Post-stroke cognitive impairment impact on motor rehabilitation: A historical cohort study

Background: Cognitive dysfunction is a common post-stroke sequelae with a negative impact on patient's functional independence. Objective: Investigate the impact of post-stroke cognitive impairment on motor rehabilitation in the subacute phase, with a particular focus on executive functioning deficit. Methods: A historical cohort was based on 145 clinical records over a period of 3 years and 5 months. A formal assessment of cognitive function was performed, using Montreal Cognitive Assessment (MoCA), INECO frontal screening (IFS) test and/or subtests of the Wechsler Adult Intelligence Scale (WAIS-III). Motor recovery was evaluated through the evolution of the motor Functional Independence Measure (FIM). Results: Out of 145 included patients, 105 manifested post-stroke cognitive dysfunction (72.4%). Patients with mild or moderate stroke were most likely to present cognitive deficits (31.4% and 54.3%, p < .001). The most impaired domain was executive function (79%), manifested in isolation (20%) or combined (59%). In mild stroke, the difference between motor FIM at discharge and admission was significantly lower in the group of patients with isolated executive functioning deficit (p = .027). Conclusions:Isolated executive functioning impairment had a negative impact on motor recovery in mild stroke. No significant association was found between global cognitive dysfunction and the motor function evolution after stroke.