Abstract
References
- 1) Zhang Y, Feng Y, Zuo J, et al. Elevated Serum Amyloid A Is Associated With Cognitive Impairment in Ischemic Stroke Patients. Front Neurol. 2022;12:789204.
- 2) Farokhi-Sisakht F, Farhoudi M, Sadigh-Eteghad S, et al. Cognitive Rehabilitation Improves Ischemic Stroke-Induced Cognitive Impairment: Role of Growth Factors. J Stroke Cerebrovasc Dis. 2019;28(10):104299.
- 3) Zinn S, Dudley TK, Bosworth HB, et al. The effect of poststroke cognitive impairment on rehabilitation process and functional outcome. Arch Phys Med Rehabil. 2004;85(7):1084-90.
- 4) Cumming TB, Marshall RS, Lazar RM. Stroke, cognitive deficits, and rehabilitation: still an incomplete picture. Int J Stroke. 2013;8(1):38-45.
- 5) Zhao Q, Wang X, Wang T, et al. Cognitive rehabilitation interventions after stroke: protocol for a systematic review and meta-analysis of randomized controlled trials. Syst Rev. 2021;10(1):66.
- 6) Zwecker M, Levenkrohn S, Fleisig Y, et al. Mini-Mental State Examination, cognitive FIM instrument, and the Loewenstein Occupational Therapy Cognitive Assessment: relation to functional outcome of stroke patients. Arch Phys Med Rehabil. 2002;83(3):342-5.
- 7) Pandian S, Arya KN. Stroke-related motor outcome measures: do they quantify the neurophysiological aspects of upper extremity recovery?. J Bodyw Mov Ther. 2014;18(3):412-23.
- 8) Wiener J, McIntyre A, Janssen S, et al. Effectiveness of High-Intensity Interval Training for Fitness and Mobility Post Stroke: A Systematic Review. PM R. 2019;11(8):868-78.
- 9) Folstein MF, Folstein SE, McHugh PR. "Mini-mental state". A practical method for grading the cognitive state of patients for the clinician. J Psychiatr Res. 1975;12(3):189-98.
- 10) Keith RA, Granger CV, Hamilton BB, Sherwin FS. The functional independence measure: a new tool for rehabilitation. Adv Clin Rehabil. 1987;1:6-18.
- 11) Lo Coco D, Lopez G, Corrao S. Cognitive impairment and stroke in elderly patients. Vasc Health Risk Manag. 2016;12:105-16.
- 12) Dharmasaroja PA. Temporal Changes in Cognitive Function in Early Recovery Phase of the Stroke. J Stroke Cerebrovasc Dis. 2021;30(10):106027.
- 13) Yeh TT, Wu CY, Hsieh YW, et al. Synergistic effects of aerobic exercise and cognitive training on cognition, physiological markers, daily function, and quality of life in stroke survivors with cognitive decline: study protocol for a randomized controlled trial. Trials. 2017;18(1):405.
- 14) Kannan L, Vora J, Bhatt T, Hughes SL. Cognitive-motor exergaming for reducing fall risk in people with chronic stroke: A randomized controlled trial. NeuroRehabilitation. 2019;44(4):493-510.
- 15) das Nair R, Cogger H, Worthington E, Lincoln NB. Cognitive rehabilitation for memory deficits after stroke. Cochrane Database Syst Rev. 2016;9(9):CD002293.
- 16) Loetscher T, Potter KJ, Wong D, das Nair R. Cognitive rehabilitation for attention deficits following stroke. Cochrane Database Syst Rev. 2019;2019(11):CD002842.
- 17) Northey JM, Cherbuin N, Pumpa KL, et al. Exercise interventions for cognitive function in adults older than 50: a systematic review with meta-analysis. Br J Sports Med. 2018;52(3):154-60.
- 18) Levine DA, Wadley VG, Langa KM, et al. Risk Factors for Poststroke Cognitive Decline: The REGARDS Study (Reasons for Geographic and Racial Differences in Stroke). Stroke. 2018;49(4):987-94.
- 19) Srithumsuk W, Kabayama M, Gondo Y, et al. The importance of stroke as a risk factor of cognitive decline in community dwelling older and oldest peoples: the SONIC study. BMC Geriatr. 2020;20(1):24.
- 20) Nurani RRS, Martini S. “Risk factors for cognitive impairment after ischemic stroke” in The 2nd International Conference on Hospital Adminstration KnE Life Sci. 2018:87–96.
- 21) Alexandrova ML, Danovska MP. Cognitive impairment one year after ischemic stroke: predictorsand dynamics of significant determinants. Turk J Med Sci. 2016;46(5):1366-73.
- 22) Ardila A, Rubio-Bruno S. Aphasia from the inside: The cognitive world of the aphasic patient. Appl Neuropsychol Adult. 2018;25(5):434-40.
- 23) Seo KC, Ko JY, Kim TU, et al. Post-stroke Aphasia as a Prognostic Factor for Cognitive and Functional Changes in Patients With Stroke: Ischemic Versus Hemorrhagic. Ann Rehabil Med. 2020;44(3):171-80.
- 24) Yao J, Liu X, Liu Q, et al. Characteristics of Non-linguistic Cognitive Impairment in Post-stroke Aphasia Patients. Front Neurol. 2020;11:1038.
- 25) Lee B, Pyun SB. Characteristics of Cognitive Impairment in Patients With Post-stroke Aphasia. Ann Rehabil Med. 2014;38(6):759-65.
- 26) Baccaro A, Wang YP, Candido M, et al. Post-stroke depression and cognitive impairment: Study design and preliminary findings in a Brazilian prospective stroke cohort (EMMA study). J Affect Disord. 2019;245:72-81.
- 27) Jacquin A, Binquet C, Rouaud O, et al. Post-stroke cognitive impairment: high prevalence and determining factors in a cohort of mild stroke. J Alzheimers Dis. 2014;40(4):1029-38. doi:10.3233/JAD-131580
- 28) Khedr EM, Hamed SA, El-Shereef HK, et al. Cognitive impairment after cerebrovascular stroke: Relationship to vascular risk factors. Neuropsychiatr Dis Treat. 2009;5:103-16.
- 29) Arba F, Quinn T, Hankey GJ, et al. Determinants of post-stroke cognitive impairment: analysis from VISTA. Acta Neurol Scand. 2017;135(6):603-7.
The Effect of Rehabilitation without Specific Cognitive Rehabilitation on the Improvement of Cognitive Functions in Stroke Patients: Evaluation with Risk Factors
Abstract
Aim: This study aimed to evaluate if rehabilitation without specific cognitive rehabilitation improved cognitive functions in patients who had suffered a stroke more than 1 year ago, and to correlate this finding with risk factors.
Material and Methods: Thirty stroke patients were included in the study. A rehabilitation program was administered to the patients for a total of 30 sessions, 5 days a week. In addition, demographic data of the patients were collected, as well as several risk factors that may impair their cognitive function. The pre-and post-treatment cognitive function of the patients was evaluated using mini-mental state examination (MMSE) and functional independence measure (FIM)-cognitive. With the FIM cognitive evaluation, cognitive functions such as comprehension, expression, social interaction, problem solving, and memory were evaluated. With MMSE, from cognitive functions; orientation, registration, attention and calculation, recall, language, and praxis were evaluated. Pre- and post-treatment motor function was measured by the Brunnstrom motor recovery stage (BMRS). Pre- and post-treatment walking ability was assessed with Functional Ambulation Categories (FAC). Along with the general comparison of cognitive function pre- and post-treatment, additional pre- and post-treatment comparisons were made according to risk factors.
Results: According to MMSE and FIM-cognitive scores, improvement in cognitive function was detected following treatment (p<0.001, p=0.001, respectively). There was no statistical improvement in FAC and BMRS scores. According to MMSE, cognitive functions were more impaired before treatment in women, those with <5 years of education, and those with aphasia (p=0.025, p=0.004, p=0.002, respectively). According to FIM-cognitive, cognitive functions were lower in patients with aphasia, and those with left-sided brain damage (p=0.002, p=0.045, respectively). There was no difference in the magnitude of improvement between the risk factors.
Conclusion: This study showed that the rehabilitation program applied without a specific cognitive rehabilitation program in patients with chronic stroke can improve cognitive functions, although it does not cause a significant improvement compared to BMRS and FAC. Therefore, we believe that rehabilitation without specific cognitive rehabilitation will improve patients' daily activities and increase their participation in treatment.
Keywords
References
- 1) Zhang Y, Feng Y, Zuo J, et al. Elevated Serum Amyloid A Is Associated With Cognitive Impairment in Ischemic Stroke Patients. Front Neurol. 2022;12:789204.
- 2) Farokhi-Sisakht F, Farhoudi M, Sadigh-Eteghad S, et al. Cognitive Rehabilitation Improves Ischemic Stroke-Induced Cognitive Impairment: Role of Growth Factors. J Stroke Cerebrovasc Dis. 2019;28(10):104299.
- 3) Zinn S, Dudley TK, Bosworth HB, et al. The effect of poststroke cognitive impairment on rehabilitation process and functional outcome. Arch Phys Med Rehabil. 2004;85(7):1084-90.
- 4) Cumming TB, Marshall RS, Lazar RM. Stroke, cognitive deficits, and rehabilitation: still an incomplete picture. Int J Stroke. 2013;8(1):38-45.
- 5) Zhao Q, Wang X, Wang T, et al. Cognitive rehabilitation interventions after stroke: protocol for a systematic review and meta-analysis of randomized controlled trials. Syst Rev. 2021;10(1):66.
- 6) Zwecker M, Levenkrohn S, Fleisig Y, et al. Mini-Mental State Examination, cognitive FIM instrument, and the Loewenstein Occupational Therapy Cognitive Assessment: relation to functional outcome of stroke patients. Arch Phys Med Rehabil. 2002;83(3):342-5.
- 7) Pandian S, Arya KN. Stroke-related motor outcome measures: do they quantify the neurophysiological aspects of upper extremity recovery?. J Bodyw Mov Ther. 2014;18(3):412-23.
- 8) Wiener J, McIntyre A, Janssen S, et al. Effectiveness of High-Intensity Interval Training for Fitness and Mobility Post Stroke: A Systematic Review. PM R. 2019;11(8):868-78.
- 9) Folstein MF, Folstein SE, McHugh PR. "Mini-mental state". A practical method for grading the cognitive state of patients for the clinician. J Psychiatr Res. 1975;12(3):189-98.
- 10) Keith RA, Granger CV, Hamilton BB, Sherwin FS. The functional independence measure: a new tool for rehabilitation. Adv Clin Rehabil. 1987;1:6-18.
- 11) Lo Coco D, Lopez G, Corrao S. Cognitive impairment and stroke in elderly patients. Vasc Health Risk Manag. 2016;12:105-16.
- 12) Dharmasaroja PA. Temporal Changes in Cognitive Function in Early Recovery Phase of the Stroke. J Stroke Cerebrovasc Dis. 2021;30(10):106027.
- 13) Yeh TT, Wu CY, Hsieh YW, et al. Synergistic effects of aerobic exercise and cognitive training on cognition, physiological markers, daily function, and quality of life in stroke survivors with cognitive decline: study protocol for a randomized controlled trial. Trials. 2017;18(1):405.
- 14) Kannan L, Vora J, Bhatt T, Hughes SL. Cognitive-motor exergaming for reducing fall risk in people with chronic stroke: A randomized controlled trial. NeuroRehabilitation. 2019;44(4):493-510.
- 15) das Nair R, Cogger H, Worthington E, Lincoln NB. Cognitive rehabilitation for memory deficits after stroke. Cochrane Database Syst Rev. 2016;9(9):CD002293.
- 16) Loetscher T, Potter KJ, Wong D, das Nair R. Cognitive rehabilitation for attention deficits following stroke. Cochrane Database Syst Rev. 2019;2019(11):CD002842.
- 17) Northey JM, Cherbuin N, Pumpa KL, et al. Exercise interventions for cognitive function in adults older than 50: a systematic review with meta-analysis. Br J Sports Med. 2018;52(3):154-60.
- 18) Levine DA, Wadley VG, Langa KM, et al. Risk Factors for Poststroke Cognitive Decline: The REGARDS Study (Reasons for Geographic and Racial Differences in Stroke). Stroke. 2018;49(4):987-94.
- 19) Srithumsuk W, Kabayama M, Gondo Y, et al. The importance of stroke as a risk factor of cognitive decline in community dwelling older and oldest peoples: the SONIC study. BMC Geriatr. 2020;20(1):24.
- 20) Nurani RRS, Martini S. “Risk factors for cognitive impairment after ischemic stroke” in The 2nd International Conference on Hospital Adminstration KnE Life Sci. 2018:87–96.
- 21) Alexandrova ML, Danovska MP. Cognitive impairment one year after ischemic stroke: predictorsand dynamics of significant determinants. Turk J Med Sci. 2016;46(5):1366-73.
- 22) Ardila A, Rubio-Bruno S. Aphasia from the inside: The cognitive world of the aphasic patient. Appl Neuropsychol Adult. 2018;25(5):434-40.
- 23) Seo KC, Ko JY, Kim TU, et al. Post-stroke Aphasia as a Prognostic Factor for Cognitive and Functional Changes in Patients With Stroke: Ischemic Versus Hemorrhagic. Ann Rehabil Med. 2020;44(3):171-80.
- 24) Yao J, Liu X, Liu Q, et al. Characteristics of Non-linguistic Cognitive Impairment in Post-stroke Aphasia Patients. Front Neurol. 2020;11:1038.
- 25) Lee B, Pyun SB. Characteristics of Cognitive Impairment in Patients With Post-stroke Aphasia. Ann Rehabil Med. 2014;38(6):759-65.
- 26) Baccaro A, Wang YP, Candido M, et al. Post-stroke depression and cognitive impairment: Study design and preliminary findings in a Brazilian prospective stroke cohort (EMMA study). J Affect Disord. 2019;245:72-81.
- 27) Jacquin A, Binquet C, Rouaud O, et al. Post-stroke cognitive impairment: high prevalence and determining factors in a cohort of mild stroke. J Alzheimers Dis. 2014;40(4):1029-38. doi:10.3233/JAD-131580
- 28) Khedr EM, Hamed SA, El-Shereef HK, et al. Cognitive impairment after cerebrovascular stroke: Relationship to vascular risk factors. Neuropsychiatr Dis Treat. 2009;5:103-16.
- 29) Arba F, Quinn T, Hankey GJ, et al. Determinants of post-stroke cognitive impairment: analysis from VISTA. Acta Neurol Scand. 2017;135(6):603-7.
Details
| Primary Language | English |
|---|---|
| Subjects | Internal Diseases |
| Journal Section | Original Articles |
| Authors | |
| Early Pub Date | May 15, 2023 |
| Publication Date | May 15, 2023 |
| Acceptance Date | January 27, 2023 |
| Published in Issue | Year 2023 Volume: 5 Issue: 2 |
Chief Editors
Assoc. Prof. Zülal Öner
Address: İzmir Bakırçay University, Department of Anatomy, İzmir, Türkiye
Assoc. Prof. Deniz Şenol
Address: Düzce University, Department of Anatomy, Düzce, Türkiye
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