Relationship of motor and cognitive performance to functional performance in stroke recovery

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Relationship of motor and cognitive performance to functional performance in stroke recovery


Author: Fong, Nai-kuen
Title: Relationship of motor and cognitive performance to functional performance in stroke recovery
Degree: M.Sc.
Year: 1997
Subject: Cerebrovascular disease -- Patients -- Rehabilitation
Hong Kong Polytechnic University -- Dissertations
Department: Multi-disciplinary Studies
Pages: ix, 109 leaves : ill. ; 30 cm
Language: English
Abstract: Stroke recovery can be quantified by measuring either intrinsic recovery or functional recovery which are inter-linked. This study is to investigate the relationship of intrinsic recovery with functional recovery of stroke patients by comparing their motor and cognitive performance to functional performance in an in-patient rehabilitation program. Motor and cognitive performance is measured by the Fugl-Meyer Assessment (FMA) and the Neurobehavioral Cognitive Status Examination (NCSE) which is compared with functional performance as measured by motor component of the Functional Independence Measure (FIM-MM) at admission, two weeks, four weeks, and discharge. A total of thirty-seven patients with first stroke aged from 51 to 70 years were selected by hapazard sampling over one year period. Results indicated that there were significant differences among all motor, functional and orientation, repetition, naming, construction, memory and judgment of cognitive sub-scores among four measurement occasions. The lower extremity and balance scores of the FMA were highly correlated with the FIM-MM at all occasions, while upper extremity and hand scores were correlated moderately. Judgment, comprehension and repetition had moderate positive relationships with functional performance. Stepwise regression showed that discharge FIM-MM was predicted best by self-care at admission, or sphincter at 2 weeks, or transfer at 4 weeks. Gain score in functional performance and the length of stay were also best predicted by lower extremity at admission. These results confirmed that a strong motor impairment basis including balance and lower extremity accounted for the functional recovery in inpatient rehabilitation. This study provides good insights to rehabilitation professionals on the effect of intrinsic recovery on functional recovery in patients after stroke. Therefore, rehabilitation outcome in clinical practice should be predicted from these significant factors at the initial stage so that purposeful activities for stroke patients can be planned. Emphasis should also be put on training of these components so as to enhance functional recovery.

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