smania
(N)
Claudio M Solaro
(CM)
Simona Spaccavento
(S)
Maria C Spitali
(MC)
Angelica Stoppini
(A)
Francesca Strogolo
(F)
Valentina Suranna
(V)
Paola Tognetti
(P)
Silvia Toniolo
(S)
Valentina Varalta
(V)
Altin Veliaj
(A)
Laura Villani
(L)
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