Lipskaya-Velikovsky Lena, Zeilig Gabi, Weingarden Harold, Rozental-Iluz Clara, Rand Debbie
Department of Occupational Therapy, School of Health Professions.
Neurological Rehabilitation, The Chaim Sheba Medical Center at Tel-HaShomer and Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
Int J Rehabil Res. 2018 Jun;41(2):122-127. doi: 10.1097/MRR.0000000000000272.
Deficits in executive functioning (EF) are often still present at the chronic stage after stroke, which may negatively impact independent living. The objectives of this study were (a) to characterize the EF and independence in daily living of community-dwelling individuals with chronic stroke by using pen-and-paper and performance-based EF assessments, (b) to explore correlations between scores detected by different EF assessments and (c) to assess the correlations between EF and independence in basic activities of daily living (BADL) and instrumental activities of daily living (IADL). This cross-sectional study included 50 (30 men and 20 women) community-dwelling individuals [mean (SD) age 59.8 (9.3)] with chronic stroke. Participants were overall independent in basic activities of daily living, without significant cognitive impairment. Participants underwent EF assessment using two pen-and-paper tools: Trail Making Test, Zoo Map subtest from the Behavioral Assessment of Dysexecutive Syndrome and two performance-based tools; EF Route-Finding Task and bill-paying subtest from the Executive Functions Performance Test. BADL, IADL, depressive symptoms, gait speed and upper extremity motor impairment were also assessed. Participants demonstrated mild to moderate EF deficits with moderate significant correlations between the scores of various EF assessments. Participants varied in their independence in IADL, and EF was significantly correlated to independence in BADL and IADL (-0.31<r<0.48; -0.37<r<-0.42; P<0.05, respectively, depending on the assessment). EF deficits with varying severity are still present at the chronic stage after stroke among independent community-dwelling individuals. These findings can guide the choice of an appropriate assessment tool for the specific needs of individuals with chronic stroke.
中风后的慢性期通常仍存在执行功能（EF）缺陷，这可能会对独立生活产生负面影响。本研究的目的是：（a）通过使用纸笔测试和基于表现的EF评估，描述社区居住的慢性中风患者的EF和日常生活独立性；（b）探索不同EF评估检测到的分数之间的相关性；（c）评估EF与基本日常生活活动（BADL）和工具性日常生活活动（IADL）独立性之间的相关性。这项横断面研究纳入了50名（30名男性和20名女性）社区居住的慢性中风患者[平均（标准差）年龄59.8（9.3）岁]。参与者在基本日常生活活动中总体上是独立的，没有明显的认知障碍。参与者使用两种纸笔工具进行EF评估：连线测验、执行功能障碍综合征行为评估中的动物园地图子测验，以及两种基于表现的工具；EF寻路任务和执行功能表现测试中的支付账单子测验。还评估了BADL、IADL、抑郁症状、步态速度和上肢运动障碍。参与者表现出轻度至中度的EF缺陷，各种EF评估分数之间存在中度显著相关性。参与者在IADL中的独立性各不相同，EF与BADL和IADL的独立性显著相关（-0.31<r<0.48；-0.37<r<-0.42；P<0.05，具体取决于评估）。在独立的社区居住个体中，中风后的慢性期仍存在不同严重程度的EF缺陷。这些发现可以指导为慢性中风患者的特定需求选择合适的评估工具。
